{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:49:12Z","timestamp":1777916952259,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Nearly half of all pregnancies in the United States are considered unintended (mistimed or unwanted), and this rate is even higher among younger and lower income women. The Affordable Care Act (ACA) dependent coverage provision may have influenced the frequency of unintended pregnancies by increasing accessibility to and affordability of family planning services among young adults. Furthermore, the impact of this provision may differ by young adult income level as those with lower income are less likely to be insured and thus more likely to benefit from this provision. Our objective was to estimate the association between the ACA dependent coverage provision and unintended pregnancy, overall, and by young adult income level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We applied a difference-in-differences approach to data from multiple cycles of the National Survey of Family Growth (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 10,104) and compared trends in unintended pregnancy between those who were eligible to benefit (ages 18\u201325 years) and those who were ineligible to benefit (ages 26\u201333 years) from the provision, overall, and among income subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We found evidence that the dependent coverage provision was associated with a \u22127.4 percentage point reduction (95% CI: \u221213.5, \u22121.3) in the prevalence of unintended pregnancy among young adults with lower income (&lt;100% of the federal poverty level). There was limited evidence, however, that the provision was associated with unintended pregnancy among young adults with higher income levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These findings suggest the ACA dependent coverage provision may have reduced unintended pregnancy among a particularly high-risk group (i.e., young adults with lower income).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2023.0956","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T04:36:51Z","timestamp":1726634211000},"page":"1699-1707","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Affordable Care Act Dependent Coverage Provision and Unintended Pregnancy"],"prefix":"10.1177","volume":"33","author":[{"given":"Colleen L.","family":"MacCallum-Bridges","sequence":"first","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics, Michigan State University, East Lansing, Michigan, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Kaestner","sequence":"additional","affiliation":[{"name":"Harris School of Public Policy, University of Chicago, Chicago, Illinois, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhehui","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics, Michigan State University, East Lansing, Michigan, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Holzman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics, Michigan State University, East Lansing, Michigan, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim A.","family":"Bruckner","sequence":"additional","affiliation":[{"name":"Department of Population Health &amp; Disease Prevention, University of California, Irvine, California, USA."},{"name":"Department of Health, Society, &amp; Behavior, University of California, Irvine, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire E.","family":"Margerison","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics, Michigan State University, East Lansing, Michigan, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"key":"e_1_3_6_2_2","unstructured":"The Guttmacher Institute. Unintended pregnancy in the United States. Guttmacher Institute; 2019. Available from: https:\/\/www.guttmacher.org\/fact-sheet\/unintended-pregnancy-united-states [Last accessed: August31 2024]."},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1506575"},{"key":"e_1_3_6_4_2","unstructured":"Zolna M Lindberg L. Unintended pregnancy: Incidence and outcomes among young adult unmarried women in the United States 2001 and 2008. Guttmacher Institute; 2012. Available from: https:\/\/www.guttmacher.org\/sites\/default\/files\/pdfs\/pubs\/unintended-pregnancy-US-2001-2008.pdf [Last accessed: August31 2024]."},{"key":"e_1_3_6_5_2","unstructured":"Centers for Disease Control and Prevention. Unintended pregnancy. 2021. Available from: https:\/\/www.cdc.gov\/reproductivehealth\/contraception\/unintendedpregnancy\/index.htm [Last accessed: May25 2024]."},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1363\/3509403"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2019.02.005"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2019.04.010"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1023\/a:1009534612388"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1363\/4419412"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2016.10.006"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2018.03.015"},{"key":"e_1_3_6_13_2","first-page":"151","volume-title":"Radical Reproductive Justice","author":"Smith A","year":"2017","unstructured":"Smith A. Beyond pro-choice versus pro-life: Women of color and reproductive justice. In: Radical Reproductive Justice. (Ross LJ, , Roberts L, , Derkas E, , Peoples W, , Bridgewater Toure P. eds). Feminist Press: New York, NY, 2017; pp. 151\u201369."},{"key":"e_1_3_6_14_2","first-page":"201","volume-title":"Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System","author":"Emanuel EJ","year":"2014","unstructured":"Emanuel EJ. What is in the affordable care act? In: Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System. PublicAffairs: New York, NY, 2014; pp. 201\u201358."},{"key":"e_1_3_6_15_2","unstructured":"Kaiser Family Foundation. Summary of the affordable care act. 2013; 1\u201313. Available from: https:\/\/www.kff.org\/health-reform\/fact-sheet\/summary-of-the-affordable-care-act\/ [Last accessed: August31 2024]."},{"key":"e_1_3_6_16_2","first-page":"209","volume-title":"The Trillion Dollar Revolution: How the Affordable Care Act Transformed Politics, Law, and Health Care in America","author":"Baicker K","year":"2020","unstructured":"Baicker K, , Sommers BD. Insurance access and health care outcomes. In: The Trillion Dollar Revolution: How the Affordable Care Act Transformed Politics, Law, and Health Care in America (Emanuel EJ, , Gluck AR. eds.) PublicAffairs: New York, NY, 2020; pp. 209\u2013224."},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.105863"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00148-017-0676-6"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13524-018-0692-5"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12728"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1257\/pol.5.4.1"},{"key":"e_1_3_6_22_2","unstructured":"Thomas M James C. The role of health coverage for communities of color. Kaiser Family Foundation: Menlo Park CA; 2009. Available from: https:\/\/www.kff.org\/wp-content\/uploads\/2013\/01\/8017.pdf [Last accessed: August31 2024]."},{"key":"e_1_3_6_23_2","unstructured":"Centers for Disease Control and Prevention. National survey of family growth: Questionnaires datasets and related documentation. 2020. 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Available from: https:\/\/www.urban.org\/sites\/default\/files\/publication\/46661\/411533-Access-to-Employer-Sponsored-Health-Insurance-among-Low-Income-Families.PDF [Last accessed: August31 2024]."}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jwh.2023.0956","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2023.0956","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2023.0956","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:00:31Z","timestamp":1777658431000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jwh.2023.0956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":31,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1089\/jwh.2023.0956"],"URL":"https:\/\/doi.org\/10.1089\/jwh.2023.0956","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}