Medicaid expansion coverage effects grew in 2015 with continued improvements in coverage quality

Health Affairs

Volumn 36, Issue 5, 2017, Pages 819-825

  Decker, Sandra L ^a   Lipton, Brandy J ^a   Sommers, Benjamin D ^b  

^a AGENCY FOR HEALTHCARE RESEARCH AND QUALITY   (United States)

^b HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; CONTROLLED STUDY; HUMAN; HUMAN EXPERIMENT; LOWEST INCOME GROUP; MEDICAID; STATISTICAL MODEL; FEMALE; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH INSURANCE; INSURANCE; MALE; MEDICALLY UNINSURED; MIDDLE AGED; POVERTY; QUESTIONNAIRE; STATISTICS AND NUMERICAL DATA; TOTAL QUALITY MANAGEMENT; UNITED STATES;

ADULT; FEMALE; HEALTH SERVICES ACCESSIBILITY; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MALE; MEDICAID; MEDICALLY UNINSURED; MIDDLE AGED; PATIENT PROTECTION AND AFFORDABLE CARE ACT; POVERTY; QUALITY IMPROVEMENT; SURVEYS AND QUESTIONNAIRES; UNITED STATES;

EID: 85019010481     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2016.1462     Document Type: Article

References (19)

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5. To access the Appendix, click on the Appendix link in the box to the right of the article online
6. Five states (California, Connecticut, Minnesota, New Jersey, and Washington) and the District of Columbia expanded Medicaid under the ACA before 2014, and we considered them to be expansion states. Estimates of the effects of the ACA's Medicaid expansion on uninsurance rates in 2014 and 2015 are provided for these five states and the District of Columbia alone, and for the states that expanded Medicaid in 2014 alone, in Appendix Exhibit B (see Note 5)
7. Sommers BD, Buchmueller T, Decker SL, Carey C, Kronick R. The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health Aff (Millwood). 2013;32(1): 165-74
8. Bertrand M, Duflo E, Mullainathan S. How much should we trust differences-in-differences estimates? Q J Econ. 2004;119(1):249-75
9. For example, for the uninsurance rate outcome, the p value for the interaction between Medicaid expansion status and the linear quarterly trend was 0.62
10. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Data sources for Modified Adjusted Gross Income (MAGI) conversions [Internet]. Washington (DC): ASPE; 2013 Feb 4 [cited 2017 Mar 24]. (Issue Brief). Available from: https://aspe.hhs.gov/basicreport/data-sources-modifiedadjusted-gross-income-magiconversions
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13. Although not subsidized, insurance coverage among people with income below poverty could have increased as a result of other ACA provisions, including the availability of private insurance through the Marketplace regardless of preexisting conditions. However, since premium subsidies were available only for families with incomes above poverty, most private insurance increases in nonexpansion states likely came from this group. Appendix Exhibit C shows private insurance rate outcomes for the sample with incomes below poverty (see Note 5). Point estimates for increases in private insurance in nonexpansion states for nonelderly adults with incomes below poverty were somewhat lower than estimates for the full sample of low-income adults
14. Sommers BD, Blendon RJ, Orav EJ. Both the "private option" and traditional Medicaid expansions improved access to care for low-income adults. Health Aff (Millwood). 2016;35(1):96-105
15. Cole MB, Galárraga O, Wilson IB, Wright B, Trivedi AN. At federally funded health centers, Medicaid expansion was associated with improved quality of care. Health Aff (Millwood). 2017;36(1):40-8
16. Long SK, Karpman M, Kenney GM, Zuckerman S, Wissoker D, Shartzer A, et al. Taking stock: gains in health insurance coverage under the ACA as of March 2015 [Internet]. Washington (DC): Urban Institute; 2015 Apr 16 [cited 2017 Mar 24]. Available from: http://hrms.urban.org/briefs/Gains-in-Health-Insurance-Coverage-under-the-ACA-as-of-March-2015.html
17. Frean M, Gruber J, Sommers BD. Premium subsidies, the mandate, and Medicaid expansion: coverage effects of the Affordable Care Act [Internet]. Cambridge (MA): National Bureau of Economic Research; 2016 Apr [cited 2017 Mar 24]. (NBER Working Paper No. 22213). Available for download (fee required) from: http://www.nber.org/papers/w22213
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