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

Health Affairs
Benjamin D SommersArnold M Epstein

Abstract

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 ...Continue Reading

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Citations

May 18, 2018·American Journal of Public Health·Lynn A BlewettGiovann Alarcon
Nov 14, 2017·Health Services Research·Glen P MaysAlan M Zaslavsky
Jun 21, 2018·Health Affairs·Benjamin D SommersArnold M Epstein
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Jul 19, 2019·American Journal of Public Health·Lindsay C KobayashiLisa F Berkman
Sep 7, 2019·JAMA : the Journal of the American Medical Association·Heidi Allen, Benjamin D Sommers
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Aug 26, 2020·Social Work in Public Health·Maria E TorresHannah Karpman

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