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The effect of medicaid expansion on access to healthcare, health behaviors and health outcomes between expansion and non-expansion states

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  • Romero, Toni
  • Ponomariov, Branco

Abstract

In 1965, Medicaid was implemented with the goal of providing insurance to low-income individuals. In 2010, the Patient Protection Affordable Care Act (PPACA) standardized and expanded the eligibility criteria for the Medicaid program across the United States. In 2012, the constitutionality of this expansion was challenged and the Supreme Court rules that states were only required to expand their Medicaid program if they wanted to utilize the additional funds allotted by the federal government. This research paper examines the effects of the expansion by looking at health data in expansion and non-expansion states. Specifically, this study compares metrics designed to gauge healthcare access, health behaviors and health outcomes to determine if expansion has had positive overall effect on expansion states. We conclude that expansion states have demonstrated improved access to healthcare and improved health outcomes than the non-expansion states. Changes in health behaviors reflect mixed results – HIV screenings are higher in expansion states but participation in flu vaccinations show no statistical significance difference between the two groups. Given the results of this analysis, we conclude that Medicaid expansion is an effective policy for states to pursue in order to further the original objectives of Medicaid by improving the health of low-income recipients.

Suggested Citation

  • Romero, Toni & Ponomariov, Branco, 2023. "The effect of medicaid expansion on access to healthcare, health behaviors and health outcomes between expansion and non-expansion states," Evaluation and Program Planning, Elsevier, vol. 99(C).
    • Handle: RePEc:eee:epplan:v:99:y:2023:i:c:s0149718923000812
    DOI: 10.1016/j.evalprogplan.2023.102304
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    References listed on IDEAS

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    1. DeVoe, J.E. & Fryer, G.E. & Phillips, R. & Green, L., 2003. "Receipt of Preventive Care among Adults: Insurance Status and Usual Source of Care," American Journal of Public Health, American Public Health Association, vol. 93(5), pages 786-791.
    2. Xuesong Han & Binh T Nguyen & Jeffrey Drope & Ahmedin Jemal, 2015. "Health-Related Outcomes among the Poor: Medicaid Expansion vs. Non-Expansion States," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-11, December.
    3. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
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