KFF designs, conducts and analyzes original public opinion and survey research on Americans’ attitudes, knowledge, and experiences with the health care system to help amplify the public’s voice in major national debates.
The rapidly increasing number of national COVID-19 cases is raising alarm among experts and state and local officials about health systems’ capacity to treat patients effectively and revealing the uneven geographic distribution of the country’s health care resources.
A special report by KFF’s Kaiser Health News (KHN) shows that more than half the counties in the United States have no intensive care unit (ICU) beds, which poses a particular danger to patients age 60 or older who fall victim to the coronavirus. Hospital ICUs have sophisticated equipment, such as bedside machines to monitor a patient’s heart rate and ventilators to help them breathe ― trouble breathing is a common symptom among seriously ill COVID-19 patients. Even in communities that do have ICU beds, the numbers vary wildly ― with some having just one bed available for thousands of senior residents.
KHN’s coverage includes a 50-state map that shows which counties have no lCU beds as well as which lack a hospital altogether. Thirty seven million Americans reside in such counties. An online “lookup” tool lets readers check the ICU bed capacity near their homes or in surrounding counties.
This report is part of KFF’s continuing efforts on the coronavirus outbreak. The national story also ran in USA Today and, as always, KHN content is available to republish free of charge. News organizations can request localized data by contacting Chris Lee.
About The Henry J. Kaiser Family Foundation and Kaiser Health News:
Filling the need for trusted information on national health issues, KFF (the Henry J. Kaiser Family Foundation) is a nonprofit organization based in San Francisco, California. KHN is an editorially independent program of KFF and is the nation’s leading and largest health and health policy newsroom, producing stories that run on kffhealthnews.org and are published by hundreds of news organizations across the country.
The domestic response to coronavirus in the U.S. is rapidly expanding. At this point, every U.S. state and territory has declared an emergency, and President Trump has declared the pandemic to represent a national emergency. Yet there are concerns that response capabilities and resources at the local and state levels could become overwhelmed in the coming days and weeks as spread occurs and severe cases outpace the capacities of health facilities. In the past, the U.S. military has sometimes been called on to provide support during a national emergency, and calls for it to play a similar role during the coronavirus response are growing. In recent days, U.S. governors, presidential candidates, and others have asked for military assistance for domestic coronavirus response, and President Trump has stated he is working with states and the Department of Defense to have the military provide additional resources and assets.
This brief answers key questions about potential U.S. military engagement in the domestic response to the coronavirus. For the purposes of this brief, “military” refers to the armed forces, specifically the active duty personnel and assets of the uniformed military service branches in the Department of Defense (Army, Navy, Air Force, Marines) as well as their reserve forces, including the National Guard. The role and specific information about other U.S. uniformed services including the Coast Guard (part of the Department of Homeland Security) and the U.S. Public Health Commissioned Corps (part of the Department of Health and Human Services) are not reviewed here.
Key Questions
1. Can states call in the National Guard and other parts of the U.S. military?
Local and state governments are expected to be initially responsible for emergency response in their jurisdictions, according the National Response Framework that guides federal, state, and local responses to emergencies. However, when the response capacity at local and/or state government level is felt to be exceeded, governors have the option to request military support by calling on national guard units in their states to mobilize. In fact, governors in almost half of U.S. states (44%) have already activated many state guard units for coronavirus response: The National Guard reports that as of March 19, over 2,000 guard members are assisting in coronavirus response activities in 27 states.
For additional military support beyond the National Guard (with state-level units under the command of their respective governors unless “federalized” by the President), governors go through a separate process (below).
2. Who decides when the U.S. military, beyond the National Guard, becomes involved in domestic emergency response?
While governors can request the help of the U.S. military beyond the National Guard, the decision of whether to provide support lies with the President of the United States or the Secretary of Defense. At the federal level, the U.S. military can become engaged in domestic response in one of two ways:
One is that the federal agency leading an emergency response can request military support by submitting a Request for Assistance to the Department of Defense (DoD). HHS had been the lead agency in the U.S. response until March 18, when it was announced that FEMA would take over as the lead. Upon receipt of the request from the civilian agency, the Secretary of Defense and other DoD leadership would review the request and evaluate it based on a number of criteria, including whether the requested support complies with existing law, whether the type of support presents a risk to DoD personnel, and what impact meeting the request might have on DoD’s ability to pursue its primary mission of national defense. Once a national emergency has been declared, governors can make the request directly to DoD, without going through the lead Federal agency.
The other is that either the President or the Secretary of Defense can choose to directly authorize federal military support for the domestic response, including deploying active duty personnel and/or calling in National Guard personnel to federal service.
3. If the U.S. military becomes involved in the domestic response to the coronavirus, who controls and commands military assets during these efforts?
State governors maintain command over state-level National Guard assets and personnel when they are mobilized for state-level responses.
For the federal response, even when the U.S. military becomes involved, leadership of the response remains with civilian agencies and DoD assets are in a support mission. In the case of coronavirus, FEMA is the lead federal agency and with support from HHS as a key operational agency, would work with military commanders to direct resources as needed, along with state and local leaders. On the military side, the Secretary of Defense typically designates one or more responsible officers, specifically one or more of the commanders of the regional combatant commands, to oversee military efforts and ensure they are coordinated with civilian efforts. For this type of domestic civil support operation, ordinarily the officers will be the commander of U.S. Northern Command (NORTHCOM) for the continental United States, Alaska, Puerto Rico, and the U.S. Virgin Islands, and commander of U.S. Pacific Command (PACOM) for Hawaii, Guam, American Samoa, and the Northern Mariana Islands.
If National Guard units are “federalized” by the President during the response, there is a joint military-civilian command structure that is put in place.
4. What U.S. military capabilities and assets could support the domestic response to the coronavirus?
The U.S. military has capabilities in a range of areas that could be called upon in the domestic response to coronavirus. It has significant capabilities and assets to support communications, transportation, infrastructure, engineering, construction, and other technical and logistical areas.
Importantly, the military also has a reservoir of experienced scientists and medical professionals, stockpiles of medical supplies (such as masks and other personal protective equipment, and respirators), and military medical facilities that include deployable, mobile “field hospitals,” permanent health facilities, and two large hospital ships with an estimated 1,000 bed capacity each – the USNS Mercy and USNS Comfort.
5. Are these capabilities available and appropriate to the domestic civilian response to coronavirus?
Even though the military has significant capabilities as described above, not all resources are available for civilian use, and not all are likely to be appropriate for civilian coronavirus response needs.
Both Secretary of Defense Esper and military officials including the Joint Staff Surgeon (the highest ranking military medical official) have cautioned against overestimating the capabilities that the U.S. military can provide in coronavirus response. The Joint Staff Surgeon has stated DoD has “less than 3% of the number of hospital beds that the private sector has” and has only 36 hospitals in the U.S., most of which are not well suited for “caring for large numbers of contagious patients.” Military doctors are trained primarily to address the health needs of a young, healthy population of active duty personnel, not necessarily communicable illnesses that are a risk primarily to older populations and those with pre-existing chronic medical conditions (though military doctors may provide such care to service members, retirees, and their dependents).
The military has the capability to deploy/construct temporary field hospitals, as well as retrofit or otherwise prepare other facilities for use as makeshift hospitals. The Navy also has two large hospital ships, each with 1,000 bed capacity. Even so, military field hospitals and hospital ships have been designed and used primarily for humanitarian, trauma and battle injury care rather than infectious disease care, and usually provide short term care, with patients typically discharged quickly to other health facilities. Secretary Esper has stated that the hospital ships might provide care for trauma cases to help alleviate pressure on U.S. hospitals and free beds for infectious disease cases when deployed as part of the domestic coronavirus response.
Another consideration for deployment of military medical resources such as field hospitals and hospital ships is who will staff these units once they are deployed. With concerns about shortages of civilian health workers already, and the continued need for DoD medical professionals to focus on military needs, it is unclear where additional health worker capacity will come from to staff multiple field hospitals and hospital ships.
6. What military capabilities have been called on thus far?
In addition to the National Guard mobilizations noted above, as of March 18 Secretary of Defense Esper has directed the department to release some supplies in support of the domestic civilian response, including 5 million masks and other personal protective equipment, along with 2,000 deployable ventilators. Secretary Esper has also stated the Navy is in the process of readying the hospital ships, with plans to deploy the USNS Comfort to New York harbor and the USNS Mercy to a location on the west coast. Both are expected to deploy before the end of March.
In remarks during a recent press conference, President Trump commented that states have also requested the U.S. military help by standing up temporary field hospitals, though no specific information about when and where these hospitals will deploy is currently available.
New York Governor Cuomo specifically asked for the Army Corps of Engineers to be used to convert, retrofit, and upgrade existing civilian facilities to serve as makeshift hospitals, and Secretary Esper has said that he will “get the Corps of Engineers up there soonest to assess the problem and see how we can help out.” Before Secretary Esper’s commitment on March 18, a spokesperson for the Corps stated they are “prepared to assist” but have not yet been assigned a mission.
7. Can the U.S. military be used to enforce quarantines or take on other policing or law enforcement activities during the domestic coronavirus response?
There are restrictions on federal military actions and responsibilities in domestic response circumstances, which are outlined in various guidelines and laws, including the Defense Support of Civil Authorities doctrine and DoD Directive 3025.18 on Defense Support for Civil Authorities, as well as several sections of the U.S. Code, including Military Support to Civilian Law Enforcement Agencies and the Posse Comitatus Act. These prohibit the federal military from serving in any law enforcement or policing role. Restricted activities include: “search, seizure, arrest, apprehension, stop and frisk, surveillance, pursuit, interrogation, investigation, evidence collection, security functions, traffic or crowd control.” An exception to these restrictions can be expressly authorized by the President (through invocation of the Insurrection Act) or granted through an act of Congress. These restrictions do not apply to state-level National Guard efforts under governors’ orders.
Under extreme circumstances some states allow governors to declare “martial law” in their states, which would have the effect of replacing civilian authority with military authority, and also the possibility of suspension of certain civil liberties. California Governor Newsom stated, “If you want to establish a framework of martial law, which is ultimate authority and enforcement, we have the capacity to do that, but we are not feeling at this moment that is a necessity.” Similarly, the President in theory has the ability to establish martial law at the federal level; however, this power is highly contested, and there is no indication this is currently being considered for the coronavirus situation.
8. Could U.S. military medical resources deployed for civilian response affect the ability of the military to meet the needs of its own members and dependents?
DoD prioritizes the health of its personnel and dependents and in the past has sought to minimize the risk for military members posed by infectious diseases as much as possible. DoD is concerned about exposure to and the spread of COVID-19 among its personnel, reporting 37 confirmed cases as of March 17 (18 among military personnel, 13 among dependent family members, 3 in civilian employees, and 3 in contractors).
Military officials have expressed concerns about military medical resources being redirected from their current tasks. With force health protection a primary objective for U.S. military medical resources, decisions about their use for domestic civilian response will weigh the potential effects on the military’s efforts to address the health of its own members and dependents.
Likewise, many health care workers who serve in reserve units of the armed forces, including the National Guard, have civilian jobs in health care. Calling them up to reserve duty would remove them from their civilian role which might negatively affect civilian response, so careful consideration of the proper role for health care workers called up for service is necessary.
A new KFF brief answers key questions about potential U.S. military engagement in the domestic response to the novel coronavirus. With concerns that local response capabilities could become overwhelmed in the coming weeks, there have been increasing calls to have the U.S. military play a greater role in support of civilian response.
The U.S. military has significant capabilities in a range of areas that could be called upon in the domestic response to coronavirus — including communications, transportation, infrastructure, engineering, construction, and other technical and logistical areas. The military also has a reservoir of experienced scientists and medical professionals, stockpiles of medical supplies (such as masks and other personal protective equipment, and respirators), and military medical facilities.
However, not all military resources are available for civilian use, and not all are likely to be appropriate for civilian coronavirus response needs. U.S. law and military rules and regulations also place some restrictions on the kinds of activities that the military can engage in as part of a domestic response. The brief examines these and other important aspects of greater military engagement in coronavirus response in the U.S.
In this article in the Journal of Health Politics, Policy and Law, Larry Levitt examines the Affordable Care Act 10 years after it’s enactment. The article notes that the law has taken numerous blows, both from the courts and from opponents seeking to undermine it. Yet, due to its policy design and the political forces the ACA has unleashed, the law has shown remarkable resilience. While there remain ongoing efforts to undo the ACA, the smart money has to be on its continued existence.
More than 170 million people in the US are covered by many different group and individually purchased private health plans. People cannot take for granted that every plan covers the same benefits, applies the same cost sharing and utilization review standards, or offers access to the same network of participating hospitals, doctors, labs, and other providers. Research demonstrates that out-of-pocket costs can, and frequently do, effectively limit access to needed care for insured patients. Public health experts warn that efforts to control spread of the coronavirus that causes COVID-19 will be less effective if people fail to seek appropriate diagnosis or care due to the cost.
Congress recently passed a new law, the Families First Coronavirus Response Act, that will, among other things, require most private health plans to cover testing for the coronavirus with no cost sharing during the emergency period. Some states have adopted similar requirements for insurers they regulate, and many private insurance companies will voluntarily expand coverage for testing.
To date, fewer changes have been adopted or considered with respect to treatment for complications from the disease.
This brief reviews current coverage standards for private health plans and how these may change in response to the COVID-19 pandemic.
What health services might patients need for COVID-19?
COVID-19 is an infectious respiratory disease caused by a new coronavirus. No vaccine or cure or specific treatment for COVID-19 has yet been developed.
Testing – Diagnosis of COVID-19 is confirmed by a test that is currently available via public health departments and, increasingly, via private laboratories. Testing also typically involves a visit to a physician office, clinic, or emergency room to collect the patient’s specimen.
Treatment – Once diagnosed, treatment for complications from COVID-19 would vary based on the patient and severity of the case. According to the World Health Organization, 80% of people who become infected will recover without needing special treatment. However more than 105 million adults in the U.S. have a higher risk of developing serious illness if they are infected with coronavirus, due to their older age (60 and older) or health condition, that could require more extensive care, such as hospitalization, respiratory therapy and other services.
What does private health insurance cover?
Most Americans under the age of 65 (about 6 in 10) are covered under one of many different job-based group health plans. Another 7 percent of the nonelderly are covered under one of thousands of different private insurance policies offered in the non-group market.
To understand what private health insurance covers, one must consider
what benefits and services are covered under a plan;
what level of cost sharing, if any, applies to covered benefits;
how, if at all, the plan covers care from out-of-network providers, which could result in “balance billing.”
In general, private plans can vary in each of these respects.
The Affordable Care Act (ACA) sets a few minimum coverage standards that apply to most private health plans. For example, the ACA requires most private plans to cover designated preventive services with no cost sharing. Even these ACA coverage standards do not apply to all private coverage, however, including short-term policies, health care sharing ministries, and certain Farm Bureau health plans that are not subject to any federal minimum coverage standards.
States also regulate and set coverage standards for private health plans, although a federal law, ERISA, preempts state regulation of many employer-provided health plans.
Within this regulatory framework, private health plans vary, at least to some extent, in terms of their covered benefits, cost sharing, and benefit limits.
Benefits
The ACA requires policies in the individual and small group health insurance markets to cover 10 categories of essential health benefits (EHB), including hospitalization, ambulatory care, lab tests, and prescription drugs. However, the details of covered benefits within each category can and do vary from plan to plan – for example, whether the ambulatory care EHB category covers telemedicine visits. In addition, large group health plans and self-insured group health plans of any size are not required to cover EHB, though most provide major medical coverage.
Coronavirus testing – The new law passed by Congress requires all group health plans and individual health insurance coverage to cover testing and associated visits related to the diagnosis of the COVID-19 during the emergency period.
This new law will not apply to some types of private coverage sold to individuals. For example, regulations issued by the Trump Administration in 2018 promote the sale of short-term policies that are not required to cover EHB.
In addition, health care sharing ministries are a private health coverage arrangement not subject to federal standards.
About 1 million people have health coverage through sharing ministries.
Also, two states have authorized their Farm Bureaus to sell private coverage that, explicitly, is not defined or regulated as health insurance.
As of 2017, 73,000 people were enrolled in Farm Bureau plans in Tennessee. The State of Iowa also has a law specifying that private coverage offered by the Farm Bureau is not insurance.
Under the new federal law, however, people enrolled in these types of non-compliant private coverage will be considered uninsured. The law also gives states the option to provide free Medicaid coverage for coronavirus testing for their uninsured residents. In addition, the new law appropriates $1 billion to the National Disaster Medical System to reimburse providers for the costs associated with diagnosis and testing of uninsured individuals.
Treatment for complications of COVID-19 – While most private health plans likely cover most items and services needed to treat complications due to COVID-19, there is no clear federal requirement to do so.
The EHB standard under the ACA defines categories of services to be covered, but it is left to states to designate “benchmark” policies that define specific covered services. As a result, coverage for at least some services needed to treat COVID-19 – such as home-delivered care, telemedicine visits, or respiratory therapy visits – could vary under health insurance plans that are subject to EHB.
Large employer health plans are not required to cover EHB. Most large employers offer major medical coverage under their group health plans, but some do not.
About 4 percent of large firms offer so-called “mini-med” plans to some or all workers as a less expensive option. For example, one mini-med plan currently marketed covers preventive services, 4 doctor visits per year, and no hospitalization or emergency care. Such plans would provide limited, if any coverage, for services to treat complications of COVID-19.
Short-term plans, health sharing ministries, and certain Farm Bureau plans are not subject to any federal coverage standards. The Families First Coronavirus Response Act does not address coverage of COVID-19 treatment costs for people who are uninsured.
Cost sharing
Private health plans typically apply cost sharing – deductibles, copays, or coinsurance – to covered benefits other than preventive services.
Coronavirus testing – The Families First Coronavirus Response Act requires all group health plans and individual health insurance coverage to waive all cost sharing for testing and associated visits related to the diagnosis of the COVID-19 during the emergency period.
Coronavirus vaccine – Certain preventive services under ACA-regulated private plans must be covered with no cost sharing. The U.S. Preventive Services Task Force, the Advisory Committee on Immunization Practices, and other agencies are tasked with periodically reviewing and recommending preventive services to be covered under this requirement, and this would likely include a coronavirus vaccine, if developed. The ACA preventive services coverage requirement takes effect for each new service 1 year after it is recommended.
Treatment for complications of COVID-19 – There is no federal requirement for private plans to waive cost sharing for COVID-19-related treatment. While many private health insurers recently announced they will voluntarily waive cost sharing for testing, industry leaders have clarified that this waiver does not generally apply to treatment. The ACA limits the amount of cost sharing that can apply for in-network covered benefits under most private plans to $8,150 in 2020 for single coverage, $16,300 for family policies. Within these limits, privately insured COVID-19 patients could face significant out-of-pocket costs for covered care.
Increasingly, cost sharing is becoming unaffordable for many private health plan enrollees. Half of adults covered under job-based plans report foregoing or delaying needed care in the past year due to cost. Among adults who do skip or delay needed care due to cost, 13% report their health condition worsened as a result.
Among covered workers in job-based plans with a deductible for self-only coverage in 2019, the average deductible was $1,655. Employer-sponsored health plan deductibles have increased six times faster than average wages over the past decade.
Under non-group plans, deductibles are even higher – on average more than $4,500 for self-only coverage in silver plans this year – although half of marketplace enrollees qualify for subsidies to significantly reduce deductibles and other cost sharing.
Provider networks
Nearly all private health plans use networks of participating hospitals, doctors, laboratories, and other providers, which could have implications for those in need of coronavirus testing or care, depending on where they present for services. Claims for out-of-network services, other than emergency services, can be denied by HMOs and other plans with closed networks. Under PPO plans that provide some coverage for out-of-network care, patients can be face higher cost sharing (e.g. patients might be required to pay 20% coinsurance for in-network claims and 50% coinsurance for out-of-network claims.)
