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		<title>California Judges Test AI Court Assistant Without Telling Litigants When It Reviews Their Cases</title>
		<link>https://hsjchronicle.com/california-judges-test-ai-court-assistant-without-telling-litigants-when-it-reviews-their-cases/</link>
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		<dc:creator><![CDATA[HSJC Newsroom]]></dc:creator>
		<pubDate>Wed, 27 May 2026 20:40:48 +0000</pubDate>
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					<description><![CDATA[<p>Two of California’s largest trial courts are testing an artificial intelligence tool that can help draft judicial orders and produce research memos, raising questions about transparency, accuracy and whether litigants should know when AI is being used in cases that affect them. So far, judges have used the technology mostly in civil matters. But records [&#8230;]</p>
<p>The post <a href="https://hsjchronicle.com/california-judges-test-ai-court-assistant-without-telling-litigants-when-it-reviews-their-cases/">California Judges Test AI Court Assistant Without Telling Litigants When It Reviews Their Cases</a> appeared first on <a href="https://hsjchronicle.com">The Hemet &amp; San Jacinto Chronicle</a>.</p>
]]></description>
										<content:encoded><![CDATA[<p>Two of California’s largest trial courts are testing an artificial intelligence tool that can help draft judicial orders and produce research memos, raising questions about transparency, accuracy and whether litigants should know when AI is being used in cases that affect them.</p>
<p>So far, judges have used the technology mostly in civil matters. But records obtained by CalMatters show the tool could eventually be tested in criminal proceedings, where decisions can affect a person’s freedom and access to justice.</p>
<p>The Los Angeles County Superior Court began a pilot program in February using software developed by Learned Hand, a company founded by Shlomo Klapper. The Riverside County Superior Court also has a $10,000 agreement with the company to test the program, mostly for civil and probate research memos that assist judges in decision-making.</p>
<p>Learned Hand uses large language models from Anthropic, OpenAI and Google to function as a virtual AI assistant for judges. The company says it tests the technology for bias and accuracy, though it has not publicly released those results.</p>
<p>In Los Angeles County, the Superior Court’s contract is worth about $314,000 and includes a roadmap for possible testing in criminal, family and probate divisions. Court officials did not provide CalMatters with detailed criteria for deciding whether the tool could safely be expanded into criminal and family courts, where the stakes are often far higher than in routine civil disputes.</p>
<p>One Los Angeles County Superior Court judge, who spoke to CalMatters on condition of anonymity because of judicial conduct rules, said the possibility of using the technology in sensitive criminal matters was alarming. The judge said colleagues discussed during a recent lunch that the tool could one day be used to help review appeals from people who argue that racial bias affected their conviction or sentence. California courts have seen a surge in such claims since lawmakers passed the Racial Justice Act in 2020.</p>
<p>“I find it outrageous,” the judge said. “AI cannot and will never replace human judgment when it comes to evaluating complex social dynamics. Ultimately, this will erode public confidence in the competence and fairness of the judiciary.”</p>
<p>Documents obtained through public records requests show most California superior courts now have policies governing generative AI. The state Judicial Council required courts to adopt such policies before using the technology. Of the 51 courts that responded to CalMatters, about a dozen said they use AI tools from companies including LexisNexis, Thomson Reuters and Microsoft Copilot.</p>
<p>The use of AI in courtrooms remains controversial because large language models can generate false citations, misleading summaries and overly confident conclusions. A 2025 MIT study found that models from major companies, including Google and Anthropic, can reduce critical thinking and brain activity.</p>
<p>AI-generated errors already have appeared in legal proceedings. Researcher Damien Charlotin has documented hundreds of instances in which litigants, attorneys and judges made mistakes after relying on AI, including nearly 90 cases in California-based state or federal courts since August 2024.</p>
