Intended vs. Actual Access to Care: Impact of Healthcare Consolidation on Maternal and Neonatal Outcomes

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. Further exacerbating the problem is the reduction of physician independence both within and outside of hospital systems.