# Administrative Supplement to Policy Change and Women's Health

> **NIH NIH R01** · MICHIGAN STATE UNIVERSITY · 2020 · $225,035

## Abstract

PROJECT SUMMARY
The central goal of our parent R01 project, Policy Change and Women's Health (HDR01095951), is to examine
the impact of Medicaid expansion, particularly under the Affordable Care Act (ACA), on preconception health,
reproductive health behavior (e.g., contraception, unintended pregnancy, and fertility), and pregnancy health
and outcomes. With this Supplement request, we propose to extend our inquiry to address the impact of
Medicaid expansion on pregnancy-associated mortality and its determinants in the postpartum period. Prior to
the ACA Medicaid expansions, many low-income women who qualified for Medicaid during pregnancy lacked
health insurance coverage prior to conception and subsequently lost coverage 60 days after delivery. This
discontinuity of insurance across the perinatal period may be a key determinant in pregnancy-associated
mortality. The expansion of Medicaid to low income women regardless of pregnancy status offers an
opportunity to examine whether increasing continuity of insurance prior to and after pregnancy improves
postpartum health care utilization, mental health, and rates of pregnancy-associated mortality. Thus, we will
extend Aim 1 of our Parent R01, which assesses the impact of Medicaid expansion on preconception health
care utilization, health behavior, and health using Pregnancy Risk Monitoring System (PRAMS) 2012-2017
data to also assess postpartum continuity of insurance, health care utilization, and mental health. We will
extend Aim 3 of our Parent R01, which examines the impact of Medicaid expansion on pregnancy health and
outcomes using vital statistics data, to assess overall and cause-specific pregnancy-related mortality.
Moreover, we will examine racial/ethnic inequities in the impact of Medicaid expansion on both determinants of
and rates in pregnancy-associated mortality. Achieving these aims will expand research on one of the potential
leading causes of pregnancy-associated mortality in the U.S.: discontinuous insurance during the perinatal
period, particularly the cessation of Medicaid eligibility after 60 days postpartum. We will also identify how
policy-level determinants impact racial/ethnic disparities in risk factors for and rates of pregnancy-associated
mortality in the U.S.

## Key facts

- **NIH application ID:** 10194963
- **Project number:** 3R01HD095951-02S1
- **Recipient organization:** MICHIGAN STATE UNIVERSITY
- **Principal Investigator:** Claire E Margerison
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $225,035
- **Award type:** 3
- **Project period:** 2020-08-16 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10194963

## Citation

> US National Institutes of Health, RePORTER application 10194963, Administrative Supplement to Policy Change and Women's Health (3R01HD095951-02S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10194963. Licensed CC0.

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