WASHINGTON: Poor Americans in states that have expanded Medicaid through the Affordable Care Act are going to the doctor more often and having less trouble paying for it, new research finds.
At the same time, two years of experience with the expansion offers additional indications that the improved access to care will ultimately improve patients’ health, a key goal of the 2010 law, often called Obamacare.
“The effects of expanding coverage will be an unfolding story over time,” said Dr. Benjamin Sommers, lead author of the study, published in the journal JAMA Internal Medicine.
“But we are starting to see the kind of broad-based improvements that we would expect with better access.”
Sommers and other researchers at Harvard University have been tracking the impact of Medicaid expansion by surveying poor residents in Arkansas and Kentucky, both of which expanded Medicaid eligibility, and in Texas, which rejected the expansion.
Since 2014, the health law has made hundreds of billions of dollars of federal aid available to states to extend Medicaid coverage to poor adults, a population that had been largely excluded from the program.
Thirty-one states, including Ohio, have opted for the expansion.
But Republican politicians in many red states continue to oppose expansion, arguing that Medicaid is unaffordable and ineffective.
The divide between states that have expanded and those that have not is profound, the new research suggests.
In Arkansas and Kentucky, for example, the share of poor adults without health insurance plummeted between 2013 and 2015, from more than 40 percent in both states to 14 percent in Arkansas and less than 9 percent in Kentucky.
In Texas, by contrast, the uninsured rated dropped only from 39 percent to 32 percent.
The new coverage in Arkansas and Kentucky, in turn, dramatically improved poor patients’ access to care and relieved financial strains, the surveys show.
The share of patients in the two states who had trouble paying medical bills fell more than 11 percentage points between 2013 and 2015, while in Texas, more patients reported medical bill problems in 2015 than in 2013.
In 2015, nearly 55 percent of low-income Arkansas residents reported having a checkup in the past year, up from 45 percent in 2013. In Kentucky, the percentage surged even more, from 46 percent to nearly 60 percent.
There were similar improvements among chronically ill patients who reported getting regular care, with the share in Arkansas jumping from 62 percent to 74 percent and in Kentucky from 69 percent to 79 percent.
By contrast, fewer low-income Texans reported getting a checkup or getting regular care for a chronic condition in 2015, compared with 2013.