In states without Medicaid expansion, poor more likely to go without medical care, GAO study finds

Uninsured adults with incomes low enough to qualify for expanded Medicaid eligibility under the Affordable Care Act—but who did not live in an expansion state—were more likely to go without necessary healthcare services, according to a new study from the Government Accountability Office.

Looking at data from the 2016 National Health Interview Survey, the nonpartisan GAO (PDF) found that 20% of low-income adults in nonexpansion states reported they could not afford needed medical care, compared with 9.4% of low-income adults in expansion states.

Of those uninsured, low-income individuals that qualified for Medicaid expansion, but did not live in an expansion state, the majority were male and more than half were employed. Most had incomes less than 100% of the federal poverty level, the study said.

An estimated 5.6 million people qualified for expanded Medicaid eligibility with about 3.7 million of those people living in nonexpansion states. In all, Medicaid covered 72.2 million individuals in the U.S. a cost of $575.9 billion that year.

RELATED: Rural states have the most to gain with Medicaid expansion, study suggests

The study also found that in expansion states: 

  • 10% of low-income adults in expansion states reported they could not afford their prescription drugs, compared with 18% in nonexpansion states. 
  • 82% of low-income adults in expansion states reported having a usual place for care when they were sick, compared with 68% of low-income adults in nonexpansion states. 
  • 31% of low-income adults in expansion states reported receiving flu vaccines, compared with 24% of low-income adults in nonexpansion states.
  • 49% of low-income adults in expansion states received cholesterol checks, compared with 42% in nonexpansion states.

RELATED: Expansion holdouts, unbalanced reporting measures could be hurting rural providers