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Medicaid expansion under the Affordable Care Act leads to better care and improves financial well-being for new enrollees

HHS logo - resized for WP - March 2016Over 90 percent of new Medicaid enrollees are satisfied with their plans and doctor

According to a new report summarizing research to date, 78 percent of new Medicaid enrollees indicated that absent Medicaid expansion under the Affordable Care Act (ACA), they wouldn’t otherwise have the resources necessary to access regular care. Additionally, the overwhelming majority of new Medicaid enrollees report being satisfied with their health plans (93 percent) and their doctors (92 percent).

The research also finds that Medicaid expansion improved the financial well-being for new enrollees, leading to fewer unpaid bills. According to estimates, Medicaid expansion reduced third party collections by $600 to $1000 per individual in expansion states.

“Today’s report is a clear reminder of the important role Medicaid expansion plays in improving access to quality, affordable care while addressing and improving overall health for millions of Americans,” said Secretary Sylvia M. Burwell. “This Administration remains committed to working with all remaining states toward Medicaid expansion so they too can realize lower uninsured rates, healthier populations, and significant economic benefits.”

The report reviews research that assesses the stability of health care delivery in Medicaid expansion states through key indicators such as increases in health care utilization and whether individuals report finding a usual place to receive care. The research finds that new Medicaid patients in expansion states are experiencing improved appointment availability with providers, and they are more likely to have been seen by a provider in the past year compared with their counterparts in non-expansion states. Further, compared with non-expansion states, enrollees in expansion states saw a 41 percent increase in preventive service visits in community health centers; access to Medicaid prescription drug refills increased 25.4 percent in states that expanded coverage, compared to only 2.8 percent in states that did not expand coverage; and cost-related barriers to dental care fell from 30 percent in 2013 prior to Medicaid expansion to 25 percent in 2014 post Medicaid expansion.  Finally, today’s report finds that in four Medicaid expansion states, the uninsured share of hospitalizations for people with HIV declined 60 percent compared to 8 percent in non-expansion states.

Recently, Louisiana became the 31st state (plus the District of Columbia) to have expanded Medicaid under the ACA. Residents in Louisiana can enroll in Medicaid expansion starting immediately, and can access services starting July 1, 2016. Since the beginning of the ACA’s first Open Enrollment Period in October 2013, Medicaid expansion states have experienced a 35.5 percent growth in enrollment compared to 10.4 percent growth in non-expansion states.

With the passage of the ACA, all states expanding Medicaid coverage to individuals with family incomes at or below 138 percent of the federal poverty level can claim increased federal matching funds. Health care costs for individuals made newly eligible through the Medicaid expansion are paid for with 100 percent federal funds in 2016, and 95 percent in 2017, scaling down to 90 percent in calendar years 2020 and beyond.

President Obama proposed in his 2017 Budget an extra incentive for states that have not yet expanded their Medicaid programs, which would provide any state that takes up Medicaid expansion the same three years of full Federal support and gradual phase down that those states that expanded in 2014 received.

To read today’s report, visit: https://aspe.hhs.gov/pdf-report/impacts-affordable-care-act-medicaid-expansion-insurance-coverage-and-access-care