Giving Birth under the ACA: Analyzing the Use of Law as a Tool to Improve Health Care

I. Introduction II. Overview of Maternity Care in the United States ... A. High Costs and Poor Outcomes: Demonstrating the Urgent Need for Maternity Care Reform ... B. Understanding the Landscape of Childbirth III. The ACA and Maternity Care ... A. The ACA’s Significant Expansion of Access to Maternity Coverage ... 1. ACA Reforms that Apply Regardless of Coverage Source ... 2. ACA Reforms That Apply to Particular Modes of Coverage ... a. Individual Market ... b. Medicaid ... B. The ACA’s Improvement of Maternity Care Benefits ... 1. ACA Reforms That Apply Regardless of Coverage Source ... 2. ACA Reforms That Apply to Particular Modes of Coverage ... a. Individual Market ... b. Private Insurance (Individual and Employer-Sponsored) ... c. Medicaid (and Medicare) ... C. The ACA’s Investments in Better Care through Programmatic and Policy Initiatives IV. Assessing the ACA’s Impact on Maternity Care: Enhancing Coverage without Shifting Culture ... A. The Need for Payment Reform in Maternity Care ... B. Improving Outcomes Requires Practicing Evidence-Based Maternity Care ... C. Transforming Birth by Elevating Midwives as Primary Maternity Care Providers V. Conclusion: Reflections on Law as a Tool to Improve Health Care