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Matern Child Health J. 2018 Dec;22(12):1771-1779. doi: 10.1007/s10995-018-2575-1.

Ohio's Medicaid Expansion and Unmet Health Needs Among Low-Income Women of Reproductive Age.

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Center for Outcomes Research and Evaluation, Yale University, 1 Church Street #200, New Haven, CT, 06510, USA.
The Ohio State University College of Public Health, 244 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43210, USA.
Ohio Colleges of Medicine Government Resource Center, 150 Pressey Hall, 1070 Carmack Road, Columbus, OH, 43210, USA.


Objective To examine changes in the prevalence and odds of unmet healthcare needs and healthcare utilization among low-income women of reproductive age (WRA) after Ohio's 2014, ACA-associated Medicaid expansion, which extended coverage to non-senior adults with a family income ≤ 138% of the federal poverty level. Methods We analyzed publically available data from the 2012 and 2015 Ohio Medicaid Assessment Survey (OMAS), a cross-sectional telephone survey of Ohio's non-institutionalized adult population. The study included 489 low-income women in 2012 and 1273 in 2015 aged 19-44 years who were newly eligible for Medicaid after expansion in January 2014. Four unmet healthcare need and three healthcare utilization measures were examined. We fit survey-weighted logistic regression models adjusted for race/ethnicity, working status, and educational attainment to determine whether the odds of each measure differed between 2012 and 2015. Results In 2015, low-income WRA had a significantly lower odds of reporting an unmet dental care need (ORadj = 0.72, 95% CI 0.54, 0.95), unmet vision care need (ORadj = 0.68, 95% CI 0.50, 0.93), unmet mental health need (ORadj = 0.57, 95% CI 0.39, 0.83), and unmet prescription need (ORadj = 0.39, 95% CI 0.45, 0.80) compared to 2012. There were no significant differences in the odds of seeing a doctor or dentist in the past year or of having a usual source of care for low-income WRA in 2012 and 2015. Conclusions for Practice After Ohio's 2014 Medicaid expansion the odds of low-income WRA having unmet healthcare needs was reduced. Future research should examine outcomes after a longer period of follow-up and include additional measures, such as self-rated health status.


Affordable Care Act (ACA); Medicaid expansion; Ohio Medicaid Assessment Survey (OMAS); Unmet health needs; Women of reproductive age

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