Health Affairs: ACA narrowed healthcare access gap

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Under the ACA, the U.S. has seen reduced socioeconomic disparities in terms of access to healthcare.

The ACA has narrowed socioeconomic disparities in access to healthcare, according to researchers at Boston University School of Public Health.

The study, appearing in Health Affairs, looks at the effect policies enacted under the ACA have had on reducing socioeconomic disparities. Using survey data from the Behavioral Risk Factor Surveillance System collected between 2011 and 2015, the researchers found a substantial reduction in coverage gaps between lower- and higher-income households.

According to the study, the populations that benefited most from the ACA included low-income workers, the unemployed and individuals who lacked a college degree.

Researchers noted significantly more progress in states which took advantage of Medicaid expansion offered under the ACA. The reduction in the gap between lower- and higher-income households was 46% in Medicaid expansion states, twice as high as the reduction noted in states that did not expand their Medicaid programs.

In all, the researchers found Medicaid expansion to be responsible for roughly half the overall gains in access to care over the first two years of the ACA’s full implementation.

The study comes as Republicans in Congress continue to seek a way to repeal and/or replace the ACA, and amid studies raising questions over whether the reduction in uninsured patients generated by Medicaid expansion will lead to benefits beyond a change in payer mix, such as improved outcomes or an eventual reduction in emergency room visits.

The study’s authors suggest plans that affect subsidies for Medicaid expansion will likely reverse the progress made in narrowing socioeconomic gaps in access to care.

The authors admit that the effect those gains in access might have on other quality metrics or outcomes remains to be seen, however.

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