- Medicaid expansion was associated with improved quality of care and health outcomes among low-income U.S. adults, a 22.7 percentage-point reduction in the uninsured rate, and increased access to healthcare services, according to a study published Monday in JAMA Internal Medicine.
- The study researchers compared data from November 2013 through December 2015 on U.S. citizens in Kentucky, Arkansas, and Texas aged 19 to 64 years old with incomes below 138% of the federal poverty level.
- Such expansion was associated with an increase of access to primary care (by 12.1 percentage points), according to the authors.
Expanding access to Medicaid services was one of the biggest milestones in the Obama's administration plan for healthcare reform. However, some states continue to forgo expansion plans. As of July 7, 31 states and the District of Columbia had expanded Medicaid, according to the Kaiser Family Foundation.
Kentucky opted to expand the program in 2014. More than 400,000 residents, representing more than 10% of the state population, enrolled in Medicaid – an 87% increase in average monthly enrollment from 2013. Arkansas used Medicaid funds to purchase private coverage for low-income adults while Texas has not expanded the program whatsoever.
HHS Secretary Sylvia Burwell says it is only a matter of time before all states adopt expansions, citing a higher rate of hospital closures in non-expansion states; and the number of working people who remain uninsured. "Helping people who are working and playing by the rules is something that is an important concept most people agree on," she said in February.
The Urban Institute last month reported the country's uninsured rate would decrease by an additional 5 million individuals if all of the remaining states were to adopt Medicaid expansion in 2017. Texas, Georgia, and Florida would have the biggest drops, according to the analysis.
Other notable study findings from the JAMA study show that Kentucky's expanded Medicaid program and Arkansas' private option include reductions in ER visits, as well as increases in outpatient visits, preventive care, and the number of adults who are reportedly in "excellent health." In addition, expansion was associated with quality of care ratings noting with a reduction in “fair/poor quality of care” by 7.1 percentage points.
"Aside from the type of coverage obtained, outcomes were similar for nearly all other outcomes between the two states using alternative approaches to expansion," the researchers concluded.
From a politics standpoint, the study doesn't paint a good picture for Kentucky's governor Matt Bevin (R) who earlier this year stated he would reverse the state's Medicaid expansion. While he later toned down his promises and stated he would seek a federal waiver to make changes to the program, subverting a program associated with positive health outcomes for a large amount of voters can't be a good strategy for the health of a population.