Our expert answers 3 Questions
I am thinking a lot about all things Affordable Care Act (ACA), but especially the insurance coverage expansions that went into effect. Michigan was one of the states that chose to expand its Medicaid program, but it did so with its own model, the Healthy Michigan Plan. Over the next several years, a team from IHPI will be conducting a formal evaluation of the Healthy Michigan Plan. We will be examining its effect on a range of important outcomes, including health insurance coverage, access to care, health behaviors and enrollee health status.
The Affordable Care Act represents the largest expansion of health insurance coverage since Medicare and Medicaid were established in the 1960s. We have decades of research documenting how insurance coverage affects the utilization of health care, but much of that evidence comes from either cross-sectional differences in coverage or modest expansions of public programs. The ACA expansions represent a much larger shock to the system than previous policy initiatives, so their effect may be quite different. In particular, increased insurance coverage will only translate to improved access to care if providers have adequate capacity to meet the increased demand.
The expansion of health insurance coverage—both Medicaid and private insurance through the newly established marketplaces—is likely to have profound implications for patients and providers. One of the things we will be studying in our evaluation is the effect on the amount of uncompensated care provided by Michigan hospitals.