Previously uninsured low-income adults benefit from Medicaid expansion

Previously uninsured low-income adults benefit from Medicaid expansion

Whatever your opinion of the Affordable Care Act – views range from “Hallelujah!” to “Socialized medicine, here we come!” – it appears to have opened the doors to insurance for perhaps millions of low-income adults who didn’t have coverage before.

Research recently published in the Annals of Internal Medicine suggests that states that expanded Medicaid coverage under the ACA saw a significant increase in rates of health insurance among low-income adults compared with states that did not expand the program.  What’s more, the researchers found improved quality of coverage, more frequent use of health care, and increased rates of diagnoses for chronic health conditions.

The researchers looked at numbers for 2014, the first year of the Medicaid expansion, which at the time occurred in 26 states. That’s because a U.S. Supreme Court ruling left the decision to expand or not up to the individual states. In a way, this turned out to be fortuitous for the researchers, because this set up a “natural experiment” that allowed for some pretty interesting comparisons, according to Laura Wherry, assistant professor of medicine at the David Geffen School of Medicine at UCLA, and the study’s lead author.

“We could use the experiences of adults in states that did not expand Medicaid as a comparison when examining the experiences of adults in states that did expand Medicaid in order to evaluate the effect of the policy,” she said.

Here’s some of what she and her team found:

  • Health insurance coverage increased 7.4 percentage points
  • Medicaid coverage increased 10.5 percentage points
  • Quality of coverage compared to one year prior increased 7.1 percentage points compared with non-expansion states
  • Other changes were visits to general practitioners (up 6.6 percentage points), overnight hospital stays (up 2.4 percentage points), and rates of diabetes and cholesterol diagnoses (up 5.2 percentage points and 5.7 percentage points, respectively)

So coverage is up and patients are being treated for conditions that could lead to more serious health issues down the line. It is, however, too early to tell if the Medicaid expansion is helping make low-income people healthier, Wherry told HealthDay News.

"This is a very early look at the impact of the Medicaid expansion," Wherry said. "It's possible over time you would see different results."

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