Affordable Care Act Coverage Expansions Associated With Economic, Health Benefits

Insurance coverage expansions under the Affordable Care Act (ACA) had measurable economic and health benefits for low-income adults and those with chronic conditions, according to research partially funded by AHRQ and published in Health Affairs. Researchers examined the status of low-income adults in three states: Arkansas, which expanded private insurance to low-income adults using the ACA-enabled federal marketplace; Kentucky, which expanded Medicaid under the ACA; and Texas, which did not expand coverage at all. Over the three-year study period ending in 2016, the uninsured rates in Arkansas and Kentucky dropped by more than 20 percentage points compared with Texas, researchers found. For previously uninsured adults, newly acquired health coverage was associated with a 41 percentage-point increase in having a usual source of care, a $337 per person reduction in annual out-of-pocket spending, significant increases in preventive health visits and glucose testing, and a 23 percentage-point increase in self reports of “excellent” health. Among adults with chronic conditions, researchers found improvements in affordability of care, regular care, medication adherence and self-reported health. Access the abstract.

Three-Year Impacts Of The Affordable Care Act: Improved Medical Care And Health Among Low-Income Adults. - PubMed - NCBI

2017 May 17. pii: 10.1377/hlthaff.2017.0293. doi: 10.1377/hlthaff.2017.0293. [Epub ahead of print]

Three-Year Impacts Of The Affordable Care Act: Improved Medical Care And Health Among Low-Income Adults.

Sommers BD1, Maylone B2, Blendon RJ3, Orav EJ4, Epstein AM5.

Author information

Abstract

Major policy uncertainty continues to surround the Affordable Care Act (ACA) at both the state and federal levels. We assessed changes in health care use and self-reported health after three years of the ACA's coverage expansion, using survey data collected from low-income adults through the end of 2016 in three states: Kentucky, which expanded Medicaid; Arkansas, which expanded private insurance to low-income adults using the federal Marketplace; and Texas, which did not expand coverage. We used a difference-in-differences model with a control group and an instrumental variables model to provide individual-level estimates of the effects of gaining insurance. By the end of 2016 the uninsurance rate in the two expansion states had dropped by more than 20 percentage points relative to the nonexpansion state. For uninsured people gaining coverage, this change was associated with a 41-percentage-point increase in having a usual source of care, a $337 reduction in annual out-of-pocket spending, significant increases in preventive health visits and glucose testing, and a 23-percentage-point increase in "excellent" self-reported health. Among adults with chronic conditions, we found improvements in affordability of care, regular care for those conditions, medication adherence, and self-reported health.

Project HOPE—The People-to-People Health Foundation, Inc.