In addition, out-of-network care exposes patients to “balance billing,” or the difference between the provider’s undiscounted charge and the amount the health plan considers reasonable. Private plan enrollees generally try to seek care from in-network providers, though sometimes they receive out-of-network care inadvertently, resulting in surprise medical bills.
Analysis of emergency visits by patients covered by large employer plans found 18% included at least one out-of-network charge.
Among non-emergency stays at in-network hospitals and facilities, 16% involved at least one out-of-network claim (e.g., by an anesthesiologist).
Coronavirus testing – Surprise medical bills could result if patients seek testing in an emergency room; even at an in-network emergency facility, physicians and other providers who work there may not be in-network. Surprise medical bills could also result in other ambulatory care settings, for example, if a patient’s in-network primary care doctor sends her test to an out-of-network commercial lab.
Treatment for complications of COVID-19 – Patients could also receive surprise out-of-network bills for treatment services, particularly when patients are hospitalized. New analysis finds that patients hospitalized at in-network hospitals for pneumonia (one complication that can arise from COVID-19 infection) are 20% more likely than average to incur at least one out-of-network charge.
Other limits on covered benefits
In addition to network restrictions on covered benefits, most private plans employ other medical management and utilization review techniques, such a requiring referrals or prior authorization for certain services before they will be covered, which could also have implications for those with COVID-19. Congress is poised to enact a law requiring waiver of prior authorization for coronavirus testing.
For most private plans, the ACA prohibits most annual or lifetime dollar limits on covered benefits, and prohibits plans from denying coverage for pre-existing conditions. These standards do not apply to short-term plans, health sharing ministries or to certain Farm Bureau plans.
Changes in Private Plan Standards for COVID-19
The policy landscape is changing rapidly as the outbreak spreads. Notable recent developments include:
The new law passed by Congress requires ACA-regulated health plans to cover coronavirus testing and to waive cost sharing and prior authorization. In addition to the test, itself, this requirement applies to visits in physician offices, urgent care centers, and emergency rooms associated with testing. This standard does not apply to short-term plans, sharing ministries, or certain Farm Bureau plans. The law does not address standards for private health plan coverage or cost sharing for COVID-19 treatment. Nor does it address balance billing.
Voluntary coverage changes by the insurance industry – Before Congress acted, many private health insurers had announced voluntary efforts to extend and expand coverage for coronavirus testing under their fully-insured policies, although in general, private insurers have not addressed balance billing (surprise bills). A few private insurers, including one serving federal employees, committed to waiving cost sharing for COVID-19-related treatment, as well. Insurers making coverage changes not otherwise required by law note that self-insured group health plans, which they administer, have the option to adopt or reject these changes. Sixty percent of covered workers in employer-sponsored plans are in self-insured coverage arrangements.
Changes in requirements for state-regulated plans – A number of state insurance commissioners have issued directives to health insurers they regulate regarding COVID-19. For example, in Washington state, all state-regulated health insurance plans and short-term medical plans must suspend prior authorization for treatment or testing of COVID-19, waive cost sharing for testing, and allow enrollees to receive testing and treatment from an out-of-network medical provider if the plan’s network does not provide reasonable access. The order also requires plans to allow enrollees a one-time refill of prescription medications before the waiting period on refills expires. In New York, guidance requires state regulated plans to cover COVID-19 testing and waive cost sharing for the lab test and the associated patient visit to in-network physician offices, urgent care centers, or emergency departments. New York-regulated insurers also must cover out-of-network testing if in-network providers are unable to provide COVID-19 testing, waive prior authorization for COVID-19 testing, and cover telehealth services. New York’s surprise medical bill protections also apply for patients who receive out-of-network bills in certain circumstances, including when in-network physicians send specimens to an out-of-network laboratory or pathologist for testing.
Federal law preempts state regulation of employer-sponsored health plans.
The risk for adverse maternal and neonatal outcomes associated with COVID-19 is largely unknown, but medical experts suspect symptoms of COVID-19 may be more severe in pregnant woman compared to non-pregnant women. Based on small studies, the novel coronavirus does not appear to pass from mother to fetus during pregnancy, but some cases of newborn infection have been noted, and more research is warranted.
Practicing social distancing during the COVID-19 pandemic may be more difficult for pregnant women, most of whom require weekly to monthly prenatal visits during pregnancy. Use of telemedicine for prenatal care may be a novel way to limit exposure to COVID-19 for pregnant women, but logistical challenges and lack of uniform coverage policy across insurers and states pose barriers to telemedicine implementation.
Due to safety concerns, pregnant and breastfeeding women have historically been excluded from treatment and vaccine trials, until after the FDA approves use in the general population. If this is the case with COVID-19, there may be a lag time between when pregnant women have access to treatment and vaccines, as compared to the rest of the population.
Cost can be a barrier to health seeking behavior. Once a vaccine for the novel coronavirus is developed, ensuring the vaccine is available without cost-sharing will likely increase vaccination rates among pregnant women.
Introduction
The novel coronavirus, also known as “SARS-CoV-2” causing the illness “COVID-19”, has sparked international concern and emergency response. While both men and women are affected by COVID-19, this brief outlines considerations for how the pandemic may specifically impact pregnant women. With over 6 million pregnancies per year in the U.S., pregnant and breastfeeding women constitute a significant portion of the population that could be impacted by COVID-19. This brief summarizes what is known thus far about pregnancy and COVID-19.
What do we know thus far about the impact of COVID-19 in pregnancy?
Does risk for COVID-19 differ between men and women?
The COVID-19 outbreak is an evolving pandemic. Little is known on how, or if, the disease differentially impacts women compared to men. To date, initial studies on the outbreak in China have found men may account for slightly more of the overall cases, and that men may have a slightly higher mortality rate from COVID-19. This could be due to biological factors (i.e. differences in immune response), medical factors (i.e. comorbidities) and lifestyle factors (i.e. smoking). However, most trackers of the pandemic, including the CDC and WHO, have not published their data by gender. Therefore, more research on this topic is warranted before conclusions are made.
Does risk for COVID-19 differ between pregnant and non-pregnant women?
According to the CDC, there is insufficient data at this time to know whether pregnant women are at increased risk for adverse health outcomes if infected by the novel coronavirus as compared to non-pregnant people. A WHO-China Joint Mission investigation of 147 pregnant women in China with suspected or confirmed COVID-19 found that 8% had severe disease and 1% were in critical condition (14% severe, 6% critical for the overall population). In a small study of pregnant women in Wuhan, China, the clinical characteristics and severity of COVID-19 also appeared similar between pregnant and non-pregnant women. That said, the American College of Obstetricians and Gynecologists (ACOG) issued a statement that “pregnant women may be at higher risk of severe illness, morbidity, or mortality compared with the general population,” likely due to physiologic changes that happen during pregnancy, and because pregnancy constitutes a state of relative immunosuppression as compared to non-pregnancy.
Can the novel coronavirus be transmitted during pregnancy or breastfeeding?
Data are also lacking about whether pregnant women infected by the novel coronavirus can pass it to their fetuses across the placenta during pregnancy, called “vertical transmission.” However, several small studies of pregnant women infected with the novel coronavirus found no evidence of vertical transmission, as none of their infants tested positive at birth, and the virus was not detected in samples of the amniotic fluid, umbilical cord blood or placental tissue (Zhu et al. 2020; Chen et al. 2020; Chen et al. 2020; Zhang et al. 2020; Li et al. 2020). That said, a few cases of newborns infected by the novel coronavirus have been reported, and it remains unclear if they were infected before, during or after delivery (Qiao, 2020; Murphy, 2020). There is no evidence to date to suggest the novel coronavirus can pass to infants through breastmilk, however the CDC has issued precautionary guidance for women with suspected or confirmed COVID-19 who are also breastfeeding.
Adverse health outcomes have been found in infants born to mothers affected by COVID-19, including respiratory distress, premature labor, and even death. However, it is unclear whether these adverse outcomes are related or not to the COVID-19 infection in their mothers. Meanwhile, guidance published by the Royal College of Obstetricians and Gynecologists (RCOG) suggests there is no data yet linking COVID-19 with an increased risk of pregnancy loss. As for maternal outcomes, some initial evidence indicates outcomes are similar between women with and without COVID-19, however other studies show symptom severity in pregnancy varies from asymptomatic to life-threatening. As the outbreak continues, more data on maternal and neonatal outcomes will likely come forward.
Access to Care
Will pregnant women be reluctant to access prenatal care due to fear of COVID-19 exposure in medical settings?
Much of the general public is worried about COVID-19. A recent KFF poll conducted from March 11-15 found 62% of adults reported being very or somewhat worried that they or someone in their family will get sick from the coronavirus. 51% of adults reported being very or somewhat worried about putting themselves at risk of exposure to the virus because they can’t afford to stay home and miss work.
For pregnant women, concern over COVID-19 may be even more heightened.Social distancing, which is now recommended as a response to the containing the spread of coronavirus transmission, presents distinct challenges for pregnant women. This advice may be hard to follow in pregnancy; most women have monthly to weekly interactions with the health system during pregnancy for prenatal checkups.
Can telemedicine be used to provide more services to pregnant women?
One possible way to provide access to prenatal care during this outbreak is to expand use of telemedicine during pregnancy; this would enable some pregnant women to stay home and participate in prenatal visits over videoconference or the phone, without coming into clinic where they risk COVID-19 exposure (Figure 1). A KFF brief explains more about potential uses of telemedicine in pregnancy.
Figure 1: During The COVID-19 Pandemic, Many Pregnancy-Related Services Could Be Delivered Via Telemedicine
Currently, however, utilization of telemedicine for pregnancy-related services is minimal. Lack of insurance coverage for telemedicine poses a large barrier to its implementation. Nearly half of all births in the U.S. are financed by Medicaid, but only a handful of state Medicaid programs specifically address obstetrical care in their telemedicine reimbursement laws. No states specifically require private insurance plans to cover pregnancy services in their telemedicine reimbursement laws. However, in approximately half of states, if telemedicine services are shown to be medically necessary and meet the same standards of care as in-person services, private insurance plans must cover telemedicine services if they would normally cover the service in-person.
Several major health insurance companies have mentioned coverage of telehealth in their response to COVID-19. For example, Aetna is offering telemedicine visits for any reason without copays, while Humana is waiving telemedicine costs for urgent care visits for 90 days. Others are “encouraging” use of telehealth, without word on cost sharing. In a White House Coronavirus Task Force briefing, Vice President Pence referenced the recently enacted Coronavirus Preparedness and Response Supplemental Appropriations Act, which broadens coverage and reimbursement for telemedicine services for Medicare. He also mentioned Medicaid may similarly make these services available. That said, the details of telehealth coverage remain murky, and there are likely to be significant gaps in access to telemedicine during this pandemic. Even beyond coverage considerations, there are logistical challenges that come with implementing a telemedicine program at a health center and start-up costs are high. For example, telemedicine platforms must be compliant with the Health Insurance Portability and Accountability Act (HIPAA), and integrate into an existing electronic health record, and clinicians must ensure their malpractice insurance covers telemedicine.
Even if telemedicine implementation became more widespread, almost all births in the U.S. occur in hospitals. Shortages of personal protective equipment (PPE) like masks, gloves, and gowns, and other hospital resources have been predicted by the World Health Organization as a result of the COVID-19 pandemic which could make frontline health workers increasingly vulnerable to COVID-19. In turn, patients may fear exposure to the virus while in the hospital for labor and delivery. Some women may also need to rearrange their birth plans, if family can no longer travel to be with them in the hospital, if family members are in quarantine, or if spouses have to stay home with children due to school closures.
Drug Development and Payment Policy
Will COVID-19 treatment and vaccine development for pregnant women lag behind rest of the population?
Implementation of an effective vaccine for the novel coronavirus is likely months to years in the future, however it is important to understand how the drug development process impacts pregnant women and how that could affect the use of any future COVID-19 treatment or vaccine. For almost all drugs in development, pregnant women (and often women who are breastfeeding) are specifically excluded from drug development trials. This is done to avoid exposing a fetus or breastfed infant to potentially harmful drugs. However, this means that when most drugs obtain FDA approval, they have not been tested in pregnant and lactating women. Only in post-approval studies, if ever, is the drug tested for these populations. This presents a lag time between when a drug is approved for use in the non-pregnant population and when safety and efficacy data is available for pregnant persons.
This same delay will likely hold true in the development of COVID-19 treatments and vaccines. To use another infectious disease as an example, the ministry of health in the Democratic Republic of Congo administered the Ebola vaccine to non-pregnant people months in advance of pregnant women; meanwhile, 319 pregnant women and 603 lactating women with infected contacts were excluded from vaccination from November 2018 to May 2019, even after the vaccine was approved for use in pregnant/lactating women in February 2019. During the 2009 H1N1 “swine flu” epidemic, pregnant women were especially vulnerable to severe complications. Vaccination of pregnant women was made a priority by the CDC and WHO, but even still, many pregnant people experienced delays in vaccination.
While there are often very compelling reasons to exclude pregnant women from research studies, it is significant to note potentially lifesaving COVID-19 treatment and vaccines may never be tested or approved for pregnant or lactating women, unless dedicated efforts to do so are made. It will be important that research and development on new treatments and vaccines for COVID-19 address the inclusion and needs of pregnant and lactating women in upcoming clinical trials. Of note, a current clinical trial of a possible COVID-19 treatment does not allow pregnant or breastfeeding women to participate at this time.
How will cost impact pregnant women’s access to COVID-19 treatments and vaccine once available?
When treatment and vaccines are eventually developed for COVID-19, cost sharing could hinder access to care. Cost plays a large factor into care seeking behavior. While women and men both feel the impact of health costs, data from KFF’s 2017 Women’s Health Survey show that cost can be particularly burdensome for women, who on average earn lower wages, have fewer financial assets, accumulate less wealth, and have higher rates of poverty than men. For example, 19% of women reported they put off or postponed preventative services in the last year due to cost, while 26% of women delayed or went without care due to cost.
The ACA requires most private health insurance plans and states with Medicaid expansion to cover recommended preventive services without cost sharing, including vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). Once ACIP recommends a new vaccine, however, it typically takes another year for coverage to commence (or in the next plan year). Therefore, even once a COVID-19 vaccine is developed and recommended by ACIP, there will likely be a significant lag time between when the vaccine is required to be covered without cost sharing. A few health insurers have said so far that they will offer a coronavirus vaccine without cost sharing once developed. CMS says a vaccine will be covered by Medicare Part D. For the individual and small group markets, and states with Medicaid expansion, the vaccine would likely be covered if and when it becomes a recommended preventive service by ACIP.
Research shows us that many pregnant women forgo recommended vaccines if not provided free of cost. A study of pregnant Medicaid patients in Florida found that vaccination rates for Tdap and influenza were low in the prenatal period when Medicaid did not cover these vaccines. However, rates rose in the postpartum period, when the vaccine was covered free of charge. These data suggest that costs pose a barrier to vaccination for at least a portion of pregnant patients.
Conclusions
There are a number of specific reasons why pregnant women may be uniquely affected by the COVID-19 pandemic, but information is limited currently. There is no definitive answer at this time about if the virus is transmitted during pregnancy or in breastmilk and more research is warranted about potential adverse health outcomes to mothers and infants. Inclusion of pregnant women and lactating women in treatment and vaccine development for COVID-19 will be important, as access to novel therapies for these groups has historically lagged far behind the non-pregnant population. Use of telemedicine for prenatal care visits could help pregnant women reduce their risk of virus exposure, however most pregnant women will still need to be admitted to hospitals for labor and delivery, potentially at time when hospitals are stressed beyond their capacity and resources. Keeping in mind the pregnant population during the COVID-19 pandemic may help mitigate potential preventable health disparities.
Another analysis that reviews studies published between February 2020 and March 2021 is available here. That more recent analysis also updates summary figures on coverage, access, and economic findings across the full body of research published between January 2014 and March 2021.
At the ten year mark since the passage of the Affordable Care Act (ACA), a substantial body of research has investigated effects of the Medicaid expansion on coverage; access to care and related measures (including utilization, quality of care and health outcomes, provider capacity, and affordability and financial security); and various economic measures. This issue brief summarizes findings from 404 studies (including 80 newly included since the last update of this analysis) of the impact of state Medicaid expansions under the ACA published beginning in January 2014 (when the coverage provisions of the ACA went into effect) and updates earlier versions of this brief with studies through January 2020.1
This brief groups outcomes into three broad categories: coverage, access, and economic measures. Research indicates that the expansion is linked to gains in coverage; improvements in access, financial security, and some measures of health status/outcomes; and economic benefits for states and providers (Figure 1).
Figure 1: Studies generally find positive effects of the ACA Medicaid expansion on different outcomes.
Studies included in this review may include multiple findings across multiple categories. For example, studies that point to increased coverage may also include findings related to access, outcomes, or economic metrics. While most early studies focused on expansion’s impact on coverage and economic measures, over time studies have increasingly focused on measures related to access to care (Figure 2).
Figure 2: More recent studies focus on outcomes related to access.
Findings related to coverage, access, and economic measures are discussed in detail in the text of this brief and are also summarized below:
Coverage: Studies show that Medicaid expansion states experienced significant coverage gains and reductions in uninsured rates among the low-income population broadly and within specific vulnerable populations. States that implemented the expansion with a waiver have seen coverage gains, but some waiver provisions appear to compromise coverage.
Access to care and related measures: Most research demonstrates that Medicaid expansion has improved access to care, utilization of services, the affordability of care, and financial security among the low-income population. Studies show improved self-reported health following expansion and an association between expansion and certain positive health outcomes. A small subset of study findings showed no effects of expansion on certain specific measures within these access-related categories. Findings on expansion’s effect on provider capacity are mixed, with studies showing increases, decreases, or no effects on measures like appointment availability or wait times.
Economic measures: Analyses find effects of expansion on numerous economic outcomes, including state budget savings, revenue gains, and overall economic growth. Multiple studies suggest that expansion can result in state savings by offsetting state costs in other areas. The federal government covered 100% of the cost of the expansion in the early years of the ACA and will cover 90% beginning in 2020. There is limited research examining the fiscal effects of the Medicaid expansion at the federal level. Additional studies show that Medicaid expansions result in reductions in uncompensated care costs for hospitals and clinics, and a growing number of studies show an association between expansion and gains in employment as well as growth in the labor market (with a minority of studies showing neutral effects in this area).
More recent studies: Recently published studies newly included in this analysis from July 2019 through January 2020 support earlier findings while using the additional years of experience with expansion to deepen findings in many areas, including expansion’s effects on health outcomes, access to services and medications for behavioral health and other needs, providers’ financial stability, and employment. Some recent analyses that include outcomes beyond those typically examined in Medicaid expansion research show that expansion is associated with decreased mortality overall and for certain specific conditions; reductions in rates of food insecurity, poverty, and home evictions; and improvements in measures of self-reported health and healthy behaviors.
Looking back and looking ahead: Looking back on 10 years since the ACA has been enacted shows that the Medicaid expansion has expanded coverage and led to increases in access and utilization to health care services, improvements in financial security and positive net effects for state budgets and revenues. This analysis may help inform states still debating whether to adopt the expansion. Future studies will continue to examine the economic implications of the expansion as the state share of costs remains constant at 10 percent. A looming economic downturn will also test how the Medicaid expansion affects coverage and state budgets. Looking ahead, while additional states may expand eligibility under the ACA, the changing landscape of Medicaid demonstration activity could limit the reach of the Medicaid expansion as envisioned under the law. For example, the administration issued new guidance that would allow states to cover certain adults (including the expansion population) through new demonstrations with eligibility restrictions and not apply other Medicaid rules in exchange for capped financing. In addition, continued efforts from the administration to conduct intense oversight and change the rules on Medicaid enrollment and financing, as well as litigation efforts to repeal the entire ACA keep the law in the spotlight and highlight future challenges. The outcome of the next election could bring significant changes to the ACA, including the Medicaid expansion.