<p>Last fall, a Los Angeles attorney was fined $10,000 for citing nonexistent cases. Earlier this month, The Sacramento Bee reported that AI use led to errors in four cases handled by prosecutors in Nevada County. Most documented examples involve attorneys or self-represented litigants, but UCLA law professors have warned that judges are likely to make more AI-related mistakes in the future. In recent months, the U.S. Senate examined apparent AI use by federal judges in Mississippi and New Jersey after rulings included significant factual errors.</p>
<p>Klapper, who previously worked as a law clerk for a federal appeals court and for the surveillance technology company Palantir, said courts need AI to reduce backlogs and operate more efficiently.</p>
<p>“Could we hire more staff?” he told CalMatters. “Maybe, but it won’t be enough to keep up with the exponential growth that is coming, or to adequately solve the current crisis. I think the only solution is to assign every judge and attorney their own AI assistant.”</p>
<p>Klapper said his goal is to combine the strengths of human judges with the capabilities of machines. He acknowledged that AI systems may contain bias but argued that models can be tested in ways humans cannot.</p>
<p>“I’m not saying all machines are free of bias,” he said. “I’m not even saying my machine is free of bias. What I’m saying is that we can test it, and people have tested it. That’s the advantage over humans.”</p>
<p>The generative AI policies for the Los Angeles and Riverside superior courts require disclosure only when a motion, ruling or other document is drafted entirely with generative AI.</p>
<p>Both courts declined to say whether litigants are being told that the tool is being tested in connection with their cases. A Los Angeles County Superior Court spokesperson told CalMatters the testing involves motions that have already been decided and is being done separately from active cases. However, the contract allows testing in live cases.</p>
<p>“Even with successful evaluation and extensive testing, the Court would still be several months, if not years, away from implementing this type of tool,” the spokesperson said.</p>
<p>The Los Angeles County contract permits the tool to be tested on two important types of criminal motions: suppression motions, which determine what evidence prosecutors may present at trial, and post-conviction relief motions, filed by people who have already been convicted and are seeking another chance at release.</p>
<p>Los Angeles County District Attorney Nathan Hochman said those provisions are his “biggest concern.” After reviewing the contract, he described the two categories as “incredibly important motions in the criminal justice system.”</p>
<p>“When you’re dealing with a person’s liberty — unlike the civil arena, which covers everything else — the stakes are of the highest importance,” Hochman said. “I don’t want to take the risk, especially in a criminal case, that AI gets it wrong. That someone’s constitutional rights are violated. That someone goes to prison wrongly or, on the other hand, that someone gets away with something.”</p>
<p>In Los Angeles, some judges learned more about the Learned Hand contract during a March presentation by Superior Court Judges Yvette Verastegui and Olivia Rosales, who oversee the criminal division. As part of an annual tour, the judges visit courthouses throughout the county to brief judges on court operations, caseloads and other issues. During a lunch, Verastegui and Rosales indicated the tool might someday be used to assist with Racial Justice Act petitions, according to a judge who attended.</p>
<p>The California Racial Justice Act allows people to challenge a criminal conviction or sentence if they believe racial bias played a role. People incarcerated in state prisons file petitions directly with the court. If a petition appears to have merit, the process can include appointment of counsel, legal briefing and evidentiary hearings before a judge decides whether to grant relief.</p>
<p>A tool such as Learned Hand could change that process. According to the judge who attended the lunch, Verastegui and Rosales said the software could generate proposed decisions for judges to consider when deciding whether to deny petitions or allow them to proceed to later stages.</p>
<p>“My concern, of course, is that courts will use that as an anchor and cling to that initial analysis,” the judge said. “It is an extremely dangerous path. Setting aside inaccuracy, which will be a major concern, it dehumanizes the entire process. It does not treat people as individuals with lived experiences. It essentially reimposes a one-size-fits-all model of justice.”</p>
<p>A second Los Angeles County Superior Court judge, who also spoke anonymously, recalled the presentation and said they would not trust or use the tool to summarize a Racial Justice Act petition.</p>
