OBJECTIVES: Affordable Care Act (ACA), enacted in 2010, creates new opportunities to cover individuals with low-to- moderate income and provides access to preventive health services, such as CDC recommended childhood vaccinations. The US CDC recommends all children get two doses of Measles-Mumps-Rubella (MMR) vaccine (first dose:12-15 months; second dose 4-6 years). This study assessed the impact of the Affordable Care Act (AFC) on MMR vaccination rates among children 7 years and younger.

METHODS: A retrospective, cross-sectional study was conducted assessing children 7 years (providing a one-year leeway) and younger using data from the National Ambulatory Medical Care Survey (2006--2018). Descriptive and multivariate analysis were conducted to assess the impact of ACA on MMR vaccination among children 7 years and younger. All analyses were weighted to determine national estimates.

RESULTS: Age at first dose of the MMR vaccine was around 12 months and at second dose was around 4 years. Prior to the ACA (2006 through 2009), MMR vaccination rates (with at least one dose of the MMR vaccine) ranged between 3% to 3.9%. Post ACA, the MMR vaccination rates (from 2010 to 2018) ranged from 1.2% to 4. 3%. Weighted multivariate analysis adjusting for time and other variables showed no significant impact of ACA on MMR.

CONCLUSIONS: CDC guidelines for age at first and second dose of the MMR vaccine are being followed. Though the ACA may have broadened health coverage and provided low-moderate income individuals with access to preventative health, MMR vaccination rates among children still remain low. Only providing access to preventive health services, such as vaccination, may not be the solution. Other measures like childhood preventable disease and vaccine awareness programs may be needed to help educate and motivate parents to seek preventive health services for their children, especially child vaccination programs.