Dive Brief:
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Hospitals in Medicaid expansion states saw fewer uninsured inpatients for major cardiovascular events within one year of expansion compared to non-expansion states, according to a new JAMA Network study.
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The study of more than 3 million non-Medicare hospitalizations from inpatient databases across 30 states didn't, however, find any changes for in-hospital mortality rates in expansion or non-expansion states.
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The researchers reviewed data for major cardiovascular events, including acute myocardial infarction, stroke and heart failure. They looked at a mix of privately insured, uninsured and Medicaid recipients.
Dive Insight:
Cardiovascular disease is the leading primary diagnosis of all hospital discharges and the leading cause of death for both men and women in the U.S. The American Heart Association predicts heart disease costs will rise to nearly $750 billion by 2035.
Insurance status is connected to patient outcomes for cardiovascular disease, as well as many other conditions. For this study, researchers looked at non-Medicare hospitalizations between 2009 and 2014. The date range allowed them to compare numbers before Medicaid expansion and after states began expanding the program in January 2014.
The report found that expansion states saw a 5.8 percentage point decrease for uninsured hospitalizations after Medicaid expansion compared to non-expansion states. The expansion states also had an 8.4 percentage point increase in the Medicaid share after expansion compared to non-expansion states.
The researchers said more digging is needed to figure out how Medicaid expansion can play a role in affecting cardiovascular outcomes.
The study's findings were the latest to show the benefits of Medicaid expansion. A June Health Affairs report found that expansion improved access to care and quality of care. That analysis reviewed more than 70 studies on the subject and additionally found decreased hospital lengths-of-stay among newly insured beneficiaries.
Medicaid expansion was the major cause of more people getting health insurance after the Affordable Care Act. Expansion alone provided more than 14 million people with health insurance. So far, 34 states and the District of Columbia expanded the program to allow people at up to 400% of the federal poverty level. There are still more than a dozen states that haven't expanded, but ballot questions are planned in multiple states this fall.
Despite gains made via Medicaid expansion, detractors say adding more people to the program can cause state budget problems. As a way to reduce enrollment, a handful of states, including Kentucky, received work requirement waivers that would demand people on Medicaid work or perform volunteer duties. A federal judge spiked Kentucky's approval and CMS re-opened a request for comments on the plan. However, CMS may soon grant seven other states Medicaid waivers with work requirements.