Methods
This literature review summarizes findings from 404 studies of the impact of state Medicaid expansions under the ACA published beginning in January 2014 (when the coverage provisions of the ACA went into effect). This version of the brief updates earlier versions and includes studies published through January 2020. It includes studies, analyses, and reports published by government, research, and policy organizations using data from 2014 or later and only includes studies that examine impacts of the Medicaid expansion in expansion states. This review excludes studies on impacts of ACA coverage expansions generally (not specific to Medicaid expansion alone), studies investigating potential effects of expansion in states that have not (or had not, at the time of the study) expanded Medicaid, and reports from advocacy organizations and media sources.
To collect relevant studies, we conducted keyword searches of PubMed and other academic health/social policy search engines as well as websites of government, research, and policy organizations that publish health policy-related research. We also used a snowballing technique of pulling additional studies from reference lists in previously pulled papers. While we tried to be as comprehensive as possible in our inclusion of studies and findings that meet our criteria, it is possible that we missed some relevant studies or findings. For each study, we read the final paper/report and summarized the population studied, data and methods used, and findings. In instances of conflicting findings within a study, or if a reviewer had questions about specific findings, multiple reviewers read and classified the study to characterize its findings. In the issue brief text, findings are broken out and reported separately in three broad categories: Medicaid expansion’s impact on coverage; access to care and related measures; and economic outcomes for the expansion states. Studies may be cited in multiple of these categories or in multiple places within a category. The Appendix at the end of the brief provides a list of citations for each of the included studies, grouped by the three categories of findings.
Report
Impacts on Coverage
Studies find positive effects of Medicaid expansion on a range of outcomes related to insurance coverage (Figure 3). In addition to changes in uninsured rates and Medicaid coverage, both overall and for specific populations, studies also consider private coverage and waiver implications.
Figure 3: Studies find that the ACA Medicaid expansion had positive effects on insurance coverage, though findings on private coverage are mixed.
Uninsured Rate and Medicaid Coverage Changes
States expanding their Medicaid programs under the ACA have seen large increases in Medicaid enrollment. These broad coverage increases have been driven by enrollment of adults made newly eligible for Medicaid under expansion. Enrollment growth also occurred among both adults and children who were previously eligible for but not enrolled in Medicaid (known as the “woodwork” or “welcome mat” effect). Some, but not all, research finds evidence of reduced coverage churn in expansion compared to non-expansion states.2345678910111213141516171819202122232425262728293031323334353637383940414243444546474849505152535455565758596061
Numerous analyses demonstrate that Medicaid expansion states experienced large reductions in uninsured ratesthat significantly exceed those in non-expansion states. The sharp declines in uninsured rates among the low-income population in expansion states are widely attributed to gains in Medicaid coverage. Declines began in 2014, and some studies showed that expansion-related enrollment growth in Medicaid and declines in uninsured rates in expansion states continued in 2015, 2016, and 2017 and that the gap between coverage rates in expansion and non-expansion states continued to widen in the years after 2014. Two studies found that despite a nationwide increase in uninsured rates from 2016 to 2017, uninsured rates remained stable in states that had expanded Medicaid and coverage losses were concentrated in non-expansion states.6263646566676869707172737475767778798081828384858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133134135136137138
Several studies identified larger coverage gains in expansion versus non-expansion states for specific vulnerable populations. While the list of specific populations studied is long, studies include: individuals across the lifespan (children, young adults, women of reproductive age with and without children, and the near-elderly), lesbian, gay, and bisexual adults, the unemployed, low-income workers, justice-involved individuals, homeless individuals, noncitizens, people living in households with mixed immigration status, migrant and seasonal agricultural workers, and early retirees. Other populations that experienced coverage gains include those with specific medical conditions or needs such as prescription drug users, people with substance use disorders including opioid use disorders, people with HIV, people with disabilities, low-income adults who screened positive for depression, adults with diabetes, cancer patients/survivors, adults with a history of cardiovascular disease or two or more cardiovascular risk factors, and veterans.139140141142143144145146147148149150151152153154155156157158159160161162163164165166167168169170171172173174175176177178179180181182183184185186187188189190191192193194195
Most analyses that looked at rural/urban coverage changes find that Medicaid expansion has had a particularly large impact on Medicaid coverage or uninsured rates in rural areas. Studies have found that Medicaid expansion reduced or eliminated disparities in coverage between adults living in rural vs. urban areas. However, as noted below, research on coverage effects in rural versus urban areas was mixed.196197198199
Studies show larger Medicaid coverage gains and reductions in uninsured rates in expansion states compared to non-expansion states occurred across most or all of the major racial/ethnic categories. Additional research also suggests that Medicaid expansion has helped to reduce disparities in coverage by income, age, marital status, disability status, and, in some studies, race/ethnicity.200201202203204205206207208209210211212213214215216217218219220221222223224
A minority of coverage studies show no effect or mixed results of expansion in certain areas. Many of these findings were included in studies that had additional findings related to coverage or disparity improvements and are also cited above. Some findings within three studies did not show greater coverage changes for rural areas. A limited number of studies found that expansion was not significantly associated with changes in the uninsured rate among certain specific groups, as Medicaid coverage gains in expansion states were offset larger private insurance gains in non-expansion states for these groups. Findings within four studies suggested that expansion was associated with an increase in coverage disparities (by gender in one study, by race/ethnicity in another, and by marital status among women in two others). In addition, one study showed no significant differences in churn rates among low-income adults between 2013 and 2015 based on the state’s expansion policy.225226227228229230231232233234235236237238239240241242243244245246247248
Private Coverage and Waiver Implications
Some studies exploring the effects of Medicaid expansion on private insurance coverage found no evidence of Medicaid expansion coverage substituting for private coverage including employer-sponsored insurance, while other studies showed declines in private coverage associated with expansion overall or among certain specific population groups. These declines in private coverage may occur if individuals previously covered through employer-sponsored or self-pay insurance opt in to Medicaid given Medicaid’s typically lower out-of-pocket costs and more comprehensive benefit packages, or if employers alter their offering of coverage in response to the expansion of Medicaid. Private coverage changes in studies that include states that expanded later than January 2014 may also reflect people above 100% FPL transitioning from subsidized Marketplace coverage to Medicaid after their state adopts the expansion.249250251252253254255256257258259260261262263264265266267268269270271272273
States implementing the expansion with a waiver have seen similar or larger gains in coverage as states not using waivers, but research finds that some provisions in these waivers present barriers to coverage.
Studies show that some states initially expanding Medicaid with Section 1115 waivers experienced coverage gains that were similar to gains in states implementing traditional Medicaid expansions. Research comparing Arkansas (which expanded through a premium assistance model) and Kentucky (which expanded through a traditional, non-waiver model) showed no significant differences in uninsured rate declines between 2013 and 2015 in the two states. An analysis of expansion waiver programs in Michigan and Indiana showed that both states experienced uninsured rate reductions between 2013 and 2015 that were higher than the average decrease among expansion states as well as large gains in Medicaid enrollment.274275276277278279
A growing body of research suggests that certain Section 1115 waiver provisions that target the expansion population have caused coverage losses or presented barriers to enrollment, particularly in Arkansas related to the implementation of a Medicaid work requirement and in Indiana related to the Healthy Indiana Plan (HIP) 2.0 monthly contribution requirements.280,281,282283284285286287288289290
Impacts on Access and Related Measures
Studies find positive effects of Medicaid expansion on a range of outcomes related to access (Figure 4). In addition to impacts on access to and utilization of care, studies consider the effect of expansion on quality of care, self-reported health, and health outcomes; provider capacity; and affordability and financial security.
Figure 4: Studies find that the ACA Medicaid expansion increased access across a range of measures, though findings on provider capacity are mixed.
Cancer Diagnosis and Treatment. Multiple studies found that expansion was associated with significantly greater increases in overall or Medicaid-covered cancer diagnosis rates and/or early-stage diagnosis rates. Multiple studies found an association between expansion and increased access to and utilization of certain types of cancer surgery, with one study finding a decreased disparity in expansion states between Medicaid and privately-insured patients in the odds of undergoing surgery for certain types of cancer.425426427428429430431432433434435436
Transplants. Additional studies found a correlation between expansion and increased heart transplant listing rates for African American adults (both overall and among Medicaid enrollees) and increased lung transplant listings for nonelderly adults.437438
Smoking Cessation. Additional research found decreased cigarette and other nicotine product purchases and increased access, utilization, and Medicaid coverage of evidence-based smoking cessation medications post-expansion in expansion states relative to non-expansion states. For example, one recent study found that Medicaid expansion lead to a 24% increase in new use of smoking cessation medication.439440441442443444
Behavioral Health. Recent evidence demonstrates that Medicaid expansion states have seen improvements in access to medications and services for the treatment of behavioral health (mental health and substance use disorder (SUD)) conditions following expansion, with many national and multi-state studies showing greater improvements in expansion compared to non-expansion states. This evidence includes studies that have shown that Medicaid expansion is associated with increases in overall prescriptions for, Medicaid-covered prescriptions for, and Medicaid spending on medications to treat opioid use disorder and opioid overdose.445446447448449450451452453454455456457458459460461462463464465466467468469470
Medication Assisted Treatment (MAT) for Treatment of Opioid Use Disorder. Multiple studies have found increases in medication assisted treatment (MAT) drug prescriptions (either overall or Medicaid-covered prescriptions) associated with expansion. Some of these studies also found that in contrast, there was no increase in opioid prescribing rates (overall or Medicaid-covered) associated with expansion over the same period. One study found that expansion was associated with an 18% increase in aggregate opioid admissions to specialty treatment facilities, nearly all of which was driven by a 113% increase in admissions from Medicaid beneficiaries.471472473474475476477478479480
Multiple recent studies have also found expansion to be associated with improvements in disparities by race/ethnicity, income, education level, insurance type, and employment status in measures of access to and utilization of care.481482483484485486487488
Studies point to changes in patterns of emergency department (ED) utilization. Some studies point to declines in uninsured ED visits or visit rates and increases in Medicaid-covered ED visits or visit rates in expansion states compared to non-expansion states, compared to pre-expansion, or compared to other populations within expansion states. Studies show inconsistent findings about how Medicaid expansion has affected ED volume or frequency of visits overall or among specific populations (e.g., Medicaid enrollees or frequent ED users), with some studies showing increases, no change, or declines. Studies also showed decreased reliance on the ED as a usual source of care and a shift in ED use toward visits for higher acuity conditions among individual patients who gained expansion coverage, compared to those who remained uninsured in non-expansion states.489490491492493494495496497498499500501502503504505506
In contrast with other studies’ findings on decreased reliance on the ED as a usual source of care, some recent studies suggest that Medicaid expansion may increase non-necessary use of certain health services. These services include hospitalization or specialty treatment for certain specific health conditions, including lupus, oral health conditions, and upper-extremity trauma. Authors explain that the non-necessary use of these services could be prevented by primary care and indicates the need for increased access to outpatient care for new enrollees.507508509510
Evidence suggests that beneficiaries and other stakeholders lack understanding of some waiver provisions designed to change utilization or improve health outcomes. Multiple studies have demonstrated confusion among beneficiaries, providers, and advocates in expansion waiver states around the basic elements of the programs or requirements for participation, as well as beneficiary reports of barriers to completion of program activities (including internet access and transportation barriers). These challenges have resulted in increased costs to beneficiaries, beneficiaries being transitioned to more limited benefit packages, low program participation, or programs not operating as intended in other ways.511512513514515516517
Some study findings did not show that expansion significantly improved some measures of access, utilization, or disparities between population groups. Many of these findings were included in studies that also found related improvements in access, utilization, or disparities measures and are also cited above. Authors of some early studies using 2014 data note that changes in utilization may take more than one year to materialize. Consistent with this premise, a longer-term study found improvements in measures of access to care and financial strain in year two of the expansion that were not observed in the first year.518519520521522523524525526527528529530531532533534535536537538539540541542543544545546547548549550551552553554555556557558559560561562563564565566567568569570571572573574
Quality of Care, Self-Reported Health, and Health Outcomes
Several studies show an association between Medicaid expansion and improvements in quality of care. These include studies focused on the low-income population broadly, academic medical center or affiliated hospital patients, or community health center patients and look at outcomes including receipt of recommended screenings or recommended care for a particular condition.575576577578579580581582
Additional studies show effects of expansion on measures of quality hospital care and outcomes. A few studies found that Medicaid expansion was associated with declines in hospital length of stay and in-hospital mortality as well as increases in hospital discharges to rehabilitation facilities, and one study found an association between expansion and declines in mechanical ventilation rates among patients hospitalized for various conditions. One recent study found that expansion was associated with decreased preventable hospitalizations, measured by reductions in annual ambulatory care-sensitive discharge rates and inpatient days. Additional analyses found that, contrary to past studies associating Medicaid insurance with longer hospital stays and higher in-hospital mortality, the shift in payer mix in expansion states (increase in Medicaid discharges and decrease in uninsured discharges) did not influence length of stay or in-hospital mortality for various types of patients.583584585,586,587588589590591592593594595
Multiple studies have found improvements in measures of self-reported health or positive health behaviors following Medicaid expansions. Studies found improvements in both measures of self-reported physical and mental health, as well as increases in healthy behaviors such as self-reported diabetes management. Additional research has documented provider reports of newly eligible adults showing improved health or receiving life-saving or life-changing treatments that they could not obtain prior to expansion.596597598599600601602603604605606607608609610611612
Studies have found an association between Medicaid expansion and improvements in certain measures of health outcomes. Studies in this area find an association between expansion and improvements in cardiac surgery patient outcomes and perforated appendix admission rates among hospitalized patients with acute appendicitis. One study did not find a significant association between expansion and differences in rates of low birth weight or preterm birth outcomes overall, but did find significant improvements in relative disparities for black infants compared with white infants in states that expanded vs. those that did not. Two studies found expansion was associated with increased odds of tobacco cessation (among adult CHC patients in one study and childless adults in the other).613614615616617618
Additionally, a growing body of research has found an association between Medicaid expansion and mortality, either population-level rates overall, for particular populations, or associated with certain health conditions. A 2019 national study found that expansion was associated with a 0.132 percentage point decline in annual mortality among near-elderly adults driven largely by reductions in disease-related deaths, an effect that translates to about 19,200 deaths that were averted during the first four years of expansion (or 15,600 deaths in expansion states could have been averted in non-expansion states). A 2020 study found that expansion was associated with a 6% lower rate of opioid overdose deaths. Another study suggests that expansion may have contributed to infant mortality rate reductions, finding that the mean infant mortality rate rose slightly in non-expansion states between 2014 and 2016, compared to a decline in expansion states over that period (this effect was particularly pronounced among the African-American population). Studies also found reductions in cardiovascular mortality among middle-aged adults and in one-year mortality among end-stage renal disease patients initiating dialysis.619620621622623
Some studies did not find significant changes associated with expansion on certain measures of quality of care, self-reported health, or health outcomes.
Some studies did not find an association between Medicaid expansion and quality outcomes; many of these studies focused on very narrow population groups and/or found a link between expansion and improvements in quality of care for some of the patient/population groups studied. One study found no significant association between Medicaid expansion and changes in quality of care delivered through Medicaid managed care plans. The authors suggest that this finding shows that the health system has generally been able to absorb new expansion enrollees without sacrificing care for existing enrollees.624625626627628629630631632633634
Some studies on specific hospital patient groups found no significant changes associated with expansion in measures of hospital care and outcomes, including rates of emergent admission, admissions from clinic, diagnosis category at admission, admission severity, rapid discharges, lengthy hospitalizations, unplanned readmissions, discharges to rehabilitation facilities, or failure to rescue. One study found that expansion was associated with an increase in length of stay for adult trauma patients.635636637638639640641642643644645646647648649
A small number of studies did not find significant changes in certain measures of self-reported health status, health outcomes including mortality, wellbeing, or healthy behaviors, or in disparities between certain population groups in these measures. One study found that although Medicaid expansion was associated with increased access to opioid pain-relievers, it was not significantly associated with any change in opioid deaths. Similarly, an earlier study found no evidence of expansion affecting drug-related overdoses or fatal alcohol poisonings. A third study found that although opioid overdose mortality rates increased more in expansion states, this difference was not caused by increased prescriptions. Given that it may take additional time for measurable changes in health to occur, researchers suggest that further work is needed to provide longer-term insight into expansion’s effects on self-reported health and health outcomes.650651652653654655656657658659660661662663664665666667668669670671672673674
Provider Capacity
Many studies conclude that providers have expanded capacity or participation in Medicaid following expansion and are meeting increased demands for care. Studies in this area include findings showing an association of expansion with increases in primary care appointment availability, the likelihood of accepting new patients with Medicaid among non-psychiatry specialist physicians, and Medicaid acceptance and market entry among select medication assisted treatment (MAT) providers. One study found improvements in receipt of checkups, care for chronic conditions, and quality of care even in areas with primary care shortages, suggesting that insurance expansions can have a positive impact even in areas with relative shortages. A survey of Medicaid managed care organizations found that over seven in ten plans operating in expansion states reported expanding their provider networks between January 2014 and December 2016 to serve the newly-eligible population.675676677678679680681682683684685686687688689690691692693694695696697698699700701
Some studies on measures of provider availability showed no changes associated with expansion. Authors note that findings of no changes may, in some cases, be viewed as favorable outcomes indicating that provider availability is not worsening in expansion states despite the increased demand for care associated with expansion. For example, despite concerns that expansion might worsen access for the already-insured, two studies found that expansion was not associated with decreased physician availability for Medicare patients.702703704705706707708709710711712713714715
Other studies found expansion was linked to problems with provider availability. Some of these studies also had positive or insignificant findings related to provider capacity for certain populations or types of appointment with negative findings related to others. These include findings that Medicaid expansion was associated with longer wait times for appointments or increased difficulty obtaining appointments with specialists. Most of these studies use early data from 2014 and 2015.716717718719720721722723724725726727
Affordability and Financial Security
Research suggests that Medicaid expansion improves the affordability of health care. Several studies show that people in expansion states have experienced reductions in unmet medical need because of cost, with national and multi-state studies showing those reductions were greater than reductions in non-expansion states. Research also suggests that Medicaid expansion results in significant reductions in out-of-pocket medical spending, and multiple studies found larger declines in trouble paying as well as worry about paying future medical bills among people in expansion states relative to non-expansion states. A recent study in Washington state found that among trauma patients, expansion was associated with a 12.4 percentage point decrease in estimated catastrophic healthcare expenditure risk. One study found that previously uninsured prescription drug users who gained Medicaid coverage in 2014 saw, on average, a $205 reduction in annual out-of-pocket spending in 2014. A January 2018 study that focused on the 100-138% FPL population in expansion and non-expansion states also found that Medicaid expansion coverage produced greater reductions than subsidized Marketplace coverage in average total out-of-pocket spending, average out-of-pocket premium spending, and average cost-sharing spending.728729730731732733734735736737738739740741742743744745746747748749750751752753754755756757758759760761762763764765766767768769770771772773
Studies have found that Medicaid expansion significantly reduced the percentage of people with medical debt, reduced the average size of medical debt, and reduced the probability of having one or more medical bills go to collections in the past 6 months.774775776777778779780781782783784
A study in Ohio showed lower medical debt holding levels among continuously-enrolled expansion enrollees compared to those who unenrolled from expansion and those who had a coverage gap, suggesting that medical debt levels rose even after a relatively short time without Medicaid expansion coverage.785786
Research also suggests an association between Medicaid expansion and improvements in broader measures of financial stability.787788789790791792793794795
For example:
A study found that Medicaid expansion was associated with a 2.2 percentage point decrease in very low food security (which is characterized by actual reduction of food intake due to unaffordability) among low-income childless adults.796
Two 2019 national studies looked at the association between Medicaid expansion and poverty rates. One found that expansion was associated with a reduction in the rate of poverty by just under 1 percentage point (or an estimated 690,000 fewer Americans living in poverty). The other found that Medicaid expansion was associated with a 1.7 percentage point reduction in the health-inclusive poverty measure (HIPM) poverty rate and a 0.9 percentage point reduction in the HIPM deep poverty rate that were significant across all demographic groups considered except single-parent households and were particularly substantial for vulnerable groups including children, the near-elderly (age 55-64), black people, Hispanics, and those who have not completed high school. The same study showed no significant change in the Census Bureau’s supplemental poverty measure (SPM).797798
Studies have found that Medicaid expansion significantly reduced the average number of collections, improved credit scores, reduced over limit credit card spending, reduced public records (such as evictions, bankruptcies, or wage garnishments), and reduced the probability of a new bankruptcy filing, among other improvements in measures of financial security. One 2019 study found that Medicaid expansion was associated with a 1.15 reduction in the rate of evictions per 1000 renter-occupied households and a 1.59 reduction in the rate of eviction filings.799800801802803804
A Michigan study found an association between expansion and improvements across a broad swath of financial measures.805
Multiple studies have found expansion to be associated with improvements in disparities by income or race/ethnicity in measures of affordability of care or financial security.806807808809810811
Some study findings did not show significant effects of expansion on measures of affordability or financial security. Several of these studies did not identify statistically significant differences in changes in unmet medical need due to cost between expansion and non-expansion states, though authors note that some of these findings may have been affected by study design or data limitations. Other studies did not find changes associated with expansion in trouble or worry about paying medical bills. Two studies did not find improvements in disparities by race/ethnicity associated with expansion in measures of unmet care needs due to cost.812813814815816817818819820821822823824825826827828829830831832
Economic Effects
Studies find positive effects of Medicaid expansion on a range of economic measures (Figure 5). Economic effects of expansion include changes to payer mix and other impacts on hospitals and other providers; effects on state budgets and economies; Medicaid spending per enrollee; marketplace effects; and employment and labor market effects.
