Health insurance in the United States is a patchwork system whereby opportunities for coverage are strongly associated with life circumstances (ie, age, income, pregnancy, parental status). For pregnant women, this situation contributes to unstable coverage before, between, and after pregnancies. The Affordable Care Act has the potential to make coverage for women of reproductive age more stable and create new opportunities to intervene on conditions associated with maternal and neonatal morbidity. In this article, we discuss the health economics of the Affordable Care Act, its implications for maternal and neonatal health, specific challenges associated with implementation, and opportunities for obstetricians to leverage the Affordable Care Act to improve the care of women.
The Affordable Care Act will fill many of the current health insurance coverage gaps in the United States and presents opportunities to influence maternal and neonatal health.
Division of General Internal Medicine and the Department of Obstetrics and Gynecology, Perelman School of Medicine, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
Corresponding author: Sindhu K. Srinivas, MD, MSCE, Hospital of the University of Pennsylvania, 3400 Spruce Street, Dulles 5, Philadelphia, PA 19104; e-mail: firstname.lastname@example.org.
* The Society for Maternal-Fetal Medicine Health Policy Committee members are Joanne Armstrong, Sean Blackwell, Suneet Chauhan, William Grobman, Andrew Helfgott, Dan O'Keeffe, Carolina Reyes, George Saade, Kathryn Schubert, Catherine Spong, and Sindhu Srinivas.
Financial Disclosure The authors did not report any potential conflicts of interest.
Dr. Spong, Associate Editor of Obstetrics & Gynecology, was not involved in the review or decision to publish this article.