<p>AI can reproduce or intensify patterns found in the data used to build a model, including human bias. Large language models have shown racial and gender bias. Previous reviews of predictive policing technology used by the Los Angeles Police Department found racial bias, and an analysis of the COMPAS risk assessment algorithm found it was more likely to label Black people as at risk of reoffending after incarceration than white people with similar records.</p>
<p>Public defenders who spoke with CalMatters shared those concerns.</p>
<p>Elizabeth Lashley-Haynes, a deputy public defender in the Los Angeles County Public Defender’s Office, said it would be “extremely problematic and bordering on unethical” for a judge to use such a tool to review Racial Justice Act petitions, which she described as highly complex.</p>
<p>“They are unlike anything that has ever been done before in the legal system,” said Lashley-Haynes, who specializes in Racial Justice Act cases. “The words used in these cases, which have racial connotations or meanings, are far beyond the scope of anything artificial intelligence can do.”</p>
<p>In interviews with CalMatters, Klapper and Los Angeles County Superior Court Executive Officer David Slayton denied that the court has plans to use the tool for Racial Justice Act petitions. A court spokesperson later confirmed by email that the contract allows the tool to be used that way, but said that has not yet occurred.</p>
<p>Klapper said that if a Racial Justice Act module were developed, the tool would need to be evaluated for possible bias and built jointly with the court.</p>
<p>“The timing is very sensitive, right?” he said. “It’s a very delicate decision, I’m not going to lie. The stakes are high; I understand why people could be very concerned. Especially when it comes to criminal matters, I have even more hesitation and more caution than usual, because fundamental rights are at stake.”</p>
<p>In Los Angeles, six Superior Court judges and their research attorneys are using Learned Hand primarily for research, motion summaries and help drafting tentative rulings, according to Slayton. He said the tool will not be expanded beyond the civil division “until court leadership is comfortable.”</p>
<p>“The court is being very prudent and careful in its use of this type of technology,” Slayton said. “Until we evaluate it and determine that it is effective in those areas, we will not expand it to others.”</p>
<p>Slayton said the tool will be reviewed quarterly to determine how it might be used in the future, though he did not give specifics about the evaluation. A court spokesperson later told CalMatters by email that Learned Hand is judged by the same standards applied to law clerks and research attorneys: accurate legal research, sound analysis, neutral judicial writing and reliable work that supports judicial decision-making.</p>
<p>Los Angeles County Superior Court Judge Samantha Jessner, who chairs the court’s Judicial Technology Advisory Committee, said she did not know until recently that the tool might be used outside the civil division. She said judges are not involved in contract negotiations because of ethical restrictions.</p>
<p>“I think we have a duty and an obligation to explore whether artificial intelligence has a place in our work as a judiciary, and that is exactly what this pilot program is for,” Jessner said.</p>
<p>The Riverside County Superior Court signed its agreement with Learned Hand in February. Emails obtained by CalMatters show Klapper suggested to Riverside court executives Jason Galkin and Sarah Hodgson that the court begin with a common civil motion, then expand quickly once the tool was established. He suggested Hodgson prepare a list of motions and workflows that create the most difficulty, citing the Racial Justice Act as an example.</p>
<p>About two weeks later, Hodgson described the most labor-intensive motions as those “trying to drive us into retirement,” including discovery motions and attorney fee motions. For criminal matters, the court suggested Klapper focus on document-heavy issues, including death penalty habeas corpus petitions and probation revocations.</p>
<p>Since Riverside’s pilot began, seven civil and probate attorneys have had access to the tool. Galkin, the court’s executive officer, said the court is evaluating the product to understand what it can do. He said the tool is not being used to draft tentative rulings.</p>
<p>“We don’t even know whether expansion is likely, so there are no established criteria for what that expansion would look like or thresholds for it,” Galkin said. “Right now, the fundamental question is: Does this help staff and assist them in achieving their professional goals?”</p>
