Abstract and Introduction
Our population-based survey of 1078 randomly sampled US women, aged 18 to 55 years, sought to characterize their understanding of and attitudes toward the Affordable Care Act (ACA). Most women, especially socially disadvantaged groups, had negative or uncertain attitudes toward the ACA and limited understanding of its health benefits, including its relevance for their own health service coverage and utilization. Our findings are important for continued research, policy, and practice, with implications for whether, when, and how improved coverage will translate to improved access and outcomes for US women.
Women's health clinicians, researchers, and policymakers are hopeful that expanding health care coverage under the Patient Protection and Affordable Care Act (ACA) will improve the health of US women. By requiring coverage, increasing access to affordable health plans, incentivizing utilization of high-value services, establishing benefit mandates, and reducing cost sharing, the ACA is expected to improve health outcomes and reduce health disparities for women. Since ACA implementation began, however, it has become clear that the public's participation in its programs and benefits is compromised by widespread confusion. Recognizing that the ACA can only have an impact on women's health (individual and population) if women are aware of available benefits and act upon them, we conducted a study to examine women's understanding of and attitudes toward the ACA. Specifically, we sought to determine (1) whether women were aware and approved of the ACA and the women's health benefits attributable to it, (2) whether women expected their coverage of women's health services and subsequent service utilization to change as a result of the ACA, and (3) whether women's awareness and attitudes differed across sociodemographic groups.