Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers.
J Prim Care Community Health
; 8(4): 206-212, 2017 Oct.
Article
en En
| MEDLINE
| ID: mdl-28513249
ABSTRACT
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Medicaid
/
Pacientes no Asegurados
/
Centros Comunitarios de Salud
/
Cobertura del Seguro
/
Patient Protection and Affordable Care Act
/
Seguro de Salud
Límite:
Adult
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Female
/
Humans
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Male
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Prim Care Community Health
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos