As of 2017, the United States had the second highest maternal mortality rate (MMR) of the OECD countries at 19 deaths per 100,000 live births and the American MMR has been increasing in recent years while the global trend in the MMR has been decreasing. In the US, cases maternal mortality and severe maternal morbidity show disparities across racial, socioeconomic, and geographic lines. The Medicaid expansions implemented under the Affordable Care Act may have extended coverage to mothers who were the most vulnerable for maternal mortality and morbidity. This study aims to examine if the rates of maternal mortality and severe morbidity in the United States have changed along with the expansion of Medicaid as well as how disparities in these adverse outcomes have been affected. Hospital discharge data from the Healthcare Cost and Utilization Project National Inpatient Sample was used to examine how rates of insurance coverage, maternal mortality, and severe maternal morbidity and disparities in these outcomes have changed over time from 2010-2017. This was achieved using descriptive analysis and difference-in-difference estimation. From 2010-2017, the rate of insurance for women hospitalized for delivery increased by 20% and the rate of maternal mortality decreased by 33.3%. The women least likely to have insurance from 2010 to 2011 saw the largest decreases in disparities in insurance coverage and in outcomes relative to the women most likely to have insurance. As such, reduction of disparities related to insurance status did occur from 2014-2017. However, the translation of these effects to the outcome disparities among racial and income groups was muted in comparison. While some groups of pregnant women did see some convergence in disparities in the rates of insurance and maternal mortality from 2014-2017, the reduction in disparities was mild and there was little to no evidence that the Medicaid expansion was the cause.
"},{"label":"Degree","value":["Bachelor of Arts with Departmental Honors"]},{"label":"Author-supplied Keywords","value":["Maternal","Mortality","Aca"]},{"label":"Administrative Note","value":"Drupal Node ID: 24185