Comprehensive reproductive care can improve women’s health outcomes and reduce health disparities and long-term health care costs, but many women from underrepresented racial and ethnic groups and/or living in poverty face many barriers to accessing the care they need.

For five years, a women-led research team at OCHIN studied the impact of Medicaid expansion under the Affordable Care Act (ACA) on access to comprehensive preventive, contraceptive, and pregnancy-related care. They also explored the role that community health centers in the United States play in connecting women to quality reproductive care.

Study results

The collaborative study, which included researchers from Oregon Health & Science University (OHSU) and ADVANCE, found that policies that fund health centers and expand coverage for reproductive health services in primary care settings are effective in ensuring ongoing access to equitable reproductive health care.

“I think that community health centers are extremely important for women’s health,” said Erika Cottrell, PhD, MPP, principal investigator (PI) at OCHIN. “They are the place where women can know that they can go receive care regardless of whether they have insurance at that time, regardless of their ability to pay. They are essential frontline providers for women’s reproductive health.”

Over 40% of health centers provide primary care-based prenatal care.

Other key findings include:

• Medicaid expansion under the ACA improves access and utilization of reproductive services.
• Health centers are an important access point for effective contraception among adolescents and young women.
• Health centers provide pregnancy planning and prenatal care that improves outcomes for pregnant people with higher risks of complications and helps drive health equity.
• OCHIN health centers provide equitable and comprehensive reproductive care with no measurable disparities between patients, regardless of their zip code.

“Most women don’t receive all of the preventive care that they need … and the reasons for this are complex,” said Brigit Hatch, MD, PhD, co-investigator and site PI at OHSU. “As a family doctor who provides this type of care every day, I recognize how important it is to understand the ways these complex systems—from state and national policies, to health systems, to patients and communities—support people in getting the care that they need. Studies like this help me to advocate for my patients’ needs beyond the exam room and make sure that we’re finding and building systems that work.”

Learn more

Learn more about the EVERYWOMAN study by visiting the website and watching the video below.