By several different measures, low-income individuals in two states that expanded Medicaid under the Affordable Care Act were better off than those in a state that didn’t expand eligibility, according to new research.
The study, published this week in the journal Health Affairs, examined changes in self-reported health and healthcare use for individuals in Kentucky, Arkansas and Texas.
Kentucky expanded Medicaid under the ACA, while Texas did not. Arkansas, on the other hand, secured a waiver that allowed it to use federal Medicaid funds to purchase private insurance for low-income individuals on the federal marketplace.
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As of the end of 2016, or three years into Medicaid expansion, Kentucky’s uninsured rate had dropped to 7.4%, and Arkansas’ was down to 11.7%. Between 2013 and 2014, both states also led the nation in reducing their uninsured rates, per a previous poll. In Texas, on the other hand, the uninsured rate was 28.2% at the end of 2016.
Among low-income adults who gained coverage in Kentucky and Arkansas, there were other benefits: they experienced a $337 reduction in annual out-of-pocket costs; 41% increase in having a usual source of care, 23% increase in “excellent” self-reported health; and significant increases in preventive health visits and glucose testing.
For those with chronic conditions—individuals who account for a large share of healthcare spending—there were improvements in regularity and affordability of care, medication adherence and self-reported health.
The three-state study echoes another recent study, also published in Health Affairs, which found that as of 2015, states that expanded Medicaid saw greater declines in uninsured rates for low-income adults compared to states that declined to expand eligibility.