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Reproductive Health Policy Variability Among the States Over Time: Implications of the Affordable Care Act of 2010 for Health Researchers

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Applied Demography and Public Health in the 21st Century

Part of the book series: Applied Demography Series ((ADS,volume 8))

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Abstract

Context Reproductive health policies in the United States constitute a complicated mix of determinants that vary geographically, politically, economically, and institutionally. The recent Affordable Care Act of 2010 (ACA) included a set of reproductive health policies that increase the complexity of the existing reproductive health policy system. Methods A series of policy briefs have been issued over the past five years that, when taken together as we do here, paint a complicated picture of reproductive health access in the United States. Many scholars have demonstrated the effects of specific policies on diverse reproductive health outcomes , but empirical research on the effects of ACA implementation on reproductive health outcomes is still in its infancy, in large part owing to a lack of suitable data sources. We compile six state-level indicators of reproductive health access that health researchers can employ to model contextual effects on reproductive health outcomes in the ACA era. Results We develop this historical and policy overview to assist health researchers in thinking through the policy and analytic complexity that has been introduced by this health care reform. We present a conceptual framework of state-level policy factors that should be evaluated prior to undertaking research related to ACA implementation at the state level. Conclusions The Affordable Care Act significantly increases the state-level policy complexity related to reproductive health. As data become available for evaluating ACA policy effects, it is important for researchers in reproductive health to account for this complexity.

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References

  • Andrapalliyal, V. (2013). Healthcare for all? The gap between rhetoric and reality in the Affordable Care Act. UCLA Law Review Discourse, 61, 58–77.

    Google Scholar 

  • Bailey, M. J., Guldi, M., & Hershbein, B. J. (2013). Recent evidence on the broad benefits of reproductive health policy. Journal of Policy Analysis and Management, 32, 888–896.

    Article  Google Scholar 

  • Bitler, M., & Currie, J. (2005). Does WIC work? The effects of WIC on pregnancy and birth outcomes. Journal of Policy Analysis and Management, 42(1), 73–91.

    Article  Google Scholar 

  • Bitler, M., & Zavodny, M. (2001). The effect of abortion restrictions on the timing of abortions. Journal of Health Economics, 20(6), 1011–1032.

    Article  Google Scholar 

  • Blank, R. M., George, C. C., & London, R. A. (1996). State abortion rates the impact of policies, providers, politics, demographics, and economic environment. Journal of Health Economics, 15(5), 513–553.

    Article  Google Scholar 

  • Boonstra, H. D., & Nash, E. (2014). A surge of state abortion restrictions puts providers- and the women they serve- in the crosshairs. Guttmacher Policy Review, 17(1), 9–15.

    Google Scholar 

  • Brindis, C. D., & Moore, K. (2014). Improving adolescent health policy: Incorporating a framework for assessing state-level polices. Annual Review of Public Health, 35, 343–361.

    Article  Google Scholar 

  • Crosby, R. A., & Holtgrave, D. R. (2006). The protective value of social capital against teen pregnancy: A state-level analysis. Journal of Adolescent Health, 38(5), 556–559.

    Article  Google Scholar 

  • Drabble, L., Thomas, S., O’Connor, L., & Roberts, S. C. (2014). State responses to alcohol use and pregnancy: Findings from the alcohol policy information system. Journal of social work practice in the addictions, 14(2), 191–206.

    Article  Google Scholar 

  • Finer, L. B., & Kost, K. (2011). Unintended pregnancy rates at the state level. Perspectives on Sexual and Reproductive Health, 43(2), 78–87.

    Article  Google Scholar 

  • Finer, L. B., Sonfield, A., & Jones, R. K. (2014). Changes in out-of-pocket payments for contraception by privately insured women during implementation of the federal contraceptive coverage requirement. Contraception, 89(2), 97–102.

    Article  Google Scholar 

  • Gius, M. P. (2007). The impact of provider availability and legal restrictions on the demand for abortions by young women. The Social Science Journal, 44(3), 495–506.

