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

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 en...

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Vydáno v:Health Affairs Ročník 36; číslo 6; s. 1119 - 1128
Hlavní autoři: Sommers, Benjamin D., Maylone, Bethany, Blendon, Robert J., Orav, E. John, Epstein, Arnold M.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States The People to People Health Foundation, Inc., Project HOPE 01.06.2017
Témata:
Adhesion
Adult
Adults
Affordability
Bias
Censuses
Chronic conditions
Chronic illnesses
Diagnostic Self Evaluation
Drugs
Economic indicators
Estimates
Expenditures
Female
Glucose
Health care
Health care expenditures
Health care policy
Health Expenditures - trends
Health insurance
Health services
Humans
Income
Indigent care
Individual differences
Insurance
Insurance coverage
Insurance Coverage - statistics & numerical data
Low income groups
Male
Markets
Mathematical models
Medicaid
Medicaid - statistics & numerical data
Medically Uninsured - statistics & numerical data
Middle Aged
Patient Protection & Affordable Care Act 2010-US
Patient Protection and Affordable Care Act
Personal expenditure
Population
Poverty
Preventive Health Services - utilization
Preventive medicine
Public health
Self report
States
Trends
Uncertainty
Uninsured people
United States
United States > US
Arkansas
Texas
Kentucky
Access To Care
Insurance Coverage < Insurance
Medicaid
Health Reform
ISSN:0278-2715, 2694-233X, 1544-5208, 2694-233X
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Popis
Shrnutí: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.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0278-2715
2694-233X
1544-5208
2694-233X
DOI:10.1377/hlthaff.2017.0293