Effect of the Affordable Care Act on Disparities in Breastfeeding: The Case of Maine
Bibliographic record
Abstract
OBJECTIVES: To evaluate the Affordable Care Act (ACA) breastfeeding provision and test whether changes in coverage affected women differently according to health insurance status. METHODS: We used the All-Payer Claims Database from Maine (2012-2014) to compare health insurance claims for lactation classes and breast pumps between women with private insurance and women with Medicaid (1) before the ACA breastfeeding provision, (2) after the provision came into effect, and (3) after health insurance expansion through the Marketplace. RESULTS: We found limited change in claims for lactation classes over the study period. By contrast, the number of claims for breast pumps among women with private insurance increased from 70 claims in the third quarter of 2012 to 629 claims 1 year later and 803 claims in the third quarter of 2014. Women with Medicaid had only 11 claims for breast pumps over the entire study period. CONCLUSIONS: This 11-fold rise in claims for breast pumps by women with private insurance suggests that these women will likely increase breastfeeding initiation or duration; however, without additional support for women with Medicaid, disparities in breastfeeding may increase.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".