Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health

Abstract

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Medicaid Expansion, Mental Health, and Access to Care among Childless Adults with and without Chronic Conditions

“…33,34 Several recent studies also used BRFSS to examine trends in health insurance and health outcomes associated with the ACA Medicaid expansion. 7,16,35 One study, by Courtemanche et al, found no association between Medicaid expansion and the health outcomes we examined. 35 However, we isolated the population most likely to benefit from the Medicaid expansion-childless adults with chronic conditions-while others analyzed broader low-income populations.…”

The affordable care act and ambulance response times

“…As noted in the introduction, several recent studies have examined the effect of the ACA on health insurance coverage (Courtemanche et al, 2017a;Courtemanche et al, 2017b;Frean et al, 2017). 11 Our interest in re-visiting this effect is twofold.…”

“…In the United States alone, these interventions include Medicaid (Currie and Gruber, 1996a;Dafny and Gruber, 2005;Baicker et al, 2013;Finkelstein et al, 2012;Taubman et al, 2014;Tello-Trillo, 2016), Medicare (Lichtenberg, 2002;Card et al, 2008), the Massachusetts universal coverage initiative (Miller, 2012a;Kolstad and Kowalski, 2012;Van der Wees et al, 2013), the 2010 expansion of coverage to young adults under the ACA (Sommers et al, 2013;Antwi et al, 2015; Barbaresco et al, 2015) and the various ACA provisions that took effect in 2014 (Sommers et al, 2015;Courtemanche et al, 2017b;Simon et al, 2017;Miller and Wherry 2017). 3 Whether increased utilization actually results in better health outcomes of patients is, however, still an open question.…”

“…By contrast, despite improving selfassessed health, the randomized Oregon Medicaid expansion had little to no impact on clinically measured health outcomes, and actually led to an increase in emergency room utilization (Baicker et al, 2013;Finkelstein et al, 2012;Taubman et al, 2014). The private insurance portion of the ACA seems to have improved access to care, but the evidence with regard to its effect on self-assessed health is decidedly mixed (Sommers et al, 2015;Courtemanche et al, 2017b). Several studies have found that the Medicaid expansion under the ACA led to modest access gains for patients, but had no discernable effect on self-assessed health (Sommers et al, 2015;Courtemanche et al, 2017b;Simon et al, 2017).…”

“…The private insurance portion of the ACA seems to have improved access to care, but the evidence with regard to its effect on self-assessed health is decidedly mixed (Sommers et al, 2015;Courtemanche et al, 2017b). Several studies have found that the Medicaid expansion under the ACA led to modest access gains for patients, but had no discernable effect on self-assessed health (Sommers et al, 2015;Courtemanche et al, 2017b;Simon et al, 2017).…”