<p>As courts continue testing AI, attorneys such as Hochman say its use may be inevitable, but should be limited to routine, repetitive and lower-level tasks.</p>
<p>“It’s the analysis of the case itself, along with the conclusions that would be reached, that makes me very distrustful of AI right now,” Hochman said. “A large part of that is because I don’t know all the data it is using to make its decision. The one thing I am completely certain of is that AI did not go to law school.”</p>
<p><em>Original source: <a href="[1.URL]" target="_blank" rel="noopener">CalMatters</a></em></p>
<p>The post <a href="https://hsjchronicle.com/california-judges-test-ai-court-assistant-without-telling-litigants-when-it-reviews-their-cases/">California Judges Test AI Court Assistant Without Telling Litigants When It Reviews Their Cases</a> appeared first on <a href="https://hsjchronicle.com">The Hemet &amp; San Jacinto Chronicle</a>.</p>
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		<title>California judges are testing a new AI clerk, and you won’t know if it’s looking at your case</title>
		<link>https://hsjchronicle.com/california-judges-are-testing-a-new-ai-clerk-and-you-wont-know-if-its-looking-at-your-case/</link>
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		<dc:creator><![CDATA[HSJC Newsroom]]></dc:creator>
		<pubDate>Tue, 26 May 2026 19:44:39 +0000</pubDate>
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		<guid isPermaLink="false">https://hsjchronicle.com/?p=72049</guid>

					<description><![CDATA[<p>Two of Southern California’s largest court systems, including Riverside County Superior Court, are testing an artificial intelligence program designed to help judges and court attorneys research cases, summarize motions and draft legal documents — with possible future use in criminal matters where liberty is at stake. The tool, created by a company called Learned Hand, [&#8230;]</p>
<p>The post <a href="https://hsjchronicle.com/california-judges-are-testing-a-new-ai-clerk-and-you-wont-know-if-its-looking-at-your-case/">California judges are testing a new AI clerk, and you won’t know if it’s looking at your case</a> appeared first on <a href="https://hsjchronicle.com">The Hemet &amp; San Jacinto Chronicle</a>.</p>
]]></description>
										<content:encoded><![CDATA[<p>Two of Southern California’s largest court systems, including Riverside County Superior Court, are testing an artificial intelligence program designed to help judges and court attorneys research cases, summarize motions and draft legal documents — with possible future use in criminal matters where liberty is at stake.</p>
<p>The tool, created by a company called Learned Hand, is being piloted in Los Angeles and Riverside counties. It functions as a kind of AI law clerk, drawing on language models from Anthropic, OpenAI and Google to produce research memos, draft orders and assist with tentative rulings.</p>
<p>So far, court officials say the technology is being used mainly in civil and probate matters. But contracts and emails obtained by CalMatters show the courts have discussed or authorized potential testing in criminal, family and probate divisions, raising concerns among judges, public defenders and prosecutors about accuracy, bias and transparency.</p>
<p>In Riverside County, the Superior Court has a $10,000 agreement with Learned Hand to test the program. Seven civil and probate attorneys have access to it, according to court officials, primarily to see whether it can help staff with research and other time-consuming tasks. Riverside court officials said the tool is not being used to draft tentative rulings.</p>
<p>Los Angeles County Superior Court has a much larger contract, worth about $314,000, that includes a plan to evaluate whether the tool could be used beyond civil cases, including in criminal, family and probate court. Los Angeles court officials told CalMatters the program is still in an early testing phase and remains months, if not years, away from broader implementation.</p>
<p>The use of artificial intelligence in courtrooms has become increasingly controversial as generative AI systems have been shown to create false citations, misstate facts and reflect biases found in the data used to train them. Those risks are especially sensitive in criminal cases, where court decisions can affect whether evidence is admitted at trial, whether a conviction stands, or whether a person remains incarcerated.</p>
