EFFECTS OF MEDICAID ABORTION COVERAGE ON MENTALLY UNHEALTHY DAYS IN ILLINOIS

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2025-10-13 DOI:10.1016/j.contraception.2025.111132

T Kim, D Marthey, JR Steinberg, M Boudreaux

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引用次数: 0

Abstract

Objectives

It is critical to document the multiple, positive impacts of Medicaid coverage for abortion. The Hyde Amendment prohibits federal spending on abortion in Medicaid, imposing burdens on low-income people. States can provide Medicaid abortion coverage with state dollars only. Illinois introduced Medicaid abortion coverage in 2018. A recent study found that this policy change increased abortion utilization and reduced births. We examined mental health effects of the change, which could derive from preemptive access security or realized abortion access experiences and outcomes.

Methods

Using the 2014-2019 and 2021-2022 Behavioral Risk Factor Surveillance System, we created a sample of 347,844 self-reported females aged 18-44 in 48 comparison states. The outcome was reporting any days of poor mental health in the past month. We used difference-in-differences (DID) models, adjusting for sociodemographic covariates with state and year fixed effects and robust standard errors.

Results

In the pre-treatment period, 50% of Illinois residents reported mentally unhealthy days, compared to 47% in control states. Among those living on lower incomes, our DID model showed a significant reduction in having any days of poor mental health among 18-44-year-old females in Illinois (6.4%-point, equivalent to 13% decline from baseline). We observed no significant changes for those with higher incomes.

Conclusions

Our results suggest that Medicaid abortion coverage improved mental health among reproductive-aged women, especially those with lower incomes. Our findings add to a critical evidence base of the multiple benefits of Medicaid abortion coverage, suggesting further need for the repeal of the Hyde Amendment and the importance of state-covered abortion.

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伊利诺斯州医疗补助堕胎覆盖范围对精神不健康天数的影响

目的记录医疗补助对堕胎的多重积极影响是至关重要的。《海德修正案》禁止联邦政府在医疗补助计划中用于堕胎，这给低收入人群带来了负担。各州只能用州政府的资金提供医疗补助堕胎保险。伊利诺伊州于2018年引入了医疗补助堕胎保险。最近的一项研究发现，这一政策变化增加了堕胎的使用率，减少了出生率。我们研究了这种变化对心理健康的影响，这可能源于先发制人的获取安全或实现堕胎的经历和结果。方法使用2014-2019年和2021-2022年行为风险因素监测系统，在48个比较州创建347,844名18-44岁自我报告的女性样本。结果是报告过去一个月里任何一天的心理健康状况不佳。我们使用差异中的差异（DID）模型，调整社会人口协变量与州和年份固定效应和稳健标准误差。结果在治疗前，伊利诺伊州有50%的居民报告心理不健康天数，而对照组为47%。在收入较低的人群中，我们的DID模型显示，伊利诺伊州18-44岁女性心理健康状况不佳的天数显著减少（6.4%，相当于比基线下降13%）。我们没有观察到高收入人群的显著变化。结论医疗补助堕胎改善了育龄妇女的心理健康状况，尤其是低收入妇女。我们的发现为医疗补助堕胎覆盖的多重好处提供了重要的证据基础，表明有必要进一步废除海德修正案，以及国家覆盖堕胎的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.