Medicaid Expansion Has Reduced the Uninsured and Uncompensated Care Costs and Improved Health Outcomes

	Of Interest
A Review of 404 Studies Finds ACA Medicaid Expansion Has Reduced the Uninsured Rate and Uncompensated Care Costs, While Increasing Affordability and Access to Care and Potentially Contributing to State Budget Savings    More Recent Research Shows Improved Health Outcomes Multiple studies over the last six years find that the Affordable Care Act’s Medicaid expansion has increased health coverage, affordability, and access to care while reducing uncompensated care costs for hospitals and clinics and potentially contributing to budget savings for states, according to a KFF review of more than 400 studies and policy reports. The literature review, with 80 studies newly included since our August 2019 update, provides a useful reference on the effects of Medicaid expansion a decade after the ACA became law, and at a time when more states are considering expansion. To date, 36 states and the District of Columbia have adopted the expansion. Later this year the Supreme Court will hear arguments in Texas v. U.S., the legal challenge that could roll back the Medicaid expansion and other provisions of the ACA. Key findings from the research review include: Recent analyses show that Medicaid expansion is associated with decreased mortality. A 2019 national study found expansion was associated with a decline in annual mortality among near-elderly adults, driven largely by reductions in disease-related deaths, an effect that translates to about 19,200 deaths that were averted during the first four years of expansion. Additional studies suggest that expansion has contributed to reductions in mortality rates for certain specific conditions. Expansion states experienced significant coverage gains and reductions in uninsured rates among the low-income population broadly and within specific vulnerable populations. The current spread of the novel coronavirus and the sometimes fatal COVID-19 disease it causes has renewed concerns about the uninsured and how they will fare in a crisis. Multiple studies suggest that expansion can result in state savings through the infusion of federal funds and by offsetting state costs in other areas. Additional studies show that expansion results in reductions in uncompensated care costs for hospitals and clinics. Medicaid expansion has improved access to care, utilization of services, the affordability of care, and financial security among the low-income population. Findings on expansion’s effect on provider capacity are mixed, with studies showing increases, decreases, or no effects on measures like appointment availability or wait times. The literature review covers studies, analyses and reports published by government, research and policy organizations between January 2014 and January 2020, using data from 2014 or later. For the full report, as well as other KFF data and analyses regarding Medicaid expansion, visit kff.org. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.
Contact: Chris Lee | (202) 347-5270 | clee@kff.org
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