<p>Los Angeles County District Attorney Nathan Hochman said he is especially concerned that the Los Angeles contract allows the technology to be used for motions to suppress evidence and motions for post-conviction relief — two significant areas of criminal law.</p>
<p>“When you’re dealing with someone’s liberty — as opposed to in the civil setting, which is everything other than liberty — the stakes couldn’t be higher,” Hochman told CalMatters. “I don’t want to take the chance, particularly in a criminal case, that AI happens to get it wrong.”</p>
<p>He said an error could cut both ways: violating a defendant’s constitutional rights or undermining a lawful prosecution.</p>
<p>Court officials in both counties have adopted generative AI policies, as required by the state Judicial Council before courts use the technology. But those policies require disclosure only when a motion, decision or other document is written entirely by generative AI. That means litigants may not be told if AI was used in part to research or draft material connected to their case.</p>
<p>Both Los Angeles and Riverside courts declined to say whether parties are being informed that the tool may be tested on their cases. A Los Angeles Superior Court spokesperson said testing is being done on motions that have already been decided and outside live case environments, though the contract permits testing on active matters.</p>
<p>“It is important to note that even with successful evaluation and thorough testing, the Court remains several months, if not years, away from implementing this type of tool,” the spokesperson said.</p>
<p>In Los Angeles County, six superior court judges and their research attorneys are using Learned Hand primarily to conduct legal research, summarize motions and assist with tentative rulings in civil matters, according to David Slayton, the court’s executive officer. Slayton said the court will not expand the tool into other divisions until court leaders are satisfied it can be used appropriately.</p>
<p>“The court is being very deliberate and careful about how we use technology like this,” Slayton said.</p>
<p>A court spokesperson later said the program is being evaluated under the same standards applied to human law clerks and research attorneys, including accuracy, legal analysis, neutrality and reliability. The court did not provide detailed criteria for how it will decide whether the technology is safe enough for use in criminal or family law matters.</p>
<p>Some judges have expressed alarm about how far the technology could go. One Los Angeles County Superior Court judge, who spoke anonymously because of judicial conduct rules, said colleagues were told during a recent luncheon that the tool might one day assist with petitions filed under California’s Racial Justice Act.</p>
<p>The 2020 law allows people to challenge criminal convictions or sentences if they believe racial bias affected the outcome. Courts across California are now processing a growing number of such claims, many filed by people in state prison.</p>
<p>According to the judge, court leaders discussed the possibility that AI could help generate tentative decisions for judges reviewing whether those petitions should be denied or move forward. The judge warned that such use could shape judicial thinking too early in the process.</p>
<p>“It’s an extremely perilous road to go down,” the judge said. “Putting aside the inaccuracy, which will be a significant concern, it dehumanizes the whole process.”</p>
<p>A second Los Angeles judge also told CalMatters they would not trust the tool to summarize or analyze a Racial Justice Act petition.</p>
<p>Los Angeles court officials and Learned Hand founder and CEO Shlomo Klapper denied that there are current plans to use the program for Racial Justice Act petitions. A court spokesperson later confirmed the contract would allow such use, but said that possibility “has not commenced in any way.”</p>
<p>Klapper said any Racial Justice Act application would need to be developed with the court and tested for bias. He acknowledged that criminal cases require heightened caution.</p>
<p>“It’s a very fraught decision,” Klapper said. “Extremely high stakes — a scenario where I understand people might be very concerned.”</p>
<p>Public defenders said those concerns are well-founded. Elizabeth Lashley-Haynes, a deputy public defender in Los Angeles County who specializes in Racial Justice Act litigation, said using AI to review such petitions would be “highly problematic and bordering on unethical.”</p>
<p>She said Racial Justice Act claims often involve subtle context, historical patterns and language with racial meanings that are difficult even for trained legal professionals to evaluate.</p>
