New Analysis Summarizes Recent Research on
the Effects of ACA Medicaid Expansion, Providing Context for Renewed
Expansion Debates in States
New federal financial
incentives for Medicaid expansion and the increased reliance on Medicaid
as a coverage safety net during the pandemic have renewed debate in the
12 states that have not adopted the Medicaid expansion under the
Affordable Care Act.
A new KFF
literature review provides context for these expansion debates
by summarizing evidence from nearly 200 studies about the effects of
Medicaid expansion that were published between February 2020 and March
2021. These studies generally have found beneficial effects across a range
of areas, including:
- Increased
coverage and access to care among populations with cancer, chronic
disease, and/or disabilities. Studies also find that Medicaid
expansion has improved overall mortality rates as well as mortality
rates associated with some specific health conditions, such as
different types of cancer, cardiovascular disease, and liver
disease.
- Improvements
in outcomes related to sexual and reproductive health, including
increased postpartum insurance coverage and use of care among pregnant
women and mothers.
- Improvements
in access to care and outcomes related to substance use disorder
(SUD) as well as other mental health care.
- Beneficial
economic impacts on state budgets, hospitals, and other providers.
- A
narrowing of racial disparities in coverage and certain health
outcomes, with more limited evidence suggesting reduced racial
disparities in access to and use of care.
- Improvements
in different social determinants of health, including individual
economic stability and access to care in rural areas.
The new analysis of
recent studies builds on an earlier
report (examining over 400 studies) concluding that expansion
is linked to gains in coverage; improvements in access, financial security,
and some measures of health status/outcomes; and economic benefits for
states and providers.
Along with the benefits,
Medicaid expansion brings increases in Medicaid spending for states and
especially for the federal government, which covers 90 percent of the
cost.
For the full literature
review, as well as other data and analyses related to ACA Medicaid
expansion, visit
kff.org.
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