Correlation Between Improved Health Outcomes, Medicaid Expansion Found
By Christine Kern, contributing writer
The expansion was associated with an increase in access to primary care.
A study published by JAMA Internal Medicine found a correlation between improved health outcomes and Medicaid expansion among low-income U.S. adults, including a 22.7 percentage-point reduction in the uninsured rate and increased access to healthcare services.
Researchers compared data from November 2013 through December 2015 on U.S. citizens in Kentucky, Arkansas, and Texas aged 19 to 64 years old with incomes below 138 percent of the federal poverty level. The objective of the study was “to assess changes in access to care, utilization, and self-reported health among low-income adults in three states taking alternative approaches to the ACA.”
The study chose those three states as Kentucky expanded its Medicare coverage in 2014, Medicare funds were used to purchase private insurance for low-income adults in Arkansas, and Texas experienced no expansion at all.
As of July 7, 31 states and the District of Columbia had expanded Medicaid, according to the Kaiser Family Foundation, with a number of states choosing to expand private insurance instead. The study was deemed necessary because while coverage gains from the ACA’s Medicaid expansion have been well documented, its impact on utilization and health are still unclear.
According to HHS Secretary Sylvia Burwell, it is only a matter of time before all states adopt expansions, citing a higher rate of hospital closures in non-expansion states; and the number of working people who remain uninsured. “Helping people who are working and playing by the rules is something that is an important concept most people agree on,” she said in February. Such expansion was associated with an increase of access to primary care (by 12.1 percentage points), according to the authors.
Ultimately, the study concluded, “In the second year of expansion, Kentucky’s Medicaid program and Arkansas’ private option were associated with significant increases in outpatient utilization, preventive care, and improved health quality; reductions in emergency department use; and improved self-reported health. Aside from the type of coverage obtained, outcomes were similar for nearly all other outcomes between the two states using alternative approaches to expansion.”