<p>“They’re like nothing else in the legal system that has ever really been done,” Lashley-Haynes said.</p>
<p>Concerns about bias are not hypothetical. AI systems can reproduce or amplify patterns found in their training data, including racial and gender bias. Studies and investigations have found bias in large language models, predictive policing systems and criminal risk assessment tools.</p>
<p>Generative AI has also already caused problems in the legal system. Researcher Damien Charlotin has documented hundreds of instances in which litigants, attorneys or judges relied on false or faulty AI-generated information, including nearly 90 cases in California state or federal courts since August 2024. Last year, a Los Angeles-based attorney was fined $10,000 for citing cases that did not exist. More recently, AI-related errors were reported in several cases handled by prosecutors in Nevada County.</p>
<p>Most known incidents have involved lawyers or self-represented litigants, but legal scholars have warned that judges are likely to make similar mistakes as AI becomes more common. In recent months, the U.S. Senate examined apparent AI use by federal judges in Mississippi and New Jersey after rulings contained serious factual errors.</p>
<p>Klapper, a former federal appellate clerk who previously worked for the surveillance technology company Palantir, argues that courts must consider AI because they face growing backlogs and limited staffing. He said the goal is not to replace judges but to give them better support.</p>
<p>“I think the only solution is to give every single judge and staff attorney their own AI clerk,” he said.</p>
<p>He also said AI systems can be tested in ways human decision-makers cannot.</p>
<p>“I’m not saying all machines aren’t biased,” Klapper said. “I’m not saying my machine isn’t even biased. I’m saying we can test it and people have tested it. And that is the benefit over humans.”</p>
<p>In Riverside County, emails obtained by CalMatters show Klapper proposed that the court begin with a routine civil motion and then expand quickly if the tool proved useful. He also suggested court officials identify motions and workflows that were especially burdensome, mentioning the Racial Justice Act as one example.</p>
<p>About two weeks later, Riverside court officials identified labor-intensive areas such as discovery motions and attorney fee motions. For criminal cases, they suggested focusing on matters with large records, including death penalty habeas petitions and parole revocation.</p>
<p>Jason Galkin, Riverside County Superior Court’s chief executive officer, said the court is still in an exploratory stage.</p>
<p>“We don’t even know if expansion is likely,” Galkin said, adding that the immediate question is whether the tool helps staff do their jobs.</p>
<p>Across California, most superior courts now have policies governing generative AI, according to public records obtained by CalMatters. About a dozen of the 51 courts that responded said they are using AI-powered tools from companies such as LexisNexis, Thomson Reuters and Microsoft.</p>
<p>Los Angeles County Superior Court Judge Samantha Jessner, who chairs the Judicial Technology Advisory Committee, said she only recently became aware that the Learned Hand tool could eventually be used outside civil court. Judges are generally not involved in contract negotiations because of ethical limitations, she said.</p>
<p>Jessner said the judiciary has a responsibility to examine whether AI has a useful role in the courts, while also proceeding cautiously.</p>
<p>Hochman said he expects AI will become part of the legal system but believes it is better suited for repetitive, low-level work than for analysis that affects the outcome of a case.</p>
<p>“The only thing I’m 100% sure of is that AI didn’t go to law school,” he said.</p>
<p><em>Original source: <a href="[1.URL]" target="_blank" rel="noopener">CalMatters</a></em></p>
<p>The post <a href="https://hsjchronicle.com/california-judges-are-testing-a-new-ai-clerk-and-you-wont-know-if-its-looking-at-your-case/">California judges are testing a new AI clerk, and you won’t know if it’s looking at your case</a> appeared first on <a href="https://hsjchronicle.com">The Hemet &amp; San Jacinto Chronicle</a>.</p>
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		<title>ACA Medicaid Expansion Improves Insurance Coverage for Pregnant People</title>
		<link>https://hsjchronicle.com/aca-medicaid-expansion-improves-insurance-coverage-for-pregnant-people/</link>
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		<pubDate>Wed, 12 Jan 2022 23:00:00 +0000</pubDate>
				<category><![CDATA[Health & Fitness]]></category>
