ArticleWomen's health issues : official publication of the Jacobs Institute of Women's Health
Impacts of the Affordable Care Act on Receipt of Women's Preventive Services in Community Health Centers in Medicaid Expansion and Nonexpansion States.
Article in Women's health issues : official publication of the Jacobs Institute of Women's Health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Socio-economic and insurance factors in preventive care: A two-stage weighted structural analysis.Dialogues in health · 2025Article
- Did the Medicaid expansion improve immunization among U.S. pregnant women?Preventive medicine reports · 2025Article
- Article
- Multi-level determinants of vaccination of the American Indian and Alaska Native population: a comprehensive overview.Frontiers in public health · 2025Review
- Factors impacting vaccine uptake among adult Medicaid beneficiaries: a systematic literature review.Health affairs scholar · 2024Review
- Assessment of organization of cervical and breast cancer screening programmes in the Latin American and the Caribbean states: The CanScreen5 framework.Cancer medicine · 2023Article
- Predicting Postpartum Transition to Primary Care in Community Health Centers.American journal of preventive medicine · 2022Article
- Assessment of Colorectal Cancer Screening Disparities in U.S. Men and Women Using a Demographically Representative Sample.Cancer research communications · 2022Article
- Impact of the Affordable Care Act Medicaid expansion on oral surgery delivery at community health centers: an observational study.BMC oral health · 2021Observational
- Examining the Association Between Affordable Care Act Medicaid Expansion and Sexually Transmitted Infection Testing Among U.S. Women.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
- Diabetes and Hypertension Prevention and Control in Community Health Centers: Impact of the Affordable Care Act.Journal of primary care & community healthArticle
- Coverage and Timing of Influenza Vaccination Among Privately Insured Pregnant Women in the United States, 2010-2018.Public health reports (Washington, D.C. : 1974)Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe Affordable Care Act (ACA) increased health insurance coverage throughout the United States and improved care delivery for some services. We assess whether ACA implementation and Medicaid expansion were followed by greater receipt of recommended preventive services among women and girls in a large network of community health centers.
methodsUsing electronic health record data from 354 community health centers in 14 states (10 expansion, 4 nonexpansion), we used generalized estimating equations and difference-in-difference methods to compare receipt of six recommended preventive services (cervical cancer screening, human papilloma virus vaccination, chlamydia screening, influenza vaccination, human immunodeficiency virus screening, and blood pressure screening) among active female patients ages 11 to 65 (N = 711,121) before and after ACA implementation and between states that expanded versus did not expand Medicaid.
resultsExcept for blood pressure screening, receipt of all examined preventive services increased after ACA implementation in both Medicaid expansion and nonexpansion states. Influenza vaccination and blood pressure screening increased more in expansion states (adjusted absolute prevalence difference-in-difference, 1.55; 95% confidence interval, 0.51-2.60; and 1.98; 95% confidence interval, 0.91-3.05, respectively). Chlamydia screening increased more in nonexpansion states (adjusted absolute prevalence difference-in-difference: -4.21; 95% confidence interval, -6.98 to -1.45). Increases in cervical cancer screening, human immunodeficiency virus screening, and human papilloma virus vaccination did not differ significantly between expansion and nonexpansion states.
conclusionsAmong female patients at community health centers, receipt of recommended preventive care improved after ACA implementation in both Medicaid expansion and nonexpansion states, although the overall rates remained low. Continued support is needed to overcome barriers to preventive care in this population.
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