Figure 5: Studies find positive effects of the ACA Medicaid expansion across a range of economic measures.
State Budgets and Economies
Analyses find effects of expansion on multiple state economic outcomes, including budget savings, revenue gains, and overall economic growth. These positive effects occurred despite Medicaid enrollment growth initially exceeding projections in many states and increases in total Medicaid spending, largely driven by increases in federal spending given the enhanced federal match rate for expansion population costs provided under the ACA (the federal share was 100% for 2014-2016). As of Summer 2019, most expansion states reported relying on general fund support to finance the state share of expansion costs, although some also use new or increased provider taxes/fees or savings accrued as a result of the expansion. While studies showed higher growth rates in total Medicaid spending (federal, state, and local) following initial expansion implementation in 2014 and 2015 compared to the previous few years, this growth rate slowed significantly beginning in 2016. There is limited research examining the fiscal effects at the federal level from the additional expenditures for the Medicaid expansion or the revenues to support that spending.833834835836837838839840841842843844845846847848849850851852853854855
National research found that there were no significant increases in spending from state funds as a result of Medicaid expansion and no significant reductions in state spending on education, transportation, or other state programs as a result of expansion during FYs 2010-2015. During this period, the federal government paid for 100% of the cost expansion. State spending could rise as the federal matching for the expansion phases down to 90%.856
Single-state studies in Louisiana and Montana showed that expansion resulted in large infusions of federal funds into the states’ economies and significant state savings. Louisiana studies showed increases in overall state and local tax receipts in 2017 and 2018. A study in Montana found positive financial effects for businesses due to infusion of federal dollars to fund health coverage for workers.857858859860861
Multiple studies suggest that Medicaid expansion resulted in state savings by offsetting state costs in other areas, including state costs related to behavioral health services and crime and the criminal justice system. For example, a study in Montana showed offsets for state SUD spending, a study in California showed reduced county safety-net spending, and a study in Michigan pointed to state savings for non-Medicaid health programs (including the state’s community mental health system, its Adult Benefit Waiver program, and spending on health care for prisoners), which, combined with increased tax revenue associated with expansion, resulted in net fiscal benefits expected through 2021. Limited research also indicates possible federal and state savings due to decreased SSI participation associated with expansion.862863864865866867868869870871872873874875876
Medicaid Spending Per Enrollee
Studies have found lower Medicaid spending per enrollee for the new ACA adult eligibility group compared to traditional Medicaid enrollees (including seniors and people with disabilities in some studies and excluding those populations in others) and that per enrollee costs for newly eligible adults have declined over time since initial implementation of the expansion.877878879880881882883884
One analysis found that in 2014, among those states reporting both spending and enrollment data, spending per enrollee for the new adult group was much lower than spending per enrollee for traditional Medicaid enrollees. Similarly, an analysis of 2012-2014 data from expansion states found that average monthly expenditures for newly eligible Medicaid enrollees were $180, 21% less than the $228 average for previously eligible enrollees.885886
A June 2017 study showed that per enrollee Medicaid spending declined in expansion states(-5.1%) but increased in non-expansion states (5.1%) between 2013 and 2014. Researchers attributed these trends to the ACA Medicaid expansion, which increased the share of relatively less expensive enrollees in the Medicaid beneficiary population mix in expansion states.887
Marketplace Effects
Studies suggest that Medicaid expansion supports the ACA Marketplaces and may help to lower Marketplace premiums. Two national studies showed that Marketplace premiums were significantly lower in expansion compared to non-expansion states, with estimates ranging from 7% lower in 2015 to 11-12% lower in a later study that looked at 2015-2018 data. Another study found that the state average plan liability risk score was higher in non-expansion than expansion states in 2015 (higher risk scores are associated with sicker state risk pools and likely translate to higher premiums). A study in Arkansas showed that the “private option” expansion has helped to boost the number of carriers offering Marketplace plans statewide, generated a younger and relatively healthy risk pool in the Marketplace, and contributed to a 2% drop in the average rate of Marketplace premiums between 2014 and 2015. A study of New Hampshire’s Premium Assistance Program (PAP) population (Medicaid expansion population enrolled in the Marketplace), however, showed higher medical costs for the PAP population compared to other Marketplace enrollees.888889890891892
Some studies point to changes in payer mix within emergency departments (EDs), specifically. Multiple studies found significant declines in uninsured ED visits and increases in Medicaid-covered ED visits following expansion implementation. In addition, one study found that expansion was associated with a 6.3% increase in ED physician reimbursement per visit in states that newly expanded coverage for adults from 0% to 138% FPL compared to non-expansion states.977978979980981982983984985986987988989990
Multiple studies found an association between expansion and significant increases in Medicaid coverage of patients/treatment at specialty substance use disorder (SUD) treatment facilities or treatment programs, with two studies also showing associated decreases in the probability that patients at these facilities were uninsured. An additional study found large shifts in sources of payment for SUD treatment among justice-involved individuals following Medicaid expansion in 2014, with significant increases in those reporting Medicaid as the source of payment.991992993994995
Numerous recent studies found an association between expansion and payer mix (decreases in uninsured patients and increases in Medicaid patients) among patients hospitalized for certain specific conditions, including a range of cardiovascular conditions and operations; diabetes-related conditions; traumatic injury; and cancer surgery. Another analysis found expansion was associated with increases in Medicaid patient admissions for five of the eight types of cancer included in the study. Additional studies found that expansion was associated with increases in the proportion of transplant listings (for lung, liver, and pre-emptive kidney transplants, especially among racial and ethnic minorities) with Medicaid coverage, as well as increases in the proportion of received pre-emptive kidney transplantations that were covered by Medicaid. Two additional studies also found an increase in the chances of enrolling in Medicaid during post-liver transplant care. A study using birth certificate data found that expansion was associated with an increased proportion of deliveries covered by Medicaid, which was offset by a decrease in the proportion covered by private insurers or other payers but no change in the proportion of women who were uninsured.9969979989991000100110021003100410051006100710081009101010111012101310141015101610171018
Studies found that expansion’s impact on payer mix and uncompensated care varied by the type and location of hospital. Two studies found larger decreases in uncompensated care and increases in Medicaid revenue among hospitals that treat a disproportionate share of low-income patients (DSH hospitals) compared to those that do not. A third study found no significant association of Medicaid expansion with changes in charge-to-cost ratio for certain surgical procedures in safety net hospitals vs. non-safety net hospitals, suggesting that safety net hospitals did not increase charges to private payers in response to expansion-related payer mix changes. A fourth study found that Medicaid expansion was significantly associated with increased Medicaid-covered discharges for rural hospitals but not for urban hospitals, but that urban hospitals saw significant reductions in uncompensated care costs while rural hospitals did not.1019102010211022
Additional studies demonstrate that Medicaid expansion has significantly improved operating margins and financial performances for hospitals, other providers, and managed care organizations. A study published in January 2018 found that Medicaid expansion was associated with improved hospital financial performance and significant reductions in the probability of hospital closure, especially in rural areas and areas with higher pre-ACA uninsured rates. Another analysis found that expansion’s effects on margins were strongest for small hospitals, for-profit and non-federal-government-operated hospitals, and hospitals located in non-metropolitan areas. A third study found larger expansion-related improvements in operating margins for public (compared to nonprofit or for-profit) hospitals and rural (compared to non-rural) hospitals.1023102410251026102710281029103010311032103310341035
A study of Ascension Health hospitals nationwide found that the decrease in uncompensated care costs for hospitals in expansion states was greater than the increase in Medicaid shortfalls between 2013 and 2014, whereas for hospitals in non-expansion states, the increase in Medicaid shortfalls exceeded the decrease in uncompensated care.1036
A survey of Medicaid managed care organizations found that nearly two-thirds of plans in expansion states reported that the expansion has had a positive effect on their financial performance.1037
Recent studies on the association between expansion and hospital costs or charges for specific conditions have found mixed results. One study found expansion was associated with increased diagnosis-related group charges for lupus hospitalizations, but another study found an association between expansion and reduced hospital costs for ambulatory care-sensitive conditions and a third found lower total index hospital charges within the homeless population in expansion states. An additional study found that hospital costs for minimally-invasive surgical care decreased for Medicaid-insured patients in expansion states, but increased for uninsured/self-pay patients.1038103910401041
Some research suggests that savings to providers following expansion may be partially offset by increases in Medicaid shortfalls (the difference between what Medicaid pays and the cost of care for Medicaid patients). One recent study found that while expansion led to substantial reductions in hospitals’ uncompensated care costs, savings were offset somewhat by increased Medicaid payment shortfalls (increases were greater in expansion relative to non-expansion states).1042
Employment and Labor Market Effects
State-specific studies have documented significant job growth resulting from expansion. Studies in Louisiana found that in FY 2017, the injection of federal expansion funds created and supported 19,195 jobs (while creating and supporting personal earnings of $1.12 billion) in sectors throughout the economy and across the state; in FY 2018, continued federal healthcare spending supported 14,263 jobs and $889.0 million in personal earnings. A study in Colorado found that the state supported 31,074 additional jobs due to Medicaid expansion as of FY 2015-2016.10431044104510461047
Some studies found expansion was linked to increased employment. National research found increases in the share of individuals with disabilities reporting employment and decreases in the share reporting not working due to a disability in Medicaid expansion states following expansion implementation, with no corresponding trends observed in non-expansion states; other research found a decline in participation in Supplemental Security Income, which requires people to demonstrate having a work-limiting disability and limits their allowable earned income. Another national study found evidence that for many of the demographic groups included in the analysis, expansion was associated with an increase in labor force participation and employment. The study also found a significant decrease in involuntary part-time work for both the full population sample and the sample of those with incomes at or below 138% FPL. A multi-state study found that by the fourth year of expansion, growth in total employment was 1.3 percentage points higher and employment growth in the health care sector was 3.2 percentage points higher in the expansion states studied than in non-expansion states.104810491050105110521053
Multiple studies showed that expansion supported enrollees’ ability to work, seek work, or volunteer. Single-state studies in Ohio and Michigan showed that large percentages of expansion beneficiaries reported that Medicaid enrollment made it easier to seek employment (among those who were unemployed but looking for work) or continue working (among those who were employed). The Michigan study found that 69% of enrollees who were working said they performed better at work once they got expansion coverage. Another study found that 46% of primary care physicians surveyed in Michigan reported that Michigan’s Medicaid expansion had a positive impact on patients’ ability to work. An additional study in Michigan found that enrollees who reported improved health due to expansion were more likely to say that expansion coverage improved their ability to work and to seek a new job. In addition, a national study found an association between Medicaid expansion and volunteer work (both formal volunteering for organizations and informally helping a neighbor), with significant increases in volunteer work occurring among low-income individuals in expansion states in the post-expansion period (through 2015) but no corresponding increase in non-expansion states. The researchers connect this finding to previous literature showing an association between improvements in individual health and household financial stabilization and an increased likelihood of volunteering.10541055105610571058
Some studies found no effects of expansion on some measures of employment or employee behavior; just one study found a negative effect of expansion on these measures. Measures in this area that showed no changes related to expansion in some studies include measures of employment rates, transitions from employment to non-employment, the rate of job switches, transitions from full- to part-time employment, labor force participation, usual hours worked per week, self-employment, and Supplemental Security Income applications. Authors of two studies note that expansion had no effect on employment and job-seeking despite concerns that the availability of free non-employer health insurance could be a disincentive to finding employment. A 2019 study comparing pairs of bordering counties in expansion and non-expansion states found that expansion was associated with a temporary 1.2% decrease in employment one year after implementation (although this effect did not persist two years after expansion) and no effect on wages at any point.1059106010611062106310641065106610671068
Emerging Studies
Medicaid expansion was associated with a statistically significant decrease in reported cases of neglect for children younger than six years, but no significant change in rates of physical abuse for children under six. Another 2019 study found that Medicaid expansion was associated with increased undercounting of Medicaid enrollment in the American Community Survey. A 2017 study found that expansion was negatively associated with the prevalence of divorce among those ages 50-64 and infers that this likely indicates a reduction in medical divorce. A study found that expansion was not associated with increased migration from non-expansion states to expansion states in 2014, indicating that individuals did not migrate in order to gain access to Medicaid benefits. An additional group of studies suggests that Medicaid expansion may have significant effects on measures related to individuals’ political activity and views. Specifically, studies show associations between Medicaid expansion and increases in voter registration, ACA favorability, and gubernatorial approval. One study found that the increase in Medicaid enrollment following Medicaid expansion was associated with increases in voter turnout for U.S. House races in 2014 compared to 2012 (i.e., a reduction in the size of the usual midterm drop-off in turnout), but another study showed only weak evidence of a potential turnout effect of expansion in the 2014 election, and a consistent lack of any impact on turnout in 2016.106910701071107210731074107510761077
The authors thank Larisa Antonisse for her work on previous versions of this brief and assistance with reviewing recently published studies included in this update, as well as Eva Allen from The Urban Institute for her assistance with reviewing studies first included in an earlier version of this brief.
