Medicaid expansion significantly boosts insurance coverage among low-income adults

April 20, 2016

Medicaid expansion significantly boosts insurance coverage among low-income adults


IHPI member Sarah Miller, Ph.D. is co-author of a new paper in Annals of Internal Medicine, and IHPI member Jeffrey Kullgren, M.D., M.S., M.P.H., was invited to write the editorial commenting on the work.  

The focus of both: The impact of Medicaid expansion on insurance coverage and care for low-income adults. 

An excerpt from the press release about the study, issued by UCLA, the home institution of the study's lead author: 

Researchers have that found states that expanded Medicaid coverage under the Affordable Care Act saw a significant increase in rates of health insurance among low-income adults compared with states that did not expand the program.

The study, published in the peer-reviewed Annals of Internal Medicine, also found improved quality of coverage, more frequent use of health care, and increased rates of diagnoses for chronic health conditions.

“Our findings are informative for residents and policymakers in states with ACA Medicaid expansions in place because it will help them understand the impacts of those expansions,” said Laura Wherry, assistant professor of medicine at the David Geffen School of Medicine at UCLA, and the study’s lead author. “It is also informative for policymakers and voters who are considering whether to expand Medicaid in their states because it will help them gauge the potential impacts of a Medicaid expansion in their states.”

Though a key part of the ACA was the expansion of Medicaid in every state to all adults earning up to 138 percent of the federal poverty level, a subsequent U.S. Supreme Court decision left the decision of whether to expand the program up to the states. As a result, only 26 states and Washington D.C. had expanded Medicaid in 2014, the first year of the provision and the period the researchers examined.

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An excerpt from Kullgren's editorial: 

The study by Wherry and Miller in this week's Annals... provides a timely analysis of national survey data from 40 427 adults who met eligibility criteria for Medicaid expansion under the ACA, should inform such debates going forward.


In sum, Wherry and Miller's study provides fresh insight into the early effects of post-ACA Medicaid expansions. In doing so, it clarifies not only what is happening in states that have expanded Medicaid and what states considering doing so can anticipate but also what is foregone by states that reject the ACA's opportunity to expand Medicaid. Whether these data will change the minds of policymakers or even refocus debates about Medicaid expansion on facts rather than opinions remains to be seen. Nevertheless, this study provides initial data and generates questions for future research that together have great potential to help states in their decisions about Medicaid expansion. How states decide will ultimately affect the health and well-being of many low-income Americans.


Examples of news coverage of the study and editorial: 

CBS News


US News & World Report

Healthcare Finance News