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Health Aff (Millwood). 2020 Mar;39(3):387-394. doi: 10.1377/hlthaff.2019.01361.

Women's Coverage, Utilization, Affordability, And Health After The ACA: A Review Of The Literature.

Author information

1
Lois K. Lee ( lois. lee@childrens. harvard. edu ) is a faculty physician in the Division of Emergency Medicine, Boston Children's Hospital, and an associate professor of pediatrics and emergency medicine at Harvard Medical School, both in Boston, Massachusetts.
2
Alyna Chien is a faculty physician in the Division of General Pediatrics, Boston Children's Hospital, and an assistant professor of pediatrics at Harvard Medical School.
3
Amanda Stewart is a faculty physician in the Division of Emergency Medicine, Boston Children's Hospital, and an instructor of pediatrics at Harvard Medical School.
4
Larissa Truschel is a fellow in the Division of Emergency Medicine, Boston Children's Hospital, and an instructor of pediatrics at Harvard Medical School.
5
Jennifer Hoffmann is a faculty physician in the Division of Emergency Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, and an assistant professor of pediatrics at the Northwestern University Feinberg School of Medicine, both in Chicago, Illinois.
6
Elyse Portillo is a fellow physician in the Division of Emergency Medicine, Boston Children's Hospital, and an instructor of pediatrics at Harvard Medical School.
7
Lydia E. Pace is an associate physician in the Division of Women's Health, Brigham and Women's Hospital, and an assistant professor in medicine at Harvard Medical School.
8
Mark Clapp is a faculty physician in the Department of Obstetrics and Gynecology, Massachusetts General Hospital, and an instructor in obstetrics, gynecology and reproductive medicine at Harvard Medical School.
9
Alison A. Galbraith is an associate professor of population medicine at the Harvard Pilgrim Health Care Institute and Harvard Medical School, both in Boston.

Abstract

Women of working age (ages 19-64) faced specific challenges in obtaining health insurance coverage and health care before the Affordable Care Act. Multiple factors contributed to women's experiencing uninsurance, underinsurance, and increased financial burdens related to obtaining health care. This literature review summarizes evidence on the law's effects on women's health care and health and finds improvements in overall coverage, access to health care, affordability, preventive care use, mental health care, use of contraceptives, and perinatal outcomes. Despite major progress after the Affordable Care Act's implementation, barriers to coverage, access, and affordability remain, and serious threats to women's health still exist. Highlighting the law's effects on women's health is critical for informing future policies directed toward the continuing improvement of women's health care and health.

KEYWORDS:

Access to care; Affordable Care Act; Contraception; Cost sharing; Health policy; Medicaid; Mental health; Preventive care; Private health insurance; Women’s health

PMID:
32119612
DOI:
10.1377/hlthaff.2019.01361

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