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

Abstract

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 (OR_adj = 0.72, 95% CI 0.54, 0.95), unmet vision care need (OR_adj = 0.68, 95% CI 0.50, 0.93), unmet mental health need (OR_adj = 0.57, 95% CI 0.39, 0.83), and unmet prescription need (OR_adj = 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.

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