Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers

Details

• Alternative Title:
  J Prim Care Community Health
• Personal Author:
  Huguet, Nathalie ; Hoopes, Megan J. ; Angier, Heather ; Marino, Miguel ; Holderness, Heather ; DeVoe, Jennifer E.
• Description:
  Background
  
  It is crucial to understand the impact of the Affordable Care Act (ACA). This study assesses changes in insurance status of patients visiting community health centers (CHCs) comparing states that expanded Medicaid to those that did not.
  
  Methods
  
  Electronic health record data on 875,571 patients aged 19 to 64 years with ≥ 1 visit between 2012 and 2015 in 412 primary care CHCs in 9 expansion and 4 nonexpansion states. We assessed changes in rates of total, uninsured, Medicaid-insured, and privately insured primary care and preventive care visits; immunizations administered, and medications ordered.
  
  Results
  
  Rates of uninsured visits decreased pre- to post-ACA, with greater drops in expansion (−57%) versus nonexpansion (−20%) states. Medicaid-insured visits increased 60% in expansion states while remaining unchanged in nonexpansion states. Privately insured visits were 2.7 times higher post-ACA in nonexpansion states with no increase in expansion states. Comparing 2015 with 2014: Uninsured visit rates continued to decrease in expansion (−28%) and nonexpansion states (−19%), Medicaid-insured rates did not significantly increase, and privately insured visits increased in nonexpansion states but did not change in expansion states.
  
  Conclusions
  
  Medicaid expansion and subsidies to purchase private coverage likely increased the accessibility of health insurance for patients who had previously not been able to access coverage.
  
  
• Subjects:
  Affordable Care Act
• Source:
  J Prim Care Community Health. 8(4):206-212.
• Pubmed ID:
  28513249
• Pubmed Central ID:
  PMC5665709
• Document Type:
  Journal Article
• Funding:
  R01 CA181452/CA/NCI NIH HHS/United States ; R01 CA204267/CA/NCI NIH HHS/United States ; R01 HS024270/HS/AHRQ HHS/United States ; U18 DP006116/DP/NCCDPHP CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  8
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:075354b6afa8a2337a2fd99a5248cc74acf431ea7d9fb6496788f10844cabb0f
• Download URL:
  https://stacks.cdc.gov/view/cdc/49555/cdc_49555_DS1.pdf
• File Type:
  [PDF - 133.43 KB ]