The Affordable Care Act (2010) and its perceived impact on assisted fertility care access: Pilot data from a national sample of women’s health practitioners in USA

Abstract

Objective: The Patient Protection & Affordable Care Act (ACA), or “Obamacare”, represents the most substantial reform of the U.S. healthcare system since the 1965 creation of Medicare and Medicaid. This investigation sought to ascertain knowledge and opinion among physicians providing women’s healthcare services about how this national health program will impact access to fertility treatments.

Methods: Between May-July 2014, doctor’s perceptions of ACA were registered by anonymous questionnaire submitted to program directors and house staff at 50 accredited obstetrics & gynecology training centers in USA. Self-reported political preferences were also tabulated for each respondent.

Results: Overall, 53.3% of participants (n = 114) claimed familiarity with ACA although this varied significantly by seniority (68.8% of faculty vs. 40% of trainees; p = .003). Among respondents 54.9% identified as liberal, 23% as moderate, and 19.5% as conservative. Most physicians in this sample (51.8%) anticipated a positive impact on assisted fertility care from ACA, 17.9% predicted an adverse effect, and just under one third (30.3%) either had no opinion or were unable to make a prediction.

Conclusions: This study offers the first analysis of women’s healthcare physicians’ opinion about the impact of ACA on assisted fertility services. Our report finds low general familiarity of ACA among doctors. Moreover, marked divisions of opinion exist among physicians concerning the ACA in general, as well as what role the ACA should play in the provision of assisted fertility care specifically. If U.S. physicians are to provide leadership on women’s healthcare policy initiatives with a view to reach consensus (especially with respect to assisted fertility services), improved awareness of the ACA and its sequela will be crucial.