    Article  Google Scholar 

  • Gold, R. B., & Nash, E. (2013). TRAP laws gain political traction while abortion clinics—and the women they serve—pay the price. Guttmacher Policy Review, 16(2), 7–12.

    Google Scholar 

  • Guttmacher Institute. (2015a). State family planning funding restrictions, State Policies in Brief, June 1, 2015.

    Google Scholar 

  • Guttmacher Institute. (2015b). Refusing to provide health services, State Policies in Brief, June 1, 2015.

    Google Scholar 

  • Guttmacher Institute. (2015c). Targeted regulation of abortion providers, State Policies in Brief (as of March 1, 2015), 2015. http://www.guttmacher.org/statecenter/spibs/spib_TRAP.pdf. Accessed March 24, 2015.

  • Guttmacher Institute. (2015d). An overview of abortion laws, State Policies in Brief (as of March 1, 2015), 2015. http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf. Accessed March 24, 2015.

  • Hasstedt, K. (2015). Abortion coverage under the Affordable Care Act: Advancing transparency, ensuring choice, and facilitating access. Guttmacher Policy Review, 18(1), 14–20.

    Google Scholar 

  • Jackson, D. L. (2005). A multi-year study of policies that affect the abortion rate at the state level, Electronic Theses, Treatises and Dissertations, Paper 3822.

    Google Scholar 

  • Jarlenski, M., Bleich, S. N., Bennett, W. L., Stuart, E. A., & Barry, C. L. (2014). Medicaid enrollment policy increased smoking cessation among pregnant women but had no impact on birth outcomes. Health Affairs, 33(6), 997–1005.

    Article  Google Scholar 

  • Jones, R. K., & Jerman, J. (2014). Abortion incidence and service availability in the United States, 2011. Perspectives on Sexual and Reproductive Health, 46(1), 3–14.

    Article  Google Scholar 

  • Joyce, T., & Kaestner, R. (1996). The effect of expansions in Medicaid income eligibility on abortion. Demography, 33(2), 181–192.

    Article  Google Scholar 

  • Kaiser Family Foundation. (2015a). State decisions on health insurance marketplaces and the Medicaid expansion, April 20, 2015. http://kff.org/health-reform/state-indicator/state-decisions-for-creating-health-insurance-exchanges-and-expanding-medicaid/

  • Kaiser Family Foundation. (2015b). State restriction of health insurance coverage of abortion, April 1, 2015. http://kff.org/womens-health-policy/state-indicator/abortion-restriction/

  • Kenney, G. M., McMorrow, S., Zuckerman, S., & Goin, D. E. (2012). A decade of health care access declines for adults holds implications for changes in the Affordable Care Act. Health Affairs, 31, 899–908.

    Article  Google Scholar 

  • Kost, K., Finer, L. B., & Singh, S. (2012). Variation in state unintended pregnancy rates in the United States. Perspectives on Sexual and Reproductive Health, 44(1), 57–64.

    Article  Google Scholar 

  • Levine, P. B., Trainor, A. B., & Zimmerman, D. J. (1996). The effect of Medicaid abortion funding restrictions on abortions, pregnancies and births. Journal of Health Economics, 15(5), 555–578.

    Article  Google Scholar 

  • Lundberg, S., & Plotnick, R. D. (1990). Effects of state welfare, abortion and family planning policies on premarital childbearing among white adolescents. Family Planning Perspectives, 22(6), 246–275.

    Article  Google Scholar 

  • Matthews, S., Ribar, D., & Wilhelm, M. (1997). The effects of economic conditions and access to reproductive health services on state abortion rates and birthrates. Family Planning Perspectives, 29(2), 52–60.

    Article  Google Scholar 

  • Medoff, M. H. (2008). Abortion costs, sexual behavior, and pregnancy rates. The Social Science Journal, 45(1), 156–172.

    Article  Google Scholar 

  • Medoff, M. H. (2012). Unintended pregnancies, restrictive abortion laws, and abortion demand, International Scholarly Research Notices.

