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ACA Medicaid Expansions and Maternal Morbidity

Author

Listed:
  • Pinka Chatterji
  • Hanna Glenn
  • Sara Markowitz
  • Jennifer Karas Montez

Abstract

In this paper, we test whether the Affordable Care Act Medicaid expansions are associated with in-hospital maternal morbidity. The ACA expansions may have affected maternal morbidity by increasing pre-conception access to health care, and by improving the quality of delivery care through enhancing hospitals’ financial positions. We use difference-in-difference models in conjunction with event studies. Data come from individual-level birth certificates and state-level hospital discharge data. The results show little evidence that the expansions are associated with overall maternal morbidity or indicators of specific adverse events including eclampsia, ruptured uterus, and unplanned hysterectomy. The results are consistent with prior research showing that the ACA Medicaid expansions are not statistically associated with pre-pregnancy health or maternal health during pregnancy. Our results add to this story and find little evidence of improvements in maternal health upon delivery.

Suggested Citation

  • Pinka Chatterji & Hanna Glenn & Sara Markowitz & Jennifer Karas Montez, 2022. "ACA Medicaid Expansions and Maternal Morbidity," NBER Working Papers 30770, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:30770
    Note: CH EH PE
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    References listed on IDEAS

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    1. Jonathan Gruber, 1997. "Health Insurance for Poor Women and Children in the US: Lessons from the Past Decade," NBER Chapters, in: Tax Policy and the Economy, Volume 11, pages 169-211, National Bureau of Economic Research, Inc.
    2. Jordan H. Rhodes & Thomas C. Buchmueller & Helen G. Levy & Sayeh S. Nikpay, 2020. "Heterogeneous Effects Of The Aca Medicaid Expansion On Hospital Financial Outcomes," Contemporary Economic Policy, Western Economic Association International, vol. 38(1), pages 81-93, January.
    3. Makayla Palmer, 2020. "Preconception subsidized insurance: Prenatal care and birth outcomes by race/ethnicity," Health Economics, John Wiley & Sons, Ltd., vol. 29(9), pages 1013-1030, September.
    4. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    5. Ali Moghtaderi & Jesse Pines & Mark Zocchi & Bernard Black, 2020. "The effect of Affordable Care Act Medicaid expansion on hospital revenue," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1682-1704, December.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    JEL classification:

    • H0 - Public Economics - - General
    • I1 - Health, Education, and Welfare - - Health

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