Evidence map›Paper›PMID 39293719›Full record

ArticleContraception2025

The limitations of using Medicaid administrative data in abortion research.

Brittni Frederiksen, Emily Dennis, Guodong Liu, Doug Leslie, Alina Salganicoff, Sarah Roberts

Abstract read
In one paragraph

Article in Contraception, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Brittni FrederiksenWomen's Health Policy, KFF, San Francisco, CA, United States. Electronic address: brittnif@kff.org.
Emily DennisCenter for Applied Studies in Health Economics, Pennsylvania State College of Medicine, Hershey, PA, United States. Electronic address: edennis3@pennstatehealth.psu.edu.
Guodong LiuCenter for Applied Studies in Health Economics, Pennsylvania State College of Medicine, Hershey, PA, United States. Electronic address: gul14@psu.edu.
Doug LeslieCenter for Applied Studies in Health Economics, Pennsylvania State College of Medicine, Hershey, PA, United States. Electronic address: dleslie@pennstatehealth.psu.edu.
Alina SalganicoffWomen's Health Policy, KFF, San Francisco, CA, United States. Electronic address: alinas@kff.org.
Sarah RobertsAdvancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA, United States. Electronic address: Sarah.Roberts@ucsf.edu.

Funding

State-level factors and maternal and child health outcomesR01HD108337 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Sarah C.M. Roberts · 2022 to 2026
$2.6M
NICHD NIH HHS R01 HD108337
6 · The paper itself

Abstract

objectivesTo identify limitations of abortion data in national Medicaid claims files by comparing abortion counts in Medicaid claims data with state abortion estimates. STUDY

designWe used procedure (Current Procedural Terminology/Healthcare Common Procedure Coding System) and drug (National Drug Code) codes to identify abortion claims in 2009 and 2010 Medicaid Analytic eXtract (MAX) and 2020 Transformed Medicaid Statistical Information System Analytic File (TAF) data. We compared the number of abortions in MAX and TAF to the number of expected abortions covered by Medicaid overall and by state. Based on recent published research, we estimated expected Medicaid-covered abortions as 62% of total abortions in states using state funds to cover abortion services for Medicaid enrollees and 0.9% in states that follow Hyde restrictions.

resultsMAX data identified 11% (38,668/345,480) of expected Medicaid-covered abortions in 2009 and 13% (44,528/330,801) of expected Medicaid-covered abortions in 2010. In 2020 TAF data, we found 25% (69,728/279,048) of the expected Medicaid-covered abortions. Among the 16 states that used state funds to cover abortions for Medicaid enrollees in 2020, the majority had <10% of expected Medicaid-covered abortions (n = 8). Three states had between 10% and 50% of expected abortions. Four states had between 51% and 75% of expected abortions. One state had insufficient data for reporting.

conclusionsAbortion claims in MAX/TAF are an undercount of abortions covered by Medicaid, and this undercount varies across states. Variation in reporting across states and across time likely introduces bias into research trying to use MAX/TAF abortion claims across states and time. Researchers should use extreme caution when using MAX/TAF for abortion-related research. IMPLICATIONS: Researchers should use caution when using the Medicaid Analytic eXtract and Transformed Medicaid Statistical Information System Analytic Files for abortion-related research questions.

Indexed as

Abortion, InducedMedicaidFemaleHumansPregnancyUnited StatesAbortionClaimsMAXMedicaidTAFT-MSIS

Identifiers

PMID39293719
PMCPMC11725448

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.