Virginia Medicaid Expansion: New Members Report Reduced Financial Concerns During The COVID-19 Pandemic

Effects of the Affordable Care Act Medicaid Expansions on Mental Health During the COVID-19 Pandemic in 2020-2021

“…Before the pandemic, Medicaid expansion has been associated with a reduction in financial distress, 68 specifically among non-Hispanic Black individuals. 24 Because coverage protects against the financial shocks of unexpected catastrophic medical events, it may confer "feelings of security" that may improve mental health among individuals that are more likely to be impacted. 18,22 However, BRFSS does not provide data to investigate these potential mechanisms, which we leave for future research.…”

“…With added shocks to mental health during the pandemic and disruptions to insurance coverage and access to essential mental health care services, one hypothesis is that Medicaid coverage for low-income individuals in expansion states may have buffered against some of the adverse impacts on mental health by providing greater access to needed mental health services (such as access to prescription drugs or mental health care providers providing psychotherapy via telehealth) compared to similar income individuals without Medicaid coverage in non-expansion states. Furthermore, Medicaid coverage during the pandemic may have conferred additional financial security in the event of losing a job or employer-sponsored coverage 24,25 or illness, which has been associated with higher rates of anxiety, depression, and substance abuse. 26 Therefore, in this study, we examine whether the prior ACA Medicaid expansions provided an added benefit to the mental health of low-income individuals compared to non-expansion states during the pandemic.…”

Medicaid can and should play an active role in advancing health equity

“…While Medicaid expansion has improved health and social needs outcomes for its members, 15,16 findings regarding improvements in health equity are mixed 17–20 . After Medicaid expansion, Black and Latino populations experienced larger reductions in uninsurance rates compared to White populations but remained more likely to be uninsured than White populations 12 .…”

“…While Medicaid expansion has improved health and social needs outcomes for its members, 15,16 findings regarding improvements in health equity are mixed. [17][18][19][20] After Medicaid expansion, Black and Latino populations experienced larger reductions in uninsurance rates compared to White populations but remained more likely to be uninsured than White populations. 12 Further, other studies document no reduction in disparities in receiving flu shots, accessing primary care, 21 or cancer screening between Black and White Medicaid members.…”

“…[22][23][24] However, other evidence suggests that Black Medicaid members experienced a greater reduction in worrying about paying for health care costs and housing compared to White members after expansion. 17,25 Perhaps this mixed evidence is not surprising given that improving equity has not historically been a stated policy goal of public health coverage, although this is changing in Medicaid.…”