    Google Scholar 

  • Meier, K. J., Haider-Markel, D. P., Stanislawski, A. J., & McFarlane, D. R. (1996). The impact of state-level restrictions on abortion. Demography, 33(3), 307–312.

    Article  Google Scholar 

  • Pew Research Center, http://pewhispanic.org/interactives/unauthorized-immigrants-2012/map/population-share/

  • Quadagno, J. (2005). One nation uninsured: Why the US has no national health insurance. Cambridge: Oxford University Press.

    Google Scholar 

  • Roh, J., & Haider-Markel, D. P. (2003). All politics is not local: National forces in state abortion initiatives. Social Science Quarterly, 84(1), 15–31.

    Article  Google Scholar 

  • Sobel, L. & Salganicoff, A. (2013). A guide to the supreme court’s review of the contraceptive coverage requirement, Kaiser Family Foundation Issue Brief, December 2013.

    Google Scholar 

  • Sobel, L. & Salganicoff, A. (2015). Round 2 on the legal challenges to contraceptive coverage: Are nonprofits substantially burdened by the accommodation? Kaiser Family Foundation Issue Brief, May 2015.

    Google Scholar 

  • Sonfield, A. (2013). Implementing the federal contraceptive coverage guarantee: Progress and prospects. Guttmacher Policy Review, 16(4), 8–12.

    Google Scholar 

  • Sonfield, A. (2015). Rounding out the contraceptive coverage guarantee: Why ‘male’ contraceptive methods matter for everyone. Guttmacher Policy Review, 18(2), 34–39.

    Google Scholar 

  • Sonfield, A., Tapales, A., Jones, R. K., & Finer, L. B. (2014). Impact of the federal contraceptive coverage guarantee on out-of-pocket payments for contraceptives: 2014 update. Contraception, 91, 44–48.

    Article  Google Scholar 

  • Tone, A. (2001). Devices and desires: A history of contraception in America. New York: Hill and Wang.

    Google Scholar 

  • Trussell, J. (1980). The impact of restricting Medicaid financing for abortion. Family Planning Perspectives, 12(3), 120–130.

    Article  Google Scholar 

  • United States Department of Health and Human Services. (2015). www.healthcare.gov

  • Yang, Z., & Gaydos, L. M. (2010). Reasons for and challenges of recent increases in teen birth rates: A study of family planning service policies and demographic changes at the state level. Journal of Adolescent Health, 46(6), 517–524.

    Article  Google Scholar 

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Acknowledgments

An earlier version of this paper was presented as a poster at Population Association of America Meetings, San Diego, CA, April 29–May 2, 2015. The authors are grateful to the School of Human Evolution and Social Change, Arizona State University, for its support of this work.

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Authors and Affiliations

  1. School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, 85287-2402, USA

    Monica Gaughan

  2. Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA

    Georgia J. Michlig

Authors
  1. Monica Gaughan
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  2. Georgia J. Michlig
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Correspondence to Monica Gaughan .

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Editors and Affiliations

  1. Hobby Center for Public Policy, University of Houston, Houston, Texas, USA

    M. Nazrul Hoque

  2. Institute for Demographic and and Socioeconomic Research, University of Texas at San Antonio, San Antonio, USA

    Beverly Pecotte

  3. Health Statistics Branch, Center for Public Health Practice, Arkansas Department of Health, Little Rock, Arkansas, USA

    Mary A. McGehee

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Gaughan, M., Michlig, G.J. (2017). Reproductive Health Policy Variability Among the States Over Time: Implications of the Affordable Care Act of 2010 for Health Researchers. In: Hoque, M., Pecotte, B., McGehee, M. (eds) Applied Demography and Public Health in the 21st Century. Applied Demography Series, vol 8. Springer, Cham. https://doi.org/10.1007/978-3-319-43688-3_3

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  • DOI: https://doi.org/10.1007/978-3-319-43688-3_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43686-9

  • Online ISBN: 978-3-319-43688-3

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