Study Results from Icahn School of Medicine at Mount Sinai Broaden Understanding of Science (Intended vs. Actual Access to Care: Impact of Healthcare Consolidation on Maternal and Neonatal Outcomes): Science

2025 DEC 30 (NewsRx) -- By a News Reporter-Staff News Editor at NewsRx Policy and Law Daily -- Investigators discuss new findings in Science. According to news reporting originating from New York City, New York, by NewsRx correspondents, research stated, “The Affordable Care Act was intended principally to increase healthcare insurance coverage to uninsured Americans. Ostensibly, 40 million people obtained coverage.”

Our news editors obtained a quote from the research from the Icahn School of Medicine at Mount Sinai, “However, American maternal mortality has significantly worsened. The overall health curve in conservative leaning states is shifted downward in comparison to liberal ones including COVID mortality, maternal mortality, neonatal mortality, life expectancy, heart disease, pulmonary, and diabetic deaths, obesity, smoking, suicides, and alcohol related auto deaths. Here, we focus on insurance coverage issues related to those outcomes and market alterations produced by Affordable Care Act (ACA) legislation and regulatory actions that may or may not have had unintended consequences. Using authoritative national public databases, we analyzed 18 health status metrics in the context of Managed Care Organizations market consolidation and Accountable Care Organizations penetration fueled by the Medicaid expansion. We ranked states from best statistics to worst incorporating 10 measures of health access including: hospital beds, patients without examination for over a year, and incidence of maternity care deserts. There is considerable variation in the USA for both healthcare status and access. Our data show these are highly correlated (r2 = 0.47, p< 0.01). States with the best outcomes have the best access. States with highest healthcare metrics and healthcare access were all traditional liberal ‘blue states’ with greater infrastructure and insurance coverage. Hospital and clinic realignments created under the ACA appear to have worsened the healthcare of women and children in the USA, particularly for patients of color. Healthcare status and access to services are highly correlated. States allocating more resources for healthcare have better outcomes. Monopoly exemptions under ACA are temporally and statistically correlated with worsening of maternal outcomes across all geographic regions where control and consolidation was permitted or encouraged. Maternity care deserts have significantly disadvantaged women of color and working-class families in rural and urban zones.”

According to the news editors, the research concluded: “Further exacerbating the problem is the reduction of physician independence both within and outside of hospital systems.”

This research has been peer-reviewed.

For more information on this research see: Intended vs. Actual Access to Care: Impact of Healthcare Consolidation on Maternal and Neonatal Outcomes. Fetal Diagnosis and Therapy, 2025:1-11. Fetal Diagnosis and Therapy can be contacted at: Karger, Allschwilerstrasse 10, Ch-4009 Basel, Switzerland. (Karger - http://www.karger.com/; Fetal Diagnosis and Therapy - http://content.karger.com/ProdukteDB/produkte.asp?Aktion=JournalHome&ProduktNr=224239)

The news editors report that additional information may be obtained by contacting Mark I. Evans, Dept. of Obstetrics Gynecology and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, United States. Additional authors for this research include Gregory F. Ryan, Lawrence D. Devoe, Jaqueline M. Worth, David W. Britt, George M. Mussalli, Myriam Mondestin-Sorrentino and Christian R. Macedonia.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1159/000549187. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal Fetal Diagnosis and Therapy is: Karger, Allschwilerstrasse 10, Ch-4009 Basel, Switzerland.

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