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Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019
John J. Park et al., “Medicaid and Private Insurance Coverage for Low-Income Asian Americans, Native Hawaiians, and Pacific Islanders, 2010-16,” Health Affairs 38, no. 11 (November 2019): 1911-1917, https://doi.org/10.1377/hlthaff.2019.00316
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009
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Jim P. Stimpson, Jessie Kemmick Pintor, and Fernando A. Wilson, “Association of Medicaid Expansion with Health Insurance Coverage by Marital Status and Sex,” PLoS One 14, no. 10 (October 2019), https://doi.org/10.1371/journal.pone.0223556
Gracie Himmelstein, “Effect of the Affordable Care Act’s Medicaid Expansions on Food Security, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1243-1248, https://doi.org/10.2105/ajph.2019.305168
Taylor Kelley, Renuka Tipirneni, and Helen Levy, “Changes in Veterans’ Coverage and Access to Care Following the Affordable Care Act, 2011-2017,” American Journal of Public Health 109, no. 9 (September 2019): 1233-1235, https://doi.org/10.2105/ajph.2019.305160
Lindsay C. Kobayashi, Onur Altindag, Yulya Truskinovsky, and Lisa F. Berkman, “Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-Being in the US Adult Population, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1236-1242, https://doi.org/10.2105/ajph.2019.305164
Charles J. Courtemanche et al., The Impact of the ACA on Insurance Coverage Disparities After Four Years (National Bureau of Economic Research, Working Paper No. 26157, August 2019), http://www.nber.org/papers/w26157
Lucie Schmidt, Lara Shore-Sheppard, and Tara Watson, The Impact of the ACA Medicaid Expansion on Disability Program Applications (National Bureau of Economic Research, Working Paper No. 26192, August 2019), http://www.nber.org/papers/w26192
Sri Lekha Tummalapalli, Samuel Leonard, Michelle M. Estrella, and Salomeh Keyhani, “The Effect of Medicaid Expansion on Self-Reported Kidney Disease,” Clinical Journal of American Society of Nephrology 14, no. 8 (August 2019): 1238-1240, https://doi.org/10.2215/cjn.02310219
Sumit D. Agarwal, Anna L. Goldman, and Benjamin D. Sommers, “Blue-Collar Workers Had Greatest Insurance Gains After ACA Implementation,” Health Affairs 38, no. 7 (July 2019): 1140-1144, https://doi.org/10.1377/hlthaff.2018.05454
Kevin N. Griffith, “Changes in Insurance Coverage and Access to Care for Young Adults in 2017,” Journal of Adolescent Health Epub ahead of print (July 2019), https://doi.org/10.1016/j.jadohealth.2019.05.020
Sameed Ahmed Khatana et al., “Association of Medicaid Expansion With Cardiovascular Mortality,” JAMA Cardiology 4, no. 7 (July 2019): 671-679, https://doi.org/10.1001/jamacardio.2019.1651
Sarah Miller, Sean Altekruse, Norman Johnson, and Laura R. Wherry, Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data (National Bureau of Economic Research, Working Paper No. 26081, July 2019), http://www.nber.org/papers/w26081
Jim P. Stimpson et al., “Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability,” JAMA Network Open 2, no. 7 (July 2019), https://doi.org/10.1001/jamanetworkopen.2019.7136
Ameen Barghi, Hugo Torres, Nancy Kressin, and Danny McCormick, “Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study,” Journal of General Internal Medicine epub ahead of print (June 2019), https://link.springer.com/article/10.1007%2Fs11606-019-05108-1
Emily Brown, Michelle Garrison, Hao Bao, Pingping Qu, Carole Jenny, and Ali Rowhani-Rahbar, “Assessment of Rates of Child Maltreatment in States With Medicaid Expansion vs States Without Medicaid Expansion,” JAMA Network Open 2, no. 6 (June 2019), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2735758
Ankit Agarwal, Aaron Katz, and Ronald Chen, “The Impact of the Affordable Care Act on Disparities in Private and Medicaid Insurance Coverage among Patients Under 65 with Newly Diagnosed Cancer,” International Journal of Radiation Oncology, Biology, Physics (May 2019), https://www.redjournal.org/article/S0360-3016(19)30783-7/pdf
Robin Cohen, Emily Terlizzi, and Michael Martinez, Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2018 (National Center for Health Statistics, May 2019), https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201905.pdf
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046
Joanna Woronkowicz, Aparna Soni, Seth Freedman, and Kosali Simon, “How Have Recent Health Insurance Expansions Affected Coverage Among Artist Occupations In The USA?,” Journal of Cultural Economics (May 2019), https://link.springer.com/article/10.1007/s10824-019-09352-5
Abeer Alharbi, M. Mahmud Khan, Ronnie Horner, Heather Brandt, and Cole Chapman, “Impact Of Medicaid Coverage Expansion Under The Affordable Care Act On Mammography And Pap Tests Utilization Among Low-Income Women,” PLOS One (April 2019), https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214886
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Xuesong Han, Robin Yabroff, Elizabeth Ward, Otis Brawley, and Ahmedin Jemal, “Comparison of Insurance Status and Diagnosis Stage Among Patients With Newly Diagnosed Cancer Before vs After Implementation of the Patient Protection and Affordable Care Act,” JAMA Oncology 4, no. 12 (August 2018): 1713-1720, https://jamanetwork.com/journals/jamaoncology/article-abstract/2697226
Mark Olfson, Melanie Wall, Colleen Barry, Christine Mauro, and Ramin Mojtabai, “Impact Of Medicaid Expansion On Coverage And Treatment Of Low-Income Adults With Substance Use Disorders,” Health Affairs 37, no. 8 (August 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.0124
Adele Shartzer, Frederic Blavin, and John Holohan, “Employer-Sponsored Insurance Stable For Low-Income Workers In Medicaid Expansion States,” Health Affairs 37, no. 4 (April 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1205
Kevin Callison and Paul Sicilian, “Economic Freedom and the Affordable Care Act: Medicaid Expansions and Labor Mobility by Race and Ethnicity,” Public Finance Review 46, no. 2 (March 2018), https://journals.sagepub.com/doi/abs/10.1177/1091142116668254
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Emily Johnston, Andrea Strahan, Peter Joski, Anne Dunlop, and E. Kathleen Adams, “Impacts of the Affordable Care Act’s Medicaid Expansion on Women of Reproductive Age,” Women’s Health Issues, 28, no. 2 (February 2018), http://www.whijournal.com/article/S1049-3867(17)30242-6/pdf
Frederic Blavin, Michael Karpman, Genevieve Kenney, and Benjamin Sommers, “Medicaid Versus Marketplace Coverage for Near-Poor Adults: Effects on Out-Of-Pocket Spending and Coverage,” Health Affairs 37 no. 2 (January 2018): 122-129 https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.1166
Ahmedin Jemal, Chun Chieh Lin, Amy Davidoff, and Xuesong Han, “Changes in Insurance Coverage and Stage at Diagnosis Among Nonelderly Patients with Cancer after the Affordable Care Act,” Journal of Clinical Oncology 35, no. 35 (December 2017), http://ascopubs.org/doi/pdf/10.1200/JCO.2017.73.7817
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830
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Haley Moss, Laura Havrilesky, and Junzo Chino, “Insurance Coverage Among Women Diagnosed with a Gynecologic Malignancy Before and After Implementation of the Affordable Care Act,” Gynecologic Oncology 146, no. 3 (September 2017), https://www.ncbi.nlm.nih.gov/pubmed/28641821
Sandra Decker, Brandy Lipton, and Benjamin Sommers, “Medicaid Expansion Coverage Effects Grew in 2015 With Continued Improvements in Coverage Quality,” Health Affairs 36 no. 5 (May 2017): 819-825, http://content.healthaffairs.org/content/36/5/819.full
Stacey McMorrow, Jason Gates, Sharon Long, and Genevieve Kenney, “Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents,” Health Affairs 36 no. 5 (May 2017): 808-818, https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1650
George Wehby and Wei Lyu, “The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender” Health Services Research epub ahead of print (May 2017), http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12711/abstract
Brandy Lipton, Sandra Decker, and Benjamin Sommers, “The Affordable Care Act Appears to Have Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Care Among Young Adults” Medical Care Research and Review 76, no.1 (April 2017): 32–55, https://www.ncbi.nlm.nih.gov/pubmed/29148341
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Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890
Kosali Simon, Aparna Soni, and John Cawley, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions” Journal of Policy Analysis and Management 36, no. 2 (March 2017), https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21972
Aparna Soni, Michael Hendryx, and Kosali Simon, “Medicaid Expansion under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas,” The Journal of Rural Health epub ahead of print (January 2017), http://onlinelibrary.wiley.com/doi/10.1111/jrh.12234/full
Tyler Winkelman, Edith Kieffer, Susan Goold, Jeffrey Morenoff, Kristen Cross, and John Ayanian, “Health Insurance Trends and Access to Behavioral Health Care Among Justice-Involved Individuals,” Journal of General Internal Medicine 31, no. 12 (December 2016): 1523-1529, https://www.ncbi.nlm.nih.gov/pubmed/27638837
Helen Levy, Thomas Buchmueller, and Sayeh Nikpay, Health Reform and Health Insurance Coverage of Early Retirees (Ann Arbor, MI: University of Michigan Retirement Research Center Working Paper, September 2016), http://www.mrrc.isr.umich.edu/publications/papers/pdf/wp345.pdf
Pauline Leung and Alexandre Mas, Employment Effects of the ACA Medicaid Expansions (Working Paper No. 22540, National Bureau of Economic Research, August 2016), http://www.nber.org/papers/w22540
Office of the Assistant Secretary for Planning and Evaluation (ASPE), Impacts of the Affordable Care Act’s Medicaid Expansion on Insurance Coverage and Access to Care (Office of the Assistant Secretary for Planning and Evaluation, June 2016), https://aspe.hhs.gov/sites/default/files/pdf/205141/medicaidexpansion.pdf
Brendan Saloner, Sachini Bandara, Emma McGinty, and Colleen Barry, “Justice-Involved Adults With Substance Use Disorders: Coverage Increased but Rates of Treatment Did Not in 2014,” Health Affairs 35 no. 6 (June 2016), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0005
Thomas Buchmueller, Zachary Levinson, Helen Levy, and Barbara Wolfe, “Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage,” American Journal of Public Health (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27196653
John Cawley, Aparna Soni, and Kosali Simon, “Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1495-1497, https://link.springer.com/article/10.1007%2Fs11606-018-4537-0
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, and Daniela Zapata, Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States (Working Paper No. 22182, The National Bureau of Economic Research, April 2016), http://www.nber.org/papers/w22182
Laura Wherry and Sarah Miller, “Early Coverage, Access, Utilization, and Health Effects Associated with the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study,” Annals of Internal Medicine, Epub ahead of print (April 2016), http://annals.org/article.aspx?articleid=2513980
Robert Kaestner, Bowen Garrett, Anuj Gangopadhyaya, and Caitlyn Fleming, Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply (Working Paper No. 21836, National Bureau of Economic Research, December 2015), http://www.nber.org/papers/w21836
Benjamin Sommers, Munira Gunja, Kenneth Finegold, and Thomas Musco, “Changes in Self-Reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act,” The Journal of the American Medical Association 314 no. 4 (July 2015): 366-374, http://jama.jamanetwork.com/article.aspx?articleid=2411283&resultClick=3
Stacey McMorrow, Genevieve Kenney, Sharon Long, and Nathaniel Anderson, “Uninsurance Among Young Adults Continues to Decline, Particularly in Medicaid Expansion States,” Health Affairs 34, no. 4 (April 2015): 616-620, http://content.healthaffairs.org/content/34/4/616.full
Benjamin Sommers, Thomas Musco, Kenneth Finegold, Munira Gunja, Amy Burke, and Audrey McDowell, “Health Reform and Changes in Health Insurance Coverage in 2014” The New England Journal of Medicine 371 (August 2014): 867-874, http://www.nejm.org/doi/full/10.1056/NEJMsr1406753
Sarah H. Gordon, Benjamin D. Sommers, Ira B. Wilson, and Amal N. Trivedi, “Effects Of Medicaid Expansion On Postpartum Coverage And Outpatient Utilization,” Health Affairs 39, no. 1 (January 2020): 77-84, https://doi.org/10.1377/hlthaff.2019.00547
John A. Graves et al., “Medicaid Expansion Slowed Rates of Health Decline for Low-Income Adults in Southern States,” Health Affairs 39, no. 1 (January 2020): 67-76, https://doi.org/10.1377/hlthaff.2019.00929
Amandeep R. Mahal et al., “Early Impact of the Affordable Care Act and Medicaid Expansion on Racial and Socioeconomic Disparities in Cancer Care,” American Journal of Clinical Oncology Epub ahead of print (January 2020), https://doi.org/10.1097/coc.0000000000000588
Shiho Kino and Ichiro Kawachi, “Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?,” Health Education & Behavior Epub ahead of print (October 2019), https://doi.org/10.1177/1090198119875998
Charles J. Courtemanche, James Marton, and Aaron Yelowitz, Medicaid Coverage across the Income Distribution under the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26145, August 2019), http://www.nber.org/papers/w26145
Huabin Luo, Zhuo Chen, Lei Xu, and Ronny Bell, “Health Care Access and Receipt of Clinical Diabetes Preventive Care for Working-Age Adults With Diabetes in States With and Without Medicaid Expansion: Results from the 2013 and 2015 BRFSS,” Journal of Public Health Management and Practice 25, no. 4 (July/August 2019): 34-43, https://doi.org/10.1097/phh.0000000000000832
Deborah Yip et al., “Association of Medicaid Expansion and Health Insurance with Receipt of Smoking Cessation Services and Smoking Behaviors in Substance Use Disorder Treatment,” The Journal of Behavioral Health Services & Research (July 2019), https://doi.org/10.1007/s11414-019-09669-1
Sarah Gordon, Benjamin Sommers, Ira Wilson, Omar Galarraga, and Amal Trivedi, “The Impact of Medicaid Expansion on Continuous Enrollment: a Two State Analysis,” Journal of General Internal Medicine epub ahead of print (June 2019), https://link.springer.com/article/10.1007/s11606-019-05101-8
Jose Mesquita-Neto, Peter Cmorej, Hassan Mouzaihem, Donald Weaver, Steve Kim, and Francis Macedo, “Disparities In Access To Cancer Surgery After Medicaid Expansion,” The American Journal of Surgery epub ahead of print (June 2019), https://www.sciencedirect.com/science/article/abs/pii/S0002961019306889
Benjamin Sommers, Anna Goldman, Robert Blendon, E. John Orav, and Arnold Epstein, “Medicaid Work Requirements – Results from the First Year in Arkansas,” The New England Journal of Medicine Special Report (June 2019), https://www.nejm.org/doi/full/10.1056/NEJMsr1901772
Andrew Admon, Michael Sjoding, Sarah Lyon, John Ayanian, Theodore Iwashyna, and Colin Cooke, “Medicaid Expansion and Mechanical Ventilation in Asthma, Chronic Obstructive Pulmonary Disease, and Heart Failure,” Annals of the American Thoracic Society epub ahead of print (February 2019), https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201811-777OC
Carrie Fry and Benjamin Sommers, “Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression,” Psychiatric Services 69, no. 11 (November 2018), https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800181
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562
Xuesong Han, Robin Yabroff, Elizabeth Ward, Otis Brawley, and Ahmedin Jemal, “Comparison of Insurance Status and Diagnosis Stage Among Patients With Newly Diagnosed Cancer Before vs After Implementation of the Patient Protection and Affordable Care Act,” JAMA Oncology 4, no. 12 (August 2018): 1713-1720, https://jamanetwork.com/journals/jamaoncology/article-abstract/2697226
Benjamin Sommers, Carrie Fry, Robert Blendon, and Arnold Epstein, “New Approaches in Medicaid: Work Requirements, Health Savings Accounts, and Health Care Access,” Health Affairs 37, no. 7 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0331
Fumiko Chino, Gita Suneja, Haley Moss, S. Yousuf Zafar, Laura Havrilesky, and Junzo Chino, “Healthcare Disparities in Cancer Patients Receiving Radiation: Changes in Insurance Status After Medicaid Expansion Under the Affordable Care Act,” International Journal of Radiation Oncology (December 2017), http://www.sciencedirect.com/science/article/pii/S0360301617341883
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420
Stephen Berry et al., “Healthcare Coverage for HIV Provider Visits before and after Implementation of the Affordable Care Act,” Clinical Infectious Diseases, (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27143660
Benjamin Sommers, Robert Blendon, and E. John Orav, “Both the ‘Private Option’ And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults,” Health Affairs 35, no. 1 (January 2016): 96-105, http://content.healthaffairs.org/content/35/1/96.abstract
Michael Dworsky and Christine Eibner, The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults (Santa Monica, CA: Rand Corporation, 2016), https://www.rand.org/pubs/research_reports/RR1736.html
Dennis McCarty, Yifan Gu, John W. McIlveen, and Bonnie K. Lind, “Medicaid Expansion and Treatment for Opioid Use Disorders in Oregon: An Interrupted Time-Series Analysis,” Addiction Science & Clinical Practice 14 (August 2019), https://doi.org/10.1186/s13722-019-0160-6
John Heintzman, Steffani Bailey, Jennifer DeVoe, Stuart Cowburn, Tanya Kapka, Truc-Vi Duong, and Miguel Marino, “In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon,” Journal of Racial and Ethnic Health Disparities (April 2016), http://www.ncbi.nlm.nih.gov/pubmed/27105630
Anna L. Goldman and Benjamin D. Sommers, “Among Low-Income Adults Enrolled In Medicaid, Churning Decreased After The Affordable Care Act,” Health Affairs 39, no. 1 (January 2020): 85-93, https://doi.org/10.1377/hlthaff.2019.00378
Nicole Kravitz-Wirtz et al., “Association of Medicaid Expansion With Opioid Overdose Mortality in the United States,” JAMA Network Open 3, no. 1 (January 2020), https://doi.org/10.1001/jamanetworkopen.2019.19066
Helmneh M. Sineshaw et al., “Association of Medicaid Expansion Under the Affordable Care Act With Stage at Diagnosis and Time to Treatment Initiation for Patients With Head and Neck Squamous Cell Carcinoma,” JAMA Otolaryngology–Head & Neck Surgery Epub ahead of print (January 2020), https://doi.org/10.1001/jamaoto.2019.4310
Jean M. Abraham, Anne B. Royalty, and Coleman Drake, “The Impact of Medicaid Expansion on Employer Provision of Health Insurance,” International Journal of Health Economics and Management 19, no. 3-4 (December 2019): 317-340, https://doi.org/10.1007/s10754-018-9256-x
Susan L. Averett, Julie K. Smith, and Yang Wang, “Medicaid Expansion and Opioid Deaths,” Health Economics 28, no. 12 (December 2019): 1491-1496, https://doi.org/10.1002/hec.3945
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553
Travis Donahoe et al., “The Affordable Care Act Medicaid Expansion and Smoking Cessation Among Low-Income Smokers,” American Journal of Preventive Medicine 57, no. 6 (December 2019): 203-210, https://doi.org/10.1016/j.amepre.2019.07.004
Hiroshi Gotanda, Gerald Kominski, and Yusuke Tsugawa, “Association Between the ACA Medicaid Expansions and Primary Care and Emergency Department Use During the First 3 Years,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05458-w
Kelsey L. Corrigan et al., “The Impact of the Patient Protection and Affordable Care Act on Insurance Coverage and Cancer-Directed Treatment in HIV-Infected Patients With Cancer in the United States,” Cancer (November 2019), https://doi.org/10.1002/cncr.32563
Xuesong Han et al., “Changes in Noninsurance and Care Unaffordability Among Cancer Survivors Following the Affordable Care Act,” Journal of the National Cancer Institute Epub ahead of print (November 2019), https://doi.org/10.1093/jnci/djz218
Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019
James A. Swartz and Susanny J. Beltran, “Prescription Opioid Availability and Opioid Overdose-Related Mortality Rates in Medicaid Expansion and Non-Expansion States,” Addiction 114, no. 11 (November 2019): 2016-2025, https://doi.org/10.1111/add.14741
Yunwei Gai and John Marthinsen, “Medicaid Expansion, HIV Testing, and HIV-Related Risk Behaviors in the United States, 2010-2017,” American Journal of Public Health 109, no. 10 (October 2019): 1404-1412, https://doi.org/10.2105/ajph.2019.305220
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009
