title: Preventive and reproductive health services for women: the role of California's family planning waiver.
abstract: OBJECTIVE
  Examine effects of a Medicaid family planning waiver on the receipt of reproductive health care and pregnancy.
  
  
  METHODS
  The present study uses a quasi-experimental design using data from the California Women's Health Survey and the Behavioral Risk Factor Surveillance System (BRFSS) for exposure and comparison groups, before and after California's Planning Access Care and Treatment waiver.
  
  
  METHODS
  The setting was California and comparison states.
  
  
  METHODS
  The study included women who were ages 18 to 44 years and below 200% of the federal poverty level (FPL), who are eligible for services under the waiver.
  
  
  METHODS
  The study measured self-reported pregnancy and receipt of routine checkup, clinical breast exam, Pap test, Chlamydia screening, and discussion of birth control with provider in the past year.
  
  
  METHODS
  The study analyzes outcomes for exposure and comparison groups using probit regression models based on data both within California and in states without waivers.
  
  
  RESULTS
  Estimates from the California Women's Health Survey analysis indicate that among parents 100% to 200% of the FPL, the waiver led to an 8-percentage point increase in the receipt of a routine checkup and a 12-percentage point increase (p = .03) in discussion of birth control. There was an estimated 3-percentage point decline (p = .05) in current pregnancies among nulliparous women. Multistate analysis using the BRFSS confirmed positive effects on routine checkups (p < .01).
  
  
  CONCLUSIONS
  The waiver appears to have led to a reduction in pregnancy rates and increased receipt of reproductive health care, particularly routine checkups.
authors.affiliation: Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30345, USA. eadam01@sph.emory.edu
authors.forename: E Kathleen
authors.initials: EK
authors.lastname: Adams
authors.forename: Genevieve M
authors.initials: GM
authors.lastname: Kenney
authors.forename: Katya
authors.initials: K
authors.lastname: Galactionova
mesh_terms: D000293:Adolescent; D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D002140:California; D005193:Family Planning Services / Q000331:legislation & jurisprudence; D005260:Female; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D011247:Pregnancy; D034121:Reproductive Health Services / Q000331:legislation & jurisprudence*; D057566:Self Report; D016387:Women's Health; D055815:Young Adult