Health Affairs Web First: ACA Improved Medical Care And Health Among Low-Income Adults

As the Senate evaluates potential changes to the Affordable Care Act (ACA), a new study, released today by Health Affairs as a Web First, examines the effects of gaining insurance coverage. The authors evaluated telephone survey data of low-income adults from 2013 through 2016 in three states: Kentucky, which expanded Medicaid; Arkansas, which expanded private insurance to low-income adults through the federal Marketplace; and Texas, which did not expand coverage to this group.

According to the study, by the end of 2016, the uninsurance rate in the two expansion states (Kentucky and Arkansas) had dropped by more than 20 percentage points relative to Texas. For the newly insured, 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 visits and glucose screening tests, and a 23-percentage-point increase in “excellent” self-reported health. The authors calculated a 56-percentage-point increase in obtaining regular medical care for those in the sample with chronic health conditions.

“As policy makers debate the ACA’s future and additional states consider whether to expand Medicaid, our findings demonstrate the benefits associated with coverage expansion for low-income adults, including those with chronic conditions,” the authors conclude. “With the Arkansas and Kentucky approaches producing similar results, our results imply that while coverage expansion is important for patients, the type of coverage obtained is less critical.”

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