Jusung Lee et al., “The Impact of Medicaid Expansion on Diabetes Management,” Diabetes Care Epub ahead of print (October 2019), https://doi.org/10.2337/dc19-1173
Johanna Catherine Maclean, Michael F. Pesko, and Steven C. Hill, “Public Insurance Expansions and Smoking Cessation Medications,” Economic Inquiry 57, no. 4 (October 2019): 1798-1820, https://doi.org/10.1111/ecin.12794
Chelsea L. Shover et al., “The Relationship of Medicaid Expansion to Psychiatric Comorbidity Care within Substance Use Disorder Treatment Programs,” Journal of Substance Abuse Treatment 105 (October 2019): 44-50, https://doi.org/10.1016/j.jsat.2019.07.012
Naomi Zewde, Erica Eliason, Heidi Allen, and Tal Gross, “The Effects of the ACA Medicaid Expansion on Nationwide Home Evictions and Eviction-Court Initiations: United States, 2000-2016,” American Journal of Public Health 109, no. 10 (October 2019): 1379-1383, https://doi.org/10.2105/ajph.2019.305230
Evan M. Chen et al., “Association of the Affordable Care Act Medicaid Expansion with Dilated Eye Examinations among the United States Population with Diabetes,” Ophthalmology Epub ahead of print (September 2019), https://doi.org/10.1016/j.ophtha.2019.09.010
Taressa K. Fraze et al., “Prevalence of Screening for Food Insecurity, Housing Instability, Utility Needs, Transportation Needs, and Interpersonal Violence by US Physician Practices and Hospitals,” JAMA Network Open 2, no. 9 (September 2019), https://doi.org/10.1001/jamanetworkopen.2019.11514
Gracie Himmelstein, “Effect of the Affordable Care Act’s Medicaid Expansions on Food Security, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1243-1248, https://doi.org/10.2105/ajph.2019.305168
Taylor Kelley, Renuka Tipirneni, and Helen Levy, “Changes in Veterans’ Coverage and Access to Care Following the Affordable Care Act, 2011-2017,” American Journal of Public Health 109, no. 9 (September 2019): 1233-1235, https://doi.org/10.2105/ajph.2019.305160
Lindsay C. Kobayashi, Onur Altindag, Yulya Truskinovsky, and Lisa F. Berkman, “Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-Being in the US Adult Population, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1236-1242, https://doi.org/10.2105/ajph.2019.305164
Sanders Korenman, Dahlia K. Remler, and Rosemary T. Hyson, “Medicaid Expansions and Poverty: Comparing Supplemental and Health-Inclusive Poverty Measures,” Social Service Review 93, no. 3 (September 2019): 429-483, https://doi.org/10.1086/705319
Sri Lekha Tummalapalli, Samuel Leonard, Michelle M. Estrella, and Salomeh Keyhani, “The Effect of Medicaid Expansion on Self-Reported Kidney Disease,” Clinical Journal of American Society of Nephrology 14, no. 8 (August 2019): 1238-1240, https://doi.org/10.2215/cjn.02310219
Kevin N. Griffith, “Changes in Insurance Coverage and Access to Care for Young Adults in 2017,” Journal of Adolescent Health Epub ahead of print (July 2019), https://doi.org/10.1016/j.jadohealth.2019.05.020
Sameed Ahmed Khatana et al., “Association of Medicaid Expansion With Cardiovascular Mortality,” JAMA Cardiology 4, no. 7 (July 2019): 671-679, https://doi.org/10.1001/jamacardio.2019.1651
Sarah Miller, Sean Altekruse, Norman Johnson, and Laura R. Wherry, Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data (National Bureau of Economic Research, Working Paper No. 26081, July 2019), http://www.nber.org/papers/w26081
Ameen Barghi, Hugo Torres, Nancy Kressin, and Danny McCormick, “Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study,” Journal of General Internal Medicine epub ahead of print (June 2019), https://link.springer.com/article/10.1007%2Fs11606-019-05108-1
Johanna Maclean and Brendan Saloner, “The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act,” Journal of Policy Analysis and Management 38, no. 2 (Spring 2019): 366-393, https://www.ncbi.nlm.nih.gov/pubmed/30882195
Stacey Fedewa, K. Robin Yabroff, Robert Smith, Ann Goding Sauer, Xuesong Han, and Ahmedin Jemal, “Changes in Breast and Colorectal Cancer Screening After Medicaid Expansion Under the Affordable Care Act,” American Journal of Preventive Medicine epub ahead of print (May 2019), https://www.sciencedirect.com/science/article/pii/S0749379719301163
Jevay Grooms and Alberto Ortega, “Examining Medicaid Expansion and the Treatment of Substance Use Disorders,” American Economic Association Papers and Proceedings 109 (May 2019): 187-192, https://www.aeaweb.org/articles?id=10.1257/pandp.20191090
Nathalie Huguet et al., “Cervical And Colorectal Cancer Screening Prevalence Before And After Affordable Care Act Medicaid Expansion,” Preventative Medicine (May 2019), https://doi.org/10.1016/j.ypmed.2019.05.003
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046
Gary Pickens et al., “Changes In Hospital Service Demand, Cost, And Patient Illness Severity Following Health Reform,” Health Services Research (May 2019), https://doi.org/10.1111/1475-6773.13165
Matthew Present, Aviva Nathan, Sandra Ham, Robert Sargis, Michael Quinn, and Elbert Huang, “The Impact of the Affordable Care Act Medicaid Expansion on Type 2 Diabetes Diagnosis and Treatment: A National Survey of Physicians,” Journal of Community Health epub ahead of print (May 2019), https://link.springer.com/article/10.1007%2Fs10900-019-00637-6
Abeer Alharbi, M. Mahmud Khan, Ronnie Horner, Heather Brandt, and Cole Chapman, “Impact Of Medicaid Coverage Expansion Under The Affordable Care Act On Mammography And Pap Tests Utilization Among Low-Income Women,” PLOS One (April 2019), https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214886
Clare Brown et al., “Association of State Medicaid Expansion Status With Low Birth Weight and Preterm Birth” Journal of the American Medical Association 321, no. 16 (April 2019), https://jamanetwork.com/journals/jama/fullarticle/2731179
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “The Affordable Care Act and Opioid Agonist Therapy for Opioid Use Disorder,” Psychiatry Online (April 2019), https://doi.org/10.1176/appi.ps.201900025
Robert Sandstrom, “Increased Utilization of Ambulatory Occupational Therapy and Physical Therapy After Medicaid Expansion” Archives of Physical Medicine and Rehabilitation epub ahead of print (March 2019), https://www.archives-pmr.org/article/S0003-9993(19)30161-3/fulltext
Bernard Black, Alex Hollingsworth, Leticia Nunes, and Kosali Simon, The Effect of Health Insurance on Mortality: Power Analysis and What We Can Learn from the Affordable Care Act Coverage Expansions, (National Bureau of Economic Research, Working Paper Series No. 25568, February 2019), https://www.nber.org/papers/w25568
Chad Cotti, Erik Nesson, and Nathan Tefft, “Impacts Of The ACA Medicaid Expansion On Health Behaviors: Evidence From Household Panel Data,” Health Economics 28, no. 2 (February 2019): 219-244, https://onlinelibrary.wiley.com/doi/pdf/10.1002/hec.3838
J.W. Awori Hayanga et al., “Lung Transplantation and Affordable Care Act Medicaid Expansion in the Era of Lung Allocation Score” Transplant International epub ahead of print (February 2019), https://onlinelibrary.wiley.com/doi/pdf/10.1111/tri.13420
Ausmita Ghosh, Kosali Simon, and Benjamin Sommers, “The Effect of Health Insurance on Prescription Drug Use Among Low-Income Adults: Evidence from Recent Medicaid Expansions,” Journal of Health Economics 63 (January 2019): 64-80, https://www.sciencedirect.com/science/article/pii/S0167629617300206
De-Chih Lee, Leiyu Shi, and Hailun Liang, “Primary Care Utilization And Clinical Quality Performance: A Comparison Between Health Centres In Medicaid Expansion States And Non-Expansion States,” Journal of Health Services Research & Policy 24, no. 1 (January 2019): 19-24, https://journals.sagepub.com/doi/abs/10.1177/1355819618788592
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “Medication Treatment For Opioid Use Disorders In Substance Use Treatment Facilities,” Health Affairs 38, no. 1 (January 2019), https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05162
Elham Mahmoudi, Alicia Cohen, Jason Buxbaum, Caroline Richardson, and Wassim Tarraf, “Gaining Medicaid Coverage During ACA Implementation: Effects on Access to Care and Preventive Services,” Journal of Health Care for the Poor and Underserved 29, no. 4 (November 2018): 1472-1487, https://muse.jhu.edu/article/708253
Xuesong Han, Robin Yabroff, Elizabeth Ward, Otis Brawley, and Ahmedin Jemal, “Comparison of Insurance Status and Diagnosis Stage Among Patients With Newly Diagnosed Cancer Before vs After Implementation of the Patient Protection and Affordable Care Act,” JAMA Oncology 4, no. 12 (August 2018): 1713-1720, https://jamanetwork.com/journals/jamaoncology/article-abstract/2697226
Mark Olfson, Melanie Wall, Colleen Barry, Christine Mauro, and Ramin Mojtabai, “Impact Of Medicaid Expansion On Coverage And Treatment Of Low-Income Adults With Substance Use Disorders,” Health Affairs 37, no. 8 (August 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.0124
Hilary Barnes, Michael Richards, Matthew McHugh, and Grant Martsolf, “Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners,” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.1158
Megan Cole, Brad Wright, Ira Wilson, Omar Gallarraga, and Amal Trivedi, “Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.1542
Angelica Meinhofer and Allison Witman, “The Role Of Health Insurance On Treatment For Opioid Use Disorders: Evidence From The Affordable Care Act Medicaid Expansion,” Journal of Health Economics 60 (June 2018): 177-197, https://www.sciencedirect.com/science/article/abs/pii/S0167629617311530
Rishi Wadhera et al., “Association of the Affordable Care Act’s Medicaid Expansion With Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure,” Circulation: Cardiovascular Quality and Outcomes 11, no. 7 (June 2018), https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.118.004729
Alana Sharp, Austin Jones, Jennifer Sherwood, Oksana Kutsa, Brian Honermann, and Gregorio Millett, “Impact of Medicaid Expansion on Access to Opioid Analgesic Medications and Medication-Assisted Treatment,” American Journal of Public Health 108, no. 5 (May 2018): 642-648, https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018.304338?journalCode=ajph
Emily Johnston, Andrea Strahan, Peter Joski, Anne Dunlop, and E. Kathleen Adams, “Impacts of the Affordable Care Act’s Medicaid Expansion on Women of Reproductive Age,” Women’s Health Issues, 28, no. 2 (February 2018), http://www.whijournal.com/article/S1049-3867(17)30242-6/pdf
Frederic Blavin, Michael Karpman, Genevieve Kenney, and Benjamin Sommers, “Medicaid Versus Marketplace Coverage for Near-Poor Adults: Effects on Out-Of-Pocket Spending and Coverage,” Health Affairs 37 no. 2 (January 2018): 122-129 https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.1166
Anna Goldman, Steffie Woolhandler, and David Himmelstein, “Out-of-pocket Spending and Premium Contributions After Implementation of the Affordable Care Act,” Journal of the American Medical Association epub ahead of print (January 2018), https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2669908
Ahmedin Jemal, Chun Chieh Lin, Amy Davidoff, and Xuesong Han, “Changes in Insurance Coverage and Stage at Diagnosis Among Nonelderly Patients with Cancer after the Affordable Care Act,” Journal of Clinical Oncology 35, no. 35 (December 2017), http://ascopubs.org/doi/pdf/10.1200/JCO.2017.73.7817
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830
Kenneth Brevoort, Daniel Grodzicki, and Martin Hackmann, Medicaid and Financial Health (National Bureau of Economic Research, Working Paper No. 24002, November 2017), http://www.nber.org/papers/w24002
Tyler Winkelman and Virginia Chang, “Medicaid Expansion, Mental Health, and Access to Care Among Childless Adults With and Without Chronic Conditions,” Journal of General Internal Medicine epub ahead of print (November 2017), https://www.ncbi.nlm.nih.gov/pubmed/29181792
Michael Dworsky, Carrie Farmer, and Mimi Shen, Veterans’ Health Insurance Coverage Under the Affordable Care Act and Implications of Repeal for the Department of Veterans Affairs, (RAND Corporation, 2017), https://www.rand.org/pubs/research_reports/RR1955.html
Sunha Choi, Sungkyu Lee, and Jason Matejkowski, “The Effects of State Medicaid Expansion on Low-Income Individuals’ Access to Health Care: Multilevel Modeling,” Population Health Management epub ahead of print (September 2017), http://online.liebertpub.com/doi/abs/10.1089/pop.2017.0104
Sharon Long, Lea Bart, Michael Karpman, Adele Shartzer, and Stephen Zuckerman, “Sustained Gains in Coverage, Access, and Affordability Under the ACA: A 2017 Update,” Health Affairs 36 no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0798
Haley Moss, Laura Havrilesky, and Junzo Chino, “Insurance Coverage Among Women Diagnosed with a Gynecologic Malignancy Before and After Implementation of the Affordable Care Act,” Gynecologic Oncology 146, no. 3 (September 2017), https://www.ncbi.nlm.nih.gov/pubmed/28641821
Dmitry Tumin et al., “Medicaid Participation among Liver Transplant Candidates after the Affordable Care Act Medicaid Expansion” Journal of the American College of Surgeons 225, no. 2 (August 2017): 173-180.e2, https://www.journalacs.org/article/S1072-7515(17)30454-4/fulltext
Jacqueline Fiore, The Impact of the Affordable Care Act’s Medicaid Expansion on Medicaid Spending by Health Care Service Category (Tulane University, July 2017), http://econ.tulane.edu/RePEc/pdf/tul1706.pdf
Joseph Labrum et al., “Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act?” Clinical Orthopaedics and Related Research 475 no. 6 (June 2017): 1527-1536, https://link.springer.com/article/10.1007%2Fs11999-017-5263-3
Gary Pickens et al., “Changes in Hospital Inpatient Utilization Following Health Care Reform,” Health Services Research epub ahead of print (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28664983
Stacey McMorrow, Jason Gates, Sharon Long, and Genevieve Kenney, “Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents,” Health Affairs 36 no. 5 (May 2017): 808-818, https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1650
Brandy Lipton, Sandra Decker, and Benjamin Sommers, “The Affordable Care Act Appears to Have Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Care Among Young Adults” Medical Care Research and Review 76, no.1 (April 2017): 32–55, https://www.ncbi.nlm.nih.gov/pubmed/29148341
Johanna Maclean and Brendan Saloner, The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act (National Bureau of Economic Research Working Paper No. 23342, April 2017), http://www.nber.org/papers/w23342.pdf
Astha Singhal, Peter Damiano, and Lindsay Sabik, “Medicaid Adult Dental Benefits Increase Use Of Dental Care, But Impact Of Expansion On Dental Services Use Was Mixed,” Health Affairs 36 no. 4 (April 2017): 723-732, http://content.healthaffairs.org/content/36/4/723.short
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health (National Bureau of Economic Research, Working Paper no. 23269, March 2017), http://www.nber.org/papers/w23269
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890
Kosali Simon, Aparna Soni, and John Cawley, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions” Journal of Policy Analysis and Management 36, no. 2 (March 2017), https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21972
Khadijah Breathett et al., “The Affordable Care Act Medicaid Expansion Correlated with Increased Heart Transplant Listings in African Americans but Not Hispanics or Caucasians,” JACC: Heart Failure 5 no. 2 (January 2017): 136-147, https://www.ncbi.nlm.nih.gov/pubmed/28109783
Anne DiGiulio et al., “State Medicaid Expansion Tobacco Cessation Coverage and Number of Adult Smokers Enrolled in Expansion Coverage – United States, 2016,” Morbidity and Mortality Weekly Report 65, no. 48 (December 2016), https://www.cdc.gov/mmwr/volumes/65/wr/mm6548a2.htm
James Kirby and Jessica Vistnes, “Access to Care Improved for People Who Gained Medicaid or Marketplace Coverage in 2014,” Health Affairs 35 no. 10 (October 2016): 1830-1834, http://content.healthaffairs.org/content/35/10/1830.full
Hefei Wen, Tyrone Borders, and Benjamin Druss, ”Number of Medicaid Prescriptions Grew, Drug Spending was Steady in Medicaid Expansion States,” Health Affairs 35, no. 12 (September 2016): 1604-1607, http://content.healthaffairs.org/content/35/9/1604.full
Jesse M. Pines, Mark Zocchi, Ali Moghtaderi, Bernard Black, Steven A. Farmer, Greg Hufstetler, Kevin Klauer and Randy Pilgrim, “Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix,” Health Affairs 35, no. 8 (August 2016), http://content.healthaffairs.org/content/35/8/1480.full
John Cawley, Aparna Soni, and Kosali Simon, “Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1495-1497, https://link.springer.com/article/10.1007%2Fs11606-018-4537-0
Luojia Hu, Robert Kaestenr, Bhashkar Mazumder, Sarah Miller, and Ashley Wong, “The Effect of the Affordable Care Act Medicaid Expansions on Financial Wellbeing,” Journal of Public Economics 163 (July 2018): 99-112, https://www.sciencedirect.com/science/article/abs/pii/S0047272718300707
Stacey McMorrow, Genevieve Kenney, Sharon Long, and Jason Gates, “Marketplaces Helped Drive Coverage Gains in 2015; Affordability Problems Remained,” Health Affairs 35 no. 10 (October 2016): 1810-1815, http://content.healthaffairs.org/content/35/10/1810.full
Mary Anderson, Jeffrey Glasheen, Debra Anoff, “Impact of State Medicaid Expansion Status on Length of Stay and In-Hospital Mortality for General Medicine Patients at US Academic Medical Centers,” Journal of Hospital Medicine Epub ahead of print (August 2016), http://onlinelibrary.wiley.com/wol1/doi/10.1002/jhm.2649/citedby
Laura Wherry and Sarah Miller, “Early Coverage, Access, Utilization, and Health Effects Associated with the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study,” Annals of Internal Medicine, Epub ahead of print (April 2016), http://annals.org/article.aspx?articleid=2513980
Benjamin Sommers, Munira Gunja, Kenneth Finegold, and Thomas Musco, “Changes in Self-Reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act,” The Journal of the American Medical Association 314 no. 4 (July 2015): 366-374, http://jama.jamanetwork.com/article.aspx?articleid=2411283&resultClick=3
Emanuel Eguia et al., “The Impact of the Affordable Care Act Medicaid Expansion on Vascular Surgery,” Annals of Vascular Surgery Epub ahead of print (January 2020), https://doi.org/10.1016/j.avsg.2020.01.006
Hawazin W. Elani, Ichiro Kawachi, and Benjamin D. Sommers, “Changes in Emergency Department Dental Visits after Medicaid Expansion,” Health Services Research Epub ahead of print (January 2020), https://doi.org/10.1111/1475-6773.13261
Sarah H. Gordon, Benjamin D. Sommers, Ira B. Wilson, and Amal N. Trivedi, “Effects Of Medicaid Expansion On Postpartum Coverage And Outpatient Utilization,” Health Affairs 39, no. 1 (January 2020): 77-84, https://doi.org/10.1377/hlthaff.2019.00547
John A. Graves et al., “Medicaid Expansion Slowed Rates of Health Decline for Low-Income Adults in Southern States,” Health Affairs 39, no. 1 (January 2020): 67-76, https://doi.org/10.1377/hlthaff.2019.00929
Alexander T. Janke, Shooshan Danagoulian, Arjun K. Venkatesh, and Phillip D. Levy, “Medicaid Expansion and Resource Utilization in the Emergency Department,” The American Journal of Emergency Medicine Epub ahead of print (January 2020), https://doi.org/10.1016/j.ajem.2019.12.050
Adam M. Almaguer et al., “Do Geographic Region, Medicaid Status, and Academic Affiliation Affect Access to Care Among Medicaid and Privately Insured Total Hip Arthroplasty Patients?,” Journal of Arthroplasty 34, no. 12 (December 2019): 2866-2871, https://doi.org/10.1016/j.arth.2019.07.030
Mark Clapp et al., “Association of Medicaid Expansion With Coverage and Access to Care for Pregnant Women,” Obstetrics & Gynecology 134, no. 5 (November 2019): 1066-1074, https://doi.org/10.1097/aog.0000000000003501
Afshin Ehsan et al., “Utilization of Left Ventricular Assist Devices in Vulnerable Adults Across Medicaid Expansion,” Journal of Surgical Research 243 (November 2019): 503-508, https://doi.org/10.1016/j.jss.2019.05.015
Kelsie M. Gould et al., “Bariatric Surgery Among Vulnerable Populations: The Effect of the Affordable Care Act’s Medicaid Expansion,” Surgery 166, no. 5 (November 2019): 820-828, https://doi.org/10.1016/j.surg.2019.05.005
Jesse M. Hinde et al., “Increasing Access to Opioid Use Disorder Treatment: Assessing State Policies and the Evidence Behind Them,” Journal of Studies on Alcohol and Drugs 80, no. 6 (November 2019): 693-697, https://doi.org/10.15288/jsad.2019.80.693
Hefei Wen, Kenton J. Johnston, Lindsay Allen, and Teresa M. Waters, “Medicaid Expansion Associated With Reductions In Preventable Hospitalizations,” Health Affairs 38, no. 11 (November 2019): 1845-1849, https://doi.org/10.1377/hlthaff.2019.00483
