Original Investigation

Insurance Type and Menopausal Hormone Therapy Use Among US Women

JAMA Network Open 10.1001/jamanetworkopen.2026.23740

July 17, 2026 at 11:00 AM EDT

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Among US women in menopause without contraindications for menopausal hormone therapy, is insurance coverage type (Medicaid vs private) associated with use of menopausal hormone therapy (MHT)?In this cross-sectional study (1666 women; weighted, approximately 22 million), Medicaid coverage was associated with 50% lower MHT use compared with private insurance, even after adjustment for confounding variables. In secondary analyses examining race and ethnicity, insurance type, and MHT use, adjustment for insurance type attenuated the initially observed difference in MHT use between Black and White women.This study found that insurance type was associated with MHT use and that differences in coverage may partially explain racial disparities in menopausal care.

Corresponding Author: Arina Chesnokova, MD, MPH, MSHP, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Gates 1, 3400 Spruce St, Philadelphia, PA 19104 (arina.chesnokova@pennmedicine.upenn.edu).

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