Medicaid Expansion Found to Improve Care, Patient Health

A recent study found that Medicaid expansion under the Affordable Care Act was associated with low-income adults receiving better healthcare.

After 2 years, low-income adults in Kentucky and Arkansas received more primary and preventative care, had fewer emergency department visits, and a higher quality of care compared with low-income adults in Texas, according to a study published by JAMA Internal Medicine.

Kentucky expanded their Medicaid using managed care, and Arkansas expanded using Medicaid funding to subsidize private insurance. Researchers found that both expansion options had similar benefits for beneficiaries.

“What this means is that it doesn't matter so much how states expand coverage,” said lead author Benjamin Sommers, PhD. “What matters is whether they expand at all.”

In the study, researchers surveyed 9000 low-income adults in the expanded states of Arkansas and Kentucky, and the unexpanded state of Texas from 2013 to 2015. Researchers discovered that the uninsured rate decreased from 42% to 14% in Arkansas, and from 40% to 9% in Kentucky.

However, they found that the Texas uninsured rate only decreased from 39% to 32% during this time.

Medicaid expansion was also associated with increased access to primary care, affordability of medication, lower out-of-pocket costs, reduced emergency department visits, and increased outpatient visits, according to the study. Diabetes screening, glucose testing, and care for chronic conditions also improved in the states that expanded Medicaid.

Researchers also found that patient-reported quality of care and health status improved.

“Health insurance matters to people's health,” Dr Sommers concluded. “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.”