Mohammad Eslami et al., “Impact of Medicaid Expansion of the Affordable Care on the Outcomes of Lower Extremity Bypass for Patients With Peripheral Artery Disease in the Vascular Quality Initiative Database,” Annals of Surgery 270, no. 4 (October 2019): 647-655, https://doi.org/10.1097/sla.0000000000003521
Shiho Kino and Ichiro Kawachi, “Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?,” Health Education & Behavior Epub ahead of print (October 2019), https://doi.org/10.1177/1090198119875998
Nadia Laniado, Avery R. Brow, Eric Tranby, and Victor M. Badner, “Trends in Non-Traumatic Dental Emergency Department Use in New York and New Jersey: A Look at Medicaid Expansion from Both Sides of the Hudson River,” Journal of Public Health Dentistry Epub ahead of print (October 2019), https://doi.org/10.1111/jphd.12343
Elizabeth A. Brown et al., “The Impact of the ACA Medicaid Expansion on Access to Care and Hospitalization Charges for Lupus Patients,” Arthritis Care & Research Epub ahead of print (September 2019), https://doi.org/10.1002/acr.24080
Craig Garthwaite et al., All Medicaid Expansions Are Not Created Equal: The Geography and Targeting of the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26289, September 2019), http://www.nber.org/papers/w26289
Nathalie Huguet et al., “Following Uninsured Patients Through Medicaid Expansion: Ambulatory Care Use and Diagnosed Conditions,” Annals of Family Medicine 17, no. 4 (July/August 2019): 336-344, https://doi.org/10.1370/afm.2385
Huabin Luo, Zhuo Chen, Lei Xu, and Ronny Bell, “Health Care Access and Receipt of Clinical Diabetes Preventive Care for Working-Age Adults With Diabetes in States With and Without Medicaid Expansion: Results from the 2013 and 2015 BRFSS,” Journal of Public Health Management and Practice 25, no. 4 (July/August 2019): 34-43, https://doi.org/10.1097/phh.0000000000000832
Emanuel Eguia et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Access to Minimally Invasive Surgical Care,” The American Journal of Surgery Epub ahead of print (July 2019), https://doi.org/10.1016/j.amjsurg.2019.07.003
Deborah Yip et al., “Association of Medicaid Expansion and Health Insurance with Receipt of Smoking Cessation Services and Smoking Behaviors in Substance Use Disorder Treatment,” The Journal of Behavioral Health Services & Research (July 2019), https://doi.org/10.1007/s11414-019-09669-1
Ramiro Manzano-Nunez et al., “Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery,” World Journal of Surgery 43, no. 6 (June 2019): 1483-1489, https://link.springer.com/article/10.1007/s00268-019-04932-0
Jose Mesquita-Neto, Peter Cmorej, Hassan Mouzaihem, Donald Weaver, Steve Kim, and Francis Macedo, “Disparities In Access To Cancer Surgery After Medicaid Expansion,” The American Journal of Surgery epub ahead of print (June 2019), https://www.sciencedirect.com/science/article/abs/pii/S0002961019306889
Rahul Ladhania, Amelia Haviland, Arvind Venkat, Rahul Telang, and Jesse Pines, “The Effect of Medicaid Expansion on the Nature of New Enrollees’ Emergency Department Use,” Medical Care Research and Review epub ahead of print (May 2019), https://journals.sagepub.com/doi/abs/10.1177/1077558719848270
Andrew Admon, Michael Sjoding, Sarah Lyon, John Ayanian, Theodore Iwashyna, and Colin Cooke, “Medicaid Expansion and Mechanical Ventilation in Asthma, Chronic Obstructive Pulmonary Disease, and Heart Failure,” Annals of the American Thoracic Society epub ahead of print (February 2019), https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201811-777OC
Jenny Nguyen, Nidharshan Anandasivam, Daniel Cooperman, Richard Pelker, and Daniel Wiznia, “Does Medicaid Insurance Provide Sufficient Access to Pediatric Orthopedic Care Under the Affordable Care Act?,” Global Pediatric Health epub ahead of print (February 2019), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381430/
Cheryl Zogg et al., “Impact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision,” Journal of the American College of Surgeons 228, no. 1 (January 2019): 29-43, https://www.journalacs.org/article/S1072-7515(18)32078-7/fulltext
Carrie Fry and Benjamin Sommers, “Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression,” Psychiatric Services 69, no. 11 (November 2018), https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800181
James McDermott et al., “Affordable Care Act’s Medicaid Expansion and Use of Regionalized Surgery at High-Volume Hospitals,” Journal of the American College of Surgeons 227, no. 5 (November 2018): 507-520.e9, https://www.journalacs.org/article/S1072-7515(18)31993-8/abstract
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562
Ehimare Akhabue, Lindsay Pool, Clyde Yancy, Philip Greenland, and Donald Lloyd-Jones, “Association of State Medicaid Expansion With Rate of Uninsured Hospitalizations for Major Cardiovascular Events, 2009-2014,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2698077
Brendan Saloner, Jonathan Levin, Hsien-Yen Chang, Christopher Jones, and G. Caleb Alexander, “Changes in Buprenorphine-Naloxone and Opioid Pain Reliever Prescriptions After the Affordable Care Act Medicaid Expansion,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2696873
Benjamin Sommers, Carrie Fry, Robert Blendon, and Arnold Epstein, “New Approaches in Medicaid: Work Requirements, Health Savings Accounts, and Health Care Access,” Health Affairs 37, no. 7 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0331
Aparna Soni, Kosali Simon, John Cawley, and Lindsay Sabik, “Effect of Medicaid Expansions of 2014 on Overall and Early-Stage Cancer Diagnoses,” American Journal of Public Health epub ahead of print (December 2017), http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2017.304166
Paul Jacobs, Genevieve Kenney, and Thomas Selden, “Newly Eligible Enrollees In Medicaid Spend Less And Use Less Care Than Those Previously Eligible,” Health Affairs 36, no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0252
Jeremy Holzmacher et al., “Association of Expanded Medicaid Coverage with Hospital Length of Stay After Injury,” JAMA Surgery published online (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28658482
United States Government Accountability Office (GAO), Medicaid Expansion: Behavioral Health Treatment Use in Selected States in 2014 (Washington, DC: GAO Report to Congressional Requesters, June 2017), https://www.gao.gov/assets/690/685415.pdf
Nathalie Huguet et al., “Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers,” Journal of Primary Care & Community Health epub ahead of print (May 2017), http://journals.sagepub.com/doi/full/10.1177/2150131917709403
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293
Nirosha Mahendraratnam, Stacie Dusetzina, and Joel Farley, “Prescription Drug Utilization and Reimbursement Increased Following State Medicaid Expansion in 2014,” Journal of Managed Care & Specialty Pharmacy 23 no. 3 (March 2017): 355-363, http://www.jmcp.org/doi/10.18553/jmcp.2017.23.3.355
Megan Hoopes, Heather Angier, Rachel Gold, Steffani Bailey, Nathalie Huguet, Miguel Marino, and Jennifer DeVoe, “Utilization of Community Health Centers in Medicaid Expansion and Nonexpansion States, 2013-2014,” Journal of Ambulatory Care Management 39 no. 4 (October 2016): 290-298, https://www.ncbi.nlm.nih.gov/pubmed/26765808
Benjamin Sommers, Robert Blendon, E. John Orav, Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420
Benjamin Sommers, Robert Blendon, and E. John Orav, “Both the ‘Private Option’ And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults,” Health Affairs 35, no. 1 (January 2016): 96-105, http://content.healthaffairs.org/content/35/1/96.abstract
Government Accountability Office, Behavioral Health: Options for Low-Income Adults to Receive Treatment in Selected States (Washington, DC: Government Accountability Office, June 2015), http://www.gao.gov/assets/680/670894.pdf
Susan Dorr Goold et al., “Primary Care, Health Promotion, and Disease Prevention with Michigan Medicaid Expansion,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05370-3
Susannah Gibbs et al., “Evaluating the Effect of Medicaid Expansion on Access to Preventive Reproductive Care for Women in Oregon,” Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.ypmed.2019.105899
Ann-Marie Rosland et al., “Diagnosis and Care of Chronic Health Conditions Among Medicaid Expansion Enrollees: a Mixed-Methods Observational Study,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2549-2558, https://doi.org/10.1007/s11606-019-05323-w
Heather Holderness et al., “Where Do Oregon Medicaid Enrollees Seek Outpatient Care Post-Affordable Care Act Medicaid Expansion?,” Medical Care 57, no. 10 (October 2019): 788-794, https://doi.org/10.1097/mlr.0000000000001189
Charles A. Daly et al., “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma,” The Journal of Hand Surgery 44, no. 9 (September 2019): 720-727, https://doi.org/10.1016/j.jhsa.2019.05.020
John Scott et al., “Lifting the Burden: State Medicaid Expansion Reduces Financial Risk for the Injured,” Journal of Trauma and Acute Care Surgery Epub ahead of print (September 2019), https://doi.org/10.1097/ta.0000000000002493
Renuka Tipirneni et al., “Association of Expanded Medicaid Coverage With Health and Job-Related Outcomes Among Enrollees With Behavioral Health Disorders,” Psychiatric Services Epub ahead of print (September 2019), https://doi.org/10.1176/appi.ps.201900179
Dennis McCarty, Yifan Gu, John W. McIlveen, and Bonnie K. Lind, “Medicaid Expansion and Treatment for Opioid Use Disorders in Oregon: An Interrupted Time-Series Analysis,” Addiction Science & Clinical Practice 14 (August 2019), https://doi.org/10.1186/s13722-019-0160-6
Tong Gan et al., “Impact of the Affordable Care Act on Colorectal Cancer Screening, Incidence, and Survival in Kentucky,” Journal of the American College of Surgeons 228, no. 4 (April 2019): 342-353.e1, https://www.journalacs.org/article/S1072-7515(19)30046-8/fulltext
Brendan Saloner, Rachel Landis, Bradley Stein, and Colleen Barry, “The Affordable Care Act in the Heart of the Opioid Crisis: Evidence from West Virginia,” Health Affairs 38, no. 4 (April 2019), https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.05049
Renuka Tipirneni et al., “Changes in Health and Ability to Work Among Medicaid Expansion Enrollees: a Mixed Methods Study,” Journal of General Internal Medicine 34, no. 2 (February 2019): 272-280, https://link.springer.com/article/10.1007/s11606-018-4736-8
Neal Bhutiani, Brian Harbrecht, Charles Scoggins, and Matthew Bozeman, “Evaluating The Early Impact Of Medicaid Expansion On Trends In Diagnosis And Treatment Of Benign Gallbladder Disease In Kentucky,” The American Journal of Surgery (January 2019), https://www.americanjournalofsurgery.com/article/S0002-9610(18)30894-8/fulltext
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf
Sarah Miller, Luojia Hu, Robert Kaestner, Bhashkar Mazumder, and Ashley Wong, The ACA Medicaid Expansion in Michigan and Financial Health, (National Bureau of Economic Research, working paper no. 25053, September 2018), https://www.nber.org/papers/w25053.pdf
Susan Dorr Goold et al., “Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study,” Journal of General Internal Medicine 33, no. 8 (June 2018): 1307-1316, https://link.springer.com/article/10.1007/s11606-018-4487-6
Shannon McConville, Maria Raven, Sarah Sabbagh, and Renee Hsia, “Frequent Emergency Department Users: A Statewide Comparison Before And After Affordable Care Act Implementation,” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0784
Donald Likosky, Devraj Sukul, Milan Seth, Chang He, Hitlander Gurm, and Richard Prager, “The Association Between Medicaid Expansion and Cardiovascular Interventions: The Michigan Experience,” Journal of the American College of Cardiology 71, no. 9 (March 2018): 1050-1051, https://www.sciencedirect.com/science/article/pii/S0735109718300056?via%3Dihub
Aabha Sharma, Scott Dresden, Emilie Powell, Raymond Kang, Joe Feinglass, “Emergency Department Visits and Hospitalizations for the Uninsured in Illinois Before and After Affordable Care Act Insurance Expansion,” Journal of Community Health 42 no. 3 (June 2017): 591-597, https://link.springer.com/article/10.1007/s10900-016-0293-4
Natoshia Askelson, Brad Wright, Suzanne Bentler, Elizabeth Momany, and Peter Damiano, “Iowa’s Medicaid Expansion Promoted Healthy Behaviors But Was Challenging to Implement and Attracted Few Participants,” Health Affairs 36 no. 5, (May 2017): 799-807, http://content.healthaffairs.org/content/36/5/799.full
Angela Fertig, Caroline Carlin, Scote Ode, and Sharon Long, “Evidence of Pent-Up Demand for Care After Medicaid Expansion,” Medical Care Research and Review epub ahead of print (March 2017), http://journals.sagepub.com/eprint/wDsfA74fuA3BIw5ZWyYT/full
Daniel Gingold, Rachelle Pierre-Mathieu, Brandon Cole, Andrew Miller, and Joneigh Khaldun, “Impact of the Affordable Care Act Medicaid Expansion on Emergency Department High Utilizers with Ambulatory Care Sensitive Conditions: A Cross-Sectional Study,” The American Journal of Emergency Medicine (January 2017), http://www.sciencedirect.com/science/article/pii/S0735675717300141
Jeffrey Horn et al., “New Medicaid Enrollees See Health and Social Benefits in Pennsylvania’s Expansion,” INQUIRY: the Journal of Health Care Organization, Provision, and Financing 53 (October 2016): 1-8, http://journals.sagepub.com/doi/full/10.1177/0046958016671807#
Qiwei He and Scott Barkowski, “The Effect of Health Insurance on Crime: Evidence from the Affordable Care Act Medicaid Expansion,” Health Economics Epub ahead of print (January 2020): 261-277, https://doi.org/10.1002/hec.3977
Johanna Maclean and Brendan Saloner, “The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act,” Journal of Policy Analysis and Management 38, no. 2 (Spring 2019): 366-393, https://www.ncbi.nlm.nih.gov/pubmed/30882195
Amanda Abraham et al., “Changes in State Technical Assistance Priorities and Block Grant Funds for Addiction After ACA Implementation,” American Journal of Public Health epub ahead of print (May 2019), https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2019.305052
Gary Pickens et al., “Changes In Hospital Service Demand, Cost, And Patient Illness Severity Following Health Reform,” Health Services Research (May 2019), https://doi.org/10.1111/1475-6773.13165
Aditi Sen and Thomas DeLeire, “How Does Expansion Of Public Health Insurance Affect Risk Pools And Premiums In The Market For Private Health Insurance? Evidence From Medicaid And The Affordable Care Act Marketplaces,” Health Economics 27 (July 2018): 1877–1903, https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3809
Micah Hartman et al., “National Health Care Spending in 2016: Spending and Enrollment Growth Slow After Initial Coverage Expansions,” Health Affairs epub ahead of print (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1299
Seth Freedman, Sayeh Nikpay, Aaron Carroll, and Kosali Simon, “Changes in inpatient payer-mix and hospitalizations following Medicaid expansion: Evidence from all-capture hospital discharge data,” PLoS One 12 no. 9 (September 2017), http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0183616
Jacqueline Fiore, The Impact of the Affordable Care Act’s Medicaid Expansion on Medicaid Spending by Health Care Service Category (Tulane University, July 2017), http://econ.tulane.edu/RePEc/pdf/tul1706.pdf
Jesse M. Hinde et al., “Increasing Access to Opioid Use Disorder Treatment: Assessing State Policies and the Evidence Behind Them,” Journal of Studies on Alcohol and Drugs 80, no. 6 (November 2019): 693-697, https://doi.org/10.15288/jsad.2019.80.693
Paul Jacobs, Genevieve Kenney, and Thomas Selden, “Newly Eligible Enrollees In Medicaid Spend Less And Use Less Care Than Those Previously Eligible,” Health Affairs 36, no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0252
Deborah Bachrach, Patricia Boozang, Avi Herring, and Dori Glanz Reyneri, States Expanding Medicaid See Significant Budget Savings and Revenue Gains, (Manatt Health Solutions, prepared by the Robert Wood Johnson Foundation’s State Health Reform Assistance Network, March 2016), http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2016/rwjf419097
Stephan R. Lindner et al., “Health Care Expenditures Among Adults With Diabetes After Oregon’s Medicaid Expansion,” Diabetes Care Epub ahead of print (December 2019), https://doi.org/10.2337/dc19-1343
Heather Holderness et al., “Where Do Oregon Medicaid Enrollees Seek Outpatient Care Post-Affordable Care Act Medicaid Expansion?,” Medical Care 57, no. 10 (October 2019): 788-794, https://doi.org/10.1097/mlr.0000000000001189
Helen Levy et al., “Macroeconomic Feedback Effects of Medicaid Expansion: Evidence from Michigan,” Journal of Health Politics, Policy and Law Epub ahead of print (October 2019), https://doi.org/10.1215/03616878-7893555
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf
Susan Dorr Goold et al., “Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study,” Journal of General Internal Medicine 33, no. 8 (June 2018): 1307-1316, https://link.springer.com/article/10.1007/s11606-018-4487-6
John Ayanian, Gabriel Ehrlich, Donald Grimes, and Helen Levy, “Economic Effects of Medicaid Expansion in Michigan,” The New England Journal of Medicine epub ahead of print (January 2017), http://www.nejm.org/doi/full/10.1056/NEJMp1613981
Meera N. Harhay, Ryan M. McKenna, and Michael O. Harhay, “Association Between Medicaid Expansion Under the Affordable Care Act and Medicaid-Covered Pre-emptive Kidney Transplantation,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2322-2325, https://doi.org/10.1007/s11606-019-05279-x
Johanna Maclean and Brendan Saloner, “The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act,” Journal of Policy Analysis and Management 38, no. 2 (Spring 2019): 366-393, https://www.ncbi.nlm.nih.gov/pubmed/30882195
Michel Boudreaux, Yoon Choi, Liyang Xie, and Daniel Marthey, “Medicaid Expansion at Title X Clinics: Client Volume, Payer Mix, and Contraceptive Method Type,” Medical Care epub ahead of print (April 2019), https://www.ncbi.nlm.nih.gov/pubmed/30973473
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “The Affordable Care Act and Opioid Agonist Therapy for Opioid Use Disorder,” Psychiatry Online (April 2019), https://doi.org/10.1176/appi.ps.201900025
Jordan Rhodes, Thomas Buchmueller, Helen Levy, and Sayeh Nikpay, “Heterogeneous Effects Of The Aca Medicaid Expansion On Hospital Financial Outcomes,” Contemporary Economic Policy epub ahead of print (April 2019), https://onlinelibrary.wiley.com/doi/full/10.1111/coep.12428
Tyler McClintock, Ye Wang, Mahek Shah, Benjamin Chung, and Steven Chang, “How Have Hospital Pricing Practices for Surgical Episodes of Care Responded to Affordable Care Act-Related Medicaid Expansion?” Urology 125 (March 2019): 79-85, https://doi.org/10.1016/j.urology.2018.10.034
Gary Young, Stephen Flaherty, E. Zepeda, Simone Singh, and Sara Rosenbaum, “Impact of ACA Medicaid Expansion on Hospitals’ Financial Status” Journal of Healthcare Management 64, no. 2 (March 2019): 91–102, https://insights.ovid.com/crossref?an=00115514-201904000-00007
J.W. Awori Hayanga et al., “Lung Transplantation and Affordable Care Act Medicaid Expansion in the Era of Lung Allocation Score” Transplant International epub ahead of print (February 2019), https://onlinelibrary.wiley.com/doi/pdf/10.1111/tri.13420
Meera Harhay et al., “Association between Medicaid Expansion under the Affordable Care Act and Preemptive Listings for Kidney Transplantation,” Clinical Journal of the American Society of Nephrology 13 (July 2018), https://cjasn.asnjournals.org/content/13/7/1069
Megan Cole, Brad Wright, Ira Wilson, Omar Gallarraga, and Amal Trivedi, “Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.1542
Angelica Meinhofer and Allison Witman, “The Role Of Health Insurance On Treatment For Opioid Use Disorders: Evidence From The Affordable Care Act Medicaid Expansion,” Journal of Health Economics 60 (June 2018): 177-197, https://www.sciencedirect.com/science/article/abs/pii/S0167629617311530
Rishi Wadhera et al., “Association of the Affordable Care Act’s Medicaid Expansion With Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure,” Cardiovascular Quality and Outcomes 11, no. 7 (June 2018), https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.118.004729
Richard Lindrooth, Marcelo Perraillon, Rose Hardy, and Gregory Tung, “Understanding the Relationship Between Medicaid Expansions and Hospital Closures,” Health Affairs epub ahead of print (January 2018), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0976
Sayeh Nikpay, Seth Freedman, Helen Levy, and Tom Buchmueller, “Effect of the Affordable Care Act Medicaid Expansion on Emergency Department Visits: Evidence From State-Level Emergency Department Databases,” Annals of Emergency Medicine 70, no.2 (August 2017), http://www.annemergmed.com/article/S0196-0644(17)30319-0/pdf
