目的:评估接受医疗补助保险的妇女中,堕胎护理的医疗补助覆盖率与累计终生堕胎发生率的关系。
方法:我们使用来自女性调查研究的2016-2019(Pre-Dobbs)数据,这些数据代表居住在美国六个州的18-44岁女性。一个国家,马里兰,有一个医疗补助计划,长期以来一直覆盖堕胎护理的费用。其他五个州,阿拉巴马,特拉华州,爱荷华州,俄亥俄州,和南卡罗来纳州,医疗补助计划不包括堕胎护理费用。我们的样本包括居住在研究状态的8972名妇女。
方法:我们的结果,累计终生流产发生率,使用间接调查方法确定,双列表实验。我们对变量使用累积终生流产的多元回归,包括妇女是否接受了医疗补助保险以及她们是否居住在马里兰州和其他五个州之一。
方法:本研究使用二级调查数据。
结果:我们估计,马里兰州的堕胎护理医疗补助覆盖率与医疗补助保险妇女相对于未接受医疗补助保险的妇女的累计终生堕胎发生率高37.0个百分点(95%CI:12.3-61.4)。
结论:我们发现,在接受医疗补助保险的个人中,医疗补助覆盖的流产护理与终生流产发生率高得多有关。我们推断,堕胎护理费用的医疗补助覆盖可能会对低收入妇女堕胎护理的可及性产生非常大的影响。
OBJECTIVE: To estimate the association of Medicaid coverage of abortion care with cumulative lifetime abortion incidence among women insured by Medicaid.
METHODS: We use 2016-2019 (Pre-Dobbs) data from the Survey of Women studies that represent women aged 18-44 living in six U.S. states. One state, Maryland, has a Medicaid program that has long covered the cost of abortion care. The other five states, Alabama, Delaware, Iowa, Ohio, and South Carolina, have Medicaid programs that do not cover the cost of abortion care. Our sample includes 8972 women residing in the study states.
METHODS: Our outcome, cumulative lifetime abortion incidence, is identified using an indirect survey method, the double list experiment. We use a multivariate regression of cumulative lifetime abortion on variables including whether women were Medicaid-insured and whether they were residing in Maryland versus in one of the other five states.
METHODS: This study used secondary survey data.
RESULTS: We estimate that Medicaid coverage of abortion care in Maryland is associated with a 37.0 percentage-point (95% CI: 12.3-61.4) higher cumulative lifetime abortion incidence among Medicaid-insured women relative to women not insured by Medicaid compared with those differences by insurance status in states whose Medicaid programs do not cover the cost of abortion care.
CONCLUSIONS: We found that Medicaid coverage of abortion care is associated with a much higher lifetime incidence of abortion among individuals insured by Medicaid. We infer that Medicaid coverage of abortion care costs may have a very large impact on the accessibility of abortion care for low-income women.