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					<description><![CDATA[<p>The Affordable Care Act (ACA) Medicaid expansion increased preconception and postpartum Medicaid coverage and led to significant declines in uninsurance and insurance churn, according to a study conducted at Columbia University Mailman School of Public Health.</p>
<p>The post <a href="https://hsjchronicle.com/aca-medicaid-expansion-improves-insurance-coverage-for-pregnant-people/">ACA Medicaid Expansion Improves Insurance Coverage for Pregnant People</a> appeared first on <a href="https://hsjchronicle.com">The Hemet &amp; San Jacinto Chronicle</a>.</p>
]]></description>
										<content:encoded><![CDATA[
<p class="wp-block-paragraph">RESULTS ARE RELEVANT TO THE THE POSTPARTUM MEDICAID PROVISIONS WITHIN THE U.S. BUILD BACK BETTER ACT</p>



<p class="wp-block-paragraph">The Affordable Care Act (ACA) Medicaid expansion increased preconception and postpartum Medicaid coverage and led to significant declines in uninsurance and insurance churn, according to a study conducted at Columbia University Mailman School of Public Health. There was limited evidence, however, that Medicaid expansion increased perinatal health care use or improved infant birth outcomes overall. The findings are published in the January 2022 issue of the journal <a rel="noreferrer noopener" href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01150" target="_blank"><em>Health Affairs.</em></a></p>



<p class="wp-block-paragraph">“In earlier research before the ACA,&nbsp;we found high rates of uninsurance among reproductive-aged women,” said&nbsp;<a href="https://www.publichealth.columbia.edu/people/our-faculty/jrd2199">Jamie Daw</a>, PhD, Columbia Mailman School assistant professor of&nbsp;<a href="https://www.publichealth.columbia.edu/academics/departments/health-policy-and-management">health policy and management</a>, and senior author. “In addition, insurance churn—moving between insurance and uninsurance or switching insurers—was common around pregnancy, and high rates of coverage instability may have contributed to lower access to care and poorer maternal and child health outcomes. The result disproportionately impacted low-income people and members of racial and ethnic minority groups who qualify for pregnancy Medicaid coverage.”</p>



<p class="wp-block-paragraph">Drawing on original, peer-reviewed quantitative research studies, Daw and colleagues systematically analyzed data published between January 2014 and April 2021. They examined the effect of the ACA state Medicaid expansions on insurance coverage, health care use, and health outcomes measured between one month prior to conception through one year postpartum, and neonatal outcomes within twenty-seven days of birth. The researchers identified 35 unique studies that met their screening criteria.</p>



<p class="wp-block-paragraph">Increases in Medicaid coverage were greater during the preconception and postpartum periods than at delivery since pregnant people already qualified for Medicaid from conception to sixty days after birth before the ACA.</p>



<p class="wp-block-paragraph">“Despite large coverage increases before and after pregnancy, we found limited evidence that the ACA Medicaid expansion improved overall perinatal health care use or health outcomes in the first few years after implementation,” noted Meghan Bellerose, &#8217;21 MPH, a PhD student at Brown University School of Public Health and first author. “However, one study found that the ACA Medicaid expansion was associated with reduced racial disparities in birth outcomes such as preterm birth, and another found a reduction in overall maternal mortality. These results are promising and merit further exploration as the U.S. continues to pursue strategies to reduce racial disparities in maternal mortality and morbidity.”</p>



<p class="wp-block-paragraph">“Our findings indicate that Medicaid expansion to low-income adults is a very effective approach to increase preconception and postpartum health insurance coverage,” said Daw. “Our ability to observe corresponding changes in health care use and outcomes is partly related to a lack of data collection on preconception and postpartum outcomes in the U.S.  Our results are highly relevant to the recent maternal healthcare call to action from the White House  and the postpartum Medicaid provisions within the Build Back Better Act, suggesting that these provisions will result in large coverage gains, but more data will be needed for rigorous evaluation of the impact of Medicaid policy changes on maternal health disparities.”<br> <br>A co-author is Lauren Collin of Columbia Mailman School.</p>



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