Medicaid Expansion Hasn't Eroded Perceived Care Access

No increase in reported use of emergency department services seen either

THURSDAY, April 10, 2014 (HealthDay News) -- Previous Medicaid expansions did not diminish perceived access to care, according to a study published online April 7 in JAMA Internal Medicine.

Chima D. Ndumele, Ph.D., from the Yale School of Public Health in New Haven, Conn., and colleagues assessed the effect of previous Medicaid expansions on self-reported access to care and the use of emergency department services. Reports by 1,714 adult Medicaid enrollees in 10 states that expanded Medicaid (June 1, 2000, to Oct. 1, 2009) and 5,097 Medicaid enrollees in 14 bordering control states that did not expand Medicaid were analyzed.

The researchers found that the mean income eligibility level increased from 82.6 to 144.2 percent of the federal poverty level in states with expanded programs, but remained constant at 77.1 percent of the federal poverty level in control states. With expansion, the proportion of adults reporting being enrolled in Medicaid increased from 7.2 to 8.8 percent. After expansion, the proportion of Medicaid enrollees reporting poor access to care declined from 8.5 percent before the expansion to 7.3 percent after the expansion, whereas a constant 5.3 percent reported poor access in control states. Emergency department use decreased from 41.2 to 40.1 percent in expansion states and from 37.3 to 36.1 percent in control states.

"We found no evidence that expanding the number of individuals eligible for Medicaid coverage eroded perceived access to care or increased the use of emergency services among adult Medicaid enrollees," the authors write.

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