State medicaid expansions did not erode perceived access to care or increase emergency services

April 8, 2014

Previous expansions in Medicaid eligibility by states were not associated with an erosion of perceived access to care or an increase in emergency department (ED) use.

In January 2014, the Patient Protection and Affordable Care Act (ACA) expanded Medicaid eligibility so coverage in the public insurance program could be offered to more low-income Americans. However, some have suggested that the demand for medical services created by Medicaid expansion may erode access to care for individuals already enrolled in Medicaid, which can be restrictive.

The authors examined previous Medicaid expansions to gauge self-reported perceptions of access to care and the use of ED services by enrollees. The authors examined data from 1,714 adult Medicaid enrollees in 10 states that expanded Medicaid between June 2000 and October 2009, and from 5,097 Medicaid enrollees in 14 bordering states that did not expand Medicaid.

In Medicaid expansion states, the proportion of Medicaid enrollees reporting poor access to care declined from 8.5 percent before the expansion to 7.3 percent after the expansion. In the control states where Medicaid was not expanded, enrollees reporting poor access to care remained constant at 5.3 percent. The proportion of Medicaid enrollees reporting use decreased from 41.2 percent to 40.1 percent in expansion states and from 37.3 percent to 36.1 percent in states that did not expand Medicaid.

"We found no evidence that expanding the number of individuals eligible for Medicaid coverage eroded perceived access to care or increased the use of emergency services among adult Medicaid enrollees," said Chima D. Ndumele, Ph.D., of the Yale School of Public Health, New Haven, Conn., and the Brown University School of Public Health, Providence, R.I., and colleagues in their JAMA Internal Medicine paper.

Explore further: Fed gov to cover 100% of new Medicaid enrollees under ACA

More information: JAMA Intern Med. Published online April 7, 2014. DOI: 10.1001/jamainternmed.2014.588

Related Stories

Fed gov to cover 100% of new Medicaid enrollees under ACA

April 4, 2013

(HealthDay)—The Department of Health and Human Services (HHS) announced the federal government will pay 100 percent of the costs of certain newly eligible adult Medicaid beneficiaries under the Affordable Care Act.

Recommended for you

Big Data can save lives, says leading cancer expert

May 16, 2016

The sharing of genetic information from millions of cancer patients around the world could be key to revolutionising cancer prevention and care, according to a leading cancer expert from Queen's University Belfast.

New soap to ward off malaria carrying mosquitoes

May 13, 2016

(Medical Xpress)—Gérard Niyondiko along with colleagues Frank Langevin and Lisa Barutel has posted a project on the crowd source funding site ulule for a product called Faso Soap. They claim the soap can cut in half the ...

Smartphones uncover how the world sleeps

May 6, 2016

A pioneering study of worldwide sleep patterns combines math modeling, mobile apps and big data to parse the roles society and biology each play in setting sleep schedules.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.