Harvard Study Connects Medicaid Expansion to Improved Quality and Access to Health Care
August 15, 2016 09:37 AM
A new study by researchers at Harvard T.H. Chan School of Public Health found that in Kentucky and Arkansas—states that have expanded Medicaid coverage under the Affordable Care Act (ACA)— low-income adults reported higher quality care and improved health compared to low-income adults in Texas, which has not expanded Medicaid coverage. The low-income adults in Kentucky and Arkansas also received more primary and preventative care and made fewer emergency departments visits. The study was published August 8, 2016 in JAMA Internal Medicine.
“Health insurance matters to people’s health,” said lead author Benjamin Sommers, assistant professor of health policy and economics at Harvard Chan School and assistant professor of medicine at Harvard Medical School. “Our study shows that with health insurance, whether it’s Medicaid or private coverage, people can better afford their medical care, get more preventive care and chronic disease management, and ultimately achieve better overall health.”
More than 30 states and the District of Columbia so far have chosen to expand coverage under the ACA.
The authors surveyed approximately 9,000 low-income adults in Arkansas, Kentucky, and Texas from late 2013 to the end of 2015. They found the following results:
Between 2013 and 2015, the uninsured rate dropped from 42% to 14% in Arkansas and from 40% to 9% in Kentucky, compared with a much smaller change in Texas (39% to 32%).
Expansion also was associated with significantly increased access to primary care, improved affordability of medications, reduced out-of-pocket spending, reduced likelihood of emergency department visits, and increased outpatient visits.
Screening for diabetes, glucose testing among people with diabetes, and regular care for chronic conditions all increased significantly after expansion.
Quality of care ratings improved significantly, as did the number of adults reporting excellent health.
Other Harvard Chan School authors included Robert Blendon, E. John Orav, and Arnold Epstein.
This project was supported by a research grant from the Commonwealth Fund.
The study is called: “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” Benjamin D. Sommers, Robert J. Blendon, E. John Orav, Arnold M. Epstein, JAMA Internal Medicine, online August 8, 2016, doi: 10.1001.jamainternmed.2016:4419