Dmitry Tumin et al., “Medicaid Participation among Liver Transplant Candidates after the Affordable Care Act Medicaid Expansion” Journal of the American College of Surgeons 225, no. 2 (August 2017): 173-180.e2, https://www.journalacs.org/article/S1072-7515(17)30454-4/fulltext
Gary Pickens et al., “Changes in Hospital Inpatient Utilization Following Health Care Reform,” Health Services Research epub ahead of print (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28664983
Mary Anderson, Jeffrey Glasheen, Debra Anoff, “Impact of State Medicaid Expansion Status on Length of Stay and In-Hospital Mortality for General Medicine Patients at US Academic Medical Centers,” Journal of Hospital Medicine Epub ahead of print (August 2016), http://onlinelibrary.wiley.com/wol1/doi/10.1002/jhm.2649/citedby
David Dranove, Craig Garthwaite, and Christopher Ody, “Uncompensated Care Decreased At Hospitals In Medicaid Expansion States But Not At Hospitals In Nonexpansion States,” Health Affairs 35 no. 8 (August 2016): 1471-1479, http://content.healthaffairs.org/content/35/8/1471.full
Jesse M. Pines, Mark Zocchi, Ali Moghtaderi, Bernard Black, Steven A. Farmer, Greg Hufstetler, Kevin Klauer and Randy Pilgrim, “Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix,” Health Affairs 35, no. 8 (August 2016), http://content.healthaffairs.org/content/35/8/1480.full
Brendan Saloner, Sachini Bandara, Emma McGinty, and Colleen Barry, “Justice-Involved Adults With Substance Use Disorders: Coverage Increased but Rates of Treatment Did Not in 2014,” Health Affairs 35 no. 6 (June 2016), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0005
Dmitry Tumin, Don Hayes Jr., Kenneth Washburn, Joseph Tobias, and Sylvester Black, “Medicaid Enrollment after Liver Transplantation: Effects of Medicaid Expansion,” Liver Transplantation (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27152888
Emanuel Eguia et al., “The Impact of the Affordable Care Act Medicaid Expansion on Vascular Surgery,” Annals of Vascular Surgery Epub ahead of print (January 2020), https://doi.org/10.1016/j.avsg.2020.01.006
Hawazin W. Elani, Ichiro Kawachi, and Benjamin D. Sommers, “Changes in Emergency Department Dental Visits after Medicaid Expansion,” Health Services Research Epub ahead of print (January 2020), https://doi.org/10.1111/1475-6773.13261
Alexander T. Janke, Shooshan Danagoulian, Arjun K. Venkatesh, and Phillip D. Levy, “Medicaid Expansion and Resource Utilization in the Emergency Department,” The American Journal of Emergency Medicine Epub ahead of print (January 2020), https://doi.org/10.1016/j.ajem.2019.12.050
Mark Clapp et al., “Association of Medicaid Expansion With Coverage and Access to Care for Pregnant Women,” Obstetrics & Gynecology 134, no. 5 (November 2019): 1066-1074, https://doi.org/10.1097/aog.0000000000003501
Hefei Wen, Kenton J. Johnston, Lindsay Allen, and Teresa M. Waters, “Medicaid Expansion Associated With Reductions In Preventable Hospitalizations,” Health Affairs 38, no. 11 (November 2019): 1845-1849, https://doi.org/10.1377/hlthaff.2019.00483
Nadia Laniado, Avery R. Brow, Eric Tranby, and Victor M. Badner, “Trends in Non-Traumatic Dental Emergency Department Use in New York and New Jersey: A Look at Medicaid Expansion from Both Sides of the Hudson River,” Journal of Public Health Dentistry Epub ahead of print (October 2019), https://doi.org/10.1111/jphd.12343
Elizabeth A. Brown et al., “The Impact of the ACA Medicaid Expansion on Access to Care and Hospitalization Charges for Lupus Patients,” Arthritis Care & Research Epub ahead of print (September 2019), https://doi.org/10.1002/acr.24080
Craig Garthwaite et al., All Medicaid Expansions Are Not Created Equal: The Geography and Targeting of the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26289, September 2019), http://www.nber.org/papers/w26289
Emanuel Eguia et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Access to Minimally Invasive Surgical Care,” The American Journal of Surgery Epub ahead of print (July 2019), https://doi.org/10.1016/j.amjsurg.2019.07.003
Ramiro Manzano-Nunez et al., “Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery,” World Journal of Surgery 43, no. 6 (June 2019): 1483-1489, https://link.springer.com/article/10.1007/s00268-019-04932-0
Rahul Ladhania, Amelia Haviland, Arvind Venkat, Rahul Telang, and Jesse Pines, “The Effect of Medicaid Expansion on the Nature of New Enrollees’ Emergency Department Use,” Medical Care Research and Review epub ahead of print (May 2019), https://journals.sagepub.com/doi/abs/10.1177/1077558719848270
Favel Mondesir et al., “Medicaid Expansion and Hospitalization for Ambulatory Care–Sensitive Conditions Among Nonelderly Adults With Diabetes,” Journal of Ambulatory Care Management epub ahead of print (May 2019), https://insights.ovid.com/pubmed?pmid=31107800
Heather Angier et al., “Racial/Ethnic Disparities in Health Insurance and Differences in Visit Type for a Population of Patients with Diabetes after Medicaid Expansion” Journal of Health Care for the Poor and Underserved 30, no.1, (March 2019) 116–130: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429963/
Jesse Pines, Rahul Ladhania BTech, Bernard Black , Christopher Corbit, Jestin Carlson, and Arvind Venkat, “Changes in Reimbursement to Emergency Physicians After Medicaid Expansion Under the Patient Protection and Affordable Care Act,” Annals of Emergency Medicine 73, no. 3 (March 2019): 213-224, https://www.sciencedirect.com/science/article/pii/S019606441831374X
Cheryl Zogg et al., “Impact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision,” Journal of the American College of Surgeons 228, no. 1 (January 2019): 29-43, https://www.journalacs.org/article/S1072-7515(18)32078-7/fulltext
Nathalie Huguet et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Visit Rates for Diabetes in Safety Net Health Centers,” Journal of the American Board of Family Medicine 31, no. 6 (November 2018): 905-916, https://www.jabfm.org/content/31/6/905.full
Ehimare Akhabue, Lindsay Pool, Clyde Yancy, Philip Greenland, and Donald Lloyd-Jones, “Association of State Medicaid Expansion With Rate of Uninsured Hospitalizations for Major Cardiovascular Events, 2009-2014,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2698077
Nathalie Huguet et al., “Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers,” Journal of Primary Care & Community Health epub ahead of print (May 2017), http://journals.sagepub.com/doi/full/10.1177/2150131917709403
Laurie Felland, Peter Cunningham, Annie Doubleday, and Cannon Warren, Effects of the Affordable Care Act on Safety Net Hospitals (Washington, DC: Mathematica Policy Research, prepared for the Assistant Secretary for Planning and Evaluation, November 2016), https://aspe.hhs.gov/sites/default/files/pdf/255491/SafetyNetHospital.pdf
Megan Hoopes, Heather Angier, Rachel Gold, Steffani Bailey, Nathalie Huguet, Miguel Marino, and Jennifer DeVoe, “Utilization of Community Health Centers in Medicaid Expansion and Nonexpansion States, 2013-2014,” Journal of Ambulatory Care Management 39 no. 4 (October 2016): 290-298, https://www.ncbi.nlm.nih.gov/pubmed/26765808
Steven Wallace, Maria-Elena Young, Michael Rodriguez, Amy Bonilla, and Nadereh Pourat, Community Health Centers Play a Critical Role in Caring for the Remaining Uninsured in the Affordable Care Act Era (UCLA Center for Health Policy Research, October 2016), http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/FQHC_PB-oct2016.pdf
Stephen Berry et al., “Healthcare Coverage for HIV Provider Visits before and after Implementation of the Affordable Care Act,” Clinical Infectious Diseases, (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27143660
Sayeh Nikpay, Thomas Buchmueller, and Helen Levy. “Affordable Care Act Medicaid Expansion Reduced Uninsured Hospital Stays in 2014,” Health Affairs 35, no.1 (January 2016): 106-110, http://content.healthaffairs.org/content/35/1/106.full
Charles A. Daly et al., “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma,” The Journal of Hand Surgery 44, no. 9 (September 2019): 720-727, https://doi.org/10.1016/j.jhsa.2019.05.020
Beatrice D. Probst, Luther Walls, Michael Cirone, and Talar Markossian, “Examining the Effect of the Affordable Care Act on Two Illinois Emergency Departments,” Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health 20, no. 5 (September 2019): 710-716, https://doi.org/10.5811/westjem.2019.6.41943
John Scott et al., “Lifting the Burden: State Medicaid Expansion Reduces Financial Risk for the Injured,” Journal of Trauma and Acute Care Surgery Epub ahead of print (September 2019), https://doi.org/10.1097/ta.0000000000002493
Neal Bhutiani, Brian Harbrecht, Charles Scoggins, and Matthew Bozeman, “Evaluating The Early Impact Of Medicaid Expansion On Trends In Diagnosis And Treatment Of Benign Gallbladder Disease In Kentucky,” The American Journal of Surgery (January 2019), https://www.americanjournalofsurgery.com/article/S0002-9610(18)30894-8/fulltext
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf
Shannon McConville, Maria Raven, Sarah Sabbagh, and Renee Hsia, “Frequent Emergency Department Users: A Statewide Comparison Before And After Affordable Care Act Implementation,” Health Affairs 37, no. 6, (June 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0784
Donald Likosky, Devraj Sukul, Milan Seth, Chang He, Hitlander Gurm, and Richard Prager, “The Association Between Medicaid Expansion and Cardiovascular Interventions: The Michigan Experience,” Journal of the American College of Cardiology 71, no. 9 (March 2018): 1050-1051, https://www.sciencedirect.com/science/article/pii/S0735109718300056?via%3Dihub
The University of Michigan Institute for Healthcare Policy & Innovation, The Healthy Michigan Plan: 2015 Report on Uncompensated Care and Insurance Rates (The University of Michigan Institute for Healthcare Policy & Innovation, prepared for the Michigan Department of Health and Human Services and the Michigan Department of Insurance and Financial Services, December 2016), http://www.michigan.gov/documents/mdhhs/2015_Report_on_Uncompensated_Care_and_Insurance_Rates-HMP_547720_7.pdf
Mathew Davis, Achamyeleh Gebremariam, John Ayanian, “Changes in Insurance Coverage Among Hospitalized Nonelderly Adults After Medicaid Expansion in Michigan,” The Journal of the American Medical Association 315 no. 23 (June 2016): 2617-2618, http://jamanetwork.com/journals/jama/fullarticle/2529615
Christine Jones, Serena Scott, Debra Anoff, Read Pierce, Jeffrey Glasheen, “Changes in Payer Mix and Physician Reimbursement After the Affordable Care Act and Medicaid Expansion,” Inquiry: The Journal of Health Care Organization, Provision, and Financing 52 (August 2015), http://inq.sagepub.com/content/52/0046958015602464.full
Olga Scrivner et al., “Job Postings in the Substance Use Disorder Treatment Related Sector During the First Five Years of Medicaid Expansion,” PLoS One 15, no. 1 (January 2020), https://doi.org/10.1371/journal.pone.0228394
Renuka Tipirneni et al., “Association of Medicaid Expansion With Enrollee Employment and Student Status in Michigan,” JAMA Network Open 3, no. 1 (January 2020), https://doi.org/10.1001/jamanetworkopen.2019.20316
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553
Lizhong Peng, Xiaohui Guo, and Chad D. Meyerhoefer, “The Effects of Medicaid Expansion on Labor Market Outcomes: Evidence from Border Counties,” Health Economics Epub ahead of print (December 2019), https://doi.org/10.1002/hec.3976
Lucie Schmidt, Lara Shore-Sheppard, and Tara Watson, The Impact of the ACA Medicaid Expansion on Disability Program Applications (National Bureau of Economic Research, Working Paper No. 26192, August 2019), http://www.nber.org/papers/w26192
Jean Hall, Adele Shartzer, Noelle Kurth, and Kathleen Thomas, “Medicaid Expansion as an Employment Incentive Program for People With Disabilities,” American Journal of Public Health epub ahead of print (July 2018), https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2018.304536
Kevin Callison and Paul Sicilian, “Economic Freedom and the Affordable Care Act: Medicaid Expansions and Labor Mobility by Race and Ethnicity,” Public Finance Review 46, no. 2 (March 2018), https://journals.sagepub.com/doi/abs/10.1177/1091142116668254
Pauline Leung and Alexandre Mas, Employment Effects of the ACA Medicaid Expansions (Working Paper No. 22540, National Bureau of Economic Research, August 2016), http://www.nber.org/papers/w22540
Angshuman Gooptu, Asako Moriya, Kosali Simon, and Benjamin Sommers, “Medicaid Expansion Did Not Result in Significant Employment Changes or Job Reductions in 2014,” Health Affairs 35, no. 1 (January 2016): 111-118, 1-12, http://content.healthaffairs.org/content/35/1/111.short
Robert Kaestner, Bowen Garrett, Anuj Gangopadhyaya, and Caitlyn Fleming, Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply (Working Paper No. 21836, National Bureau of Economic Research, December 2015), http://www.nber.org/papers/w21836
Priyanka Anand, Jody Schimmel Hyde, Maggie Colby, and Paul O’Leary, “The Impact of Affordable Care Act Medicaid Expansions on Applications to Federal Disability Programs,” Forum for Health Economics and Policy (February 2019), https://www.ncbi.nlm.nih.gov/pubmed/30796844
Renuka Tipirneni et al., “Association of Expanded Medicaid Coverage With Health and Job-Related Outcomes Among Enrollees With Behavioral Health Disorders,” Psychiatric Services Epub ahead of print (September 2019), https://doi.org/10.1176/appi.ps.201900179
Susan Dorr Goold et al., “Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study,” Journal of General Internal Medicine 33, no. 8 (June 2018): 1307-1316, https://link.springer.com/article/10.1007/s11606-018-4487-6
John Ayanian, Gabriel Ehrlich, Donald Grimes, and Helen Levy, “Economic Effects of Medicaid Expansion in Michigan,” The New England Journal of Medicine epub ahead of print (January 2017), http://www.nejm.org/doi/full/10.1056/NEJMp1613981
Michel Boudreaux, James M. Noon, Brett Fried, and Joanne Pascale, “Medicaid Expansion and the Medicaid Undercount in the American Community Survey,” Health Services Research 54, no. 6 (December 2019): 1263-1272, https://doi.org/10.1111/1475-6773.13213
Emily Brown, Michelle Garrison, Hao Bao, Pingping Qu, Carole Jenny, and Ali Rowhani-Rahbar, “Assessment of Rates of Child Maltreatment in States With Medicaid Expansion vs States Without Medicaid Expansion,” JAMA Network Open 2, no. 6 (June 2019), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2735758
Daniel Hopkins and Kalind Parish, “The Medicaid Expansion and Attitudes toward the Affordable Care Act: Testing for a Policy Feedback on Mass Opinion,” Public Opinion Quarterly 83, no. 1 (April 2019): 123-134, https://academic.oup.com/poq/article-abstract/83/1/123/5430239
Michael Sances and Joshua Clinton, New Policy, New Politics? The Effect of Medicaid Expansion on Public Support for the Affordable Care Act, (University of Memphis and Vanderbilt University, February 2017), https://csap.yale.edu/sites/default/files/files/apppw_jc2_3-8-17.pdf
Jean M. Abraham, Anne B. Royalty, and Coleman Drake, “The Impact of Medicaid Expansion on Employer Provision of Health Insurance,” International Journal of Health Economics and Management 19, no. 3-4 (December 2019): 317-340, https://doi.org/10.1007/s10754-018-9256-x
Amanda Abraham et al., “Changes in State Technical Assistance Priorities and Block Grant Funds for Addiction After ACA Implementation,” American Journal of Public Health epub ahead of print (May 2019), https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2019.305052
Andrew Admon, Michael Sjoding, Sarah Lyon, John Ayanian, Theodore Iwashyna, and Colin Cooke, “Medicaid Expansion and Mechanical Ventilation in Asthma, Chronic Obstructive Pulmonary Disease, and Heart Failure,” Annals of the American Thoracic Society epub ahead of print (February 2019), https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201811-777OC
Sumit D. Agarwal, Anna L. Goldman, and Benjamin D. Sommers, “Blue-Collar Workers Had Greatest Insurance Gains After ACA Implementation,” Health Affairs 38, no. 7 (July 2019): 1140-1144, https://doi.org/10.1377/hlthaff.2018.05454
Ankit Agarwal, Aaron Katz, and Ronald Chen, “The Impact of the Affordable Care Act on Disparities in Private and Medicaid Insurance Coverage among Patients Under 65 with Newly Diagnosed Cancer,” International Journal of Radiation Oncology, Biology, Physics (May 2019), https://www.redjournal.org/article/S0360-3016(19)30783-7/pdf
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562
Ehimare Akhabue, Lindsay Pool, Clyde Yancy, Philip Greenland, and Donald Lloyd-Jones, “Association of State Medicaid Expansion With Rate of Uninsured Hospitalizations for Major Cardiovascular Events, 2009-2014,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2698077
Abeer Alharbi, M. Mahmud Khan, Ronnie Horner, Heather Brandt, and Cole Chapman, “Impact Of Medicaid Coverage Expansion Under The Affordable Care Act On Mammography And Pap Tests Utilization Among Low-Income Women,” PLOS One (April 2019), https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214886
Adam M. Almaguer et al., “Do Geographic Region, Medicaid Status, and Academic Affiliation Affect Access to Care Among Medicaid and Privately Insured Total Hip Arthroplasty Patients?,” Journal of Arthroplasty 34, no. 12 (December 2019): 2866-2871, https://doi.org/10.1016/j.arth.2019.07.030
Priyanka Anand, Jody Schimmel Hyde, Maggie Colby, and Paul O’Leary, “The Impact of Affordable Care Act Medicaid Expansions on Applications to Federal Disability Programs,” Forum for Health Economics and Policy (February 2019), https://www.ncbi.nlm.nih.gov/pubmed/30796844
Mary Anderson, Jeffrey Glasheen, Debra Anoff, “Impact of State Medicaid Expansion Status on Length of Stay and In-Hospital Mortality for General Medicine Patients at US Academic Medical Centers,” Journal of Hospital Medicine Epub ahead of print (August 2016), http://onlinelibrary.wiley.com/wol1/doi/10.1002/jhm.2649/citedby
Heather Angier et al., “Racial/Ethnic Disparities in Health Insurance and Differences in Visit Type for a Population of Patients with Diabetes after Medicaid Expansion” Journal of Health Care for the Poor and Underserved 30, no.1, (March 2019) 116–130: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429963/
Natoshia Askelson, Brad Wright, Suzanne Bentler, Elizabeth Momany, and Peter Damiano, “Iowa’s Medicaid Expansion Promoted Healthy Behaviors But Was Challenging to Implement and Attracted Few Participants,” Health Affairs 36 no. 5, (May 2017): 799-807, http://content.healthaffairs.org/content/36/5/799.full
Susan L. Averett, Julie K. Smith, and Yang Wang, “Medicaid Expansion and Opioid Deaths,” Health Economics 28, no. 12 (December 2019): 1491-1496, https://doi.org/10.1002/hec.3945
John Ayanian, Gabriel Ehrlich, Donald Grimes, and Helen Levy, “Economic Effects of Medicaid Expansion in Michigan,” The New England Journal of Medicine epub ahead of print (January 2017), http://www.nejm.org/doi/full/10.1056/NEJMp1613981
Deborah Bachrach, Patricia Boozang, Avi Herring, and Dori Glanz Reyneri, States Expanding Medicaid See Significant Budget Savings and Revenue Gains, (Manatt Health Solutions, prepared by the Robert Wood Johnson Foundation’s State Health Reform Assistance Network, March 2016), http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2016/rwjf419097
Ameen Barghi, Hugo Torres, Nancy Kressin, and Danny McCormick, “Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study,” Journal of General Internal Medicine epub ahead of print (June 2019), https://link.springer.com/article/10.1007%2Fs11606-019-05108-1
Hilary Barnes, Michael Richards, Matthew McHugh, and Grant Martsolf, “Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners,” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.1158
Stephen Berry et al., “Healthcare Coverage for HIV Provider Visits before and after Implementation of the Affordable Care Act,” Clinical Infectious Diseases, (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27143660
Neal Bhutiani, Brian Harbrecht, Charles Scoggins, and Matthew Bozeman, “Evaluating The Early Impact Of Medicaid Expansion On Trends In Diagnosis And Treatment Of Benign Gallbladder Disease In Kentucky,” The American Journal of Surgery (January 2019), https://www.americanjournalofsurgery.com/article/S0002-9610(18)30894-8/fulltext
Bernard Black, Alex Hollingsworth, Leticia Nunes, and Kosali Simon, The Effect of Health Insurance on Mortality: Power Analysis and What We Can Learn from the Affordable Care Act Coverage Expansions, (National Bureau of Economic Research, Working Paper Series No. 25568, February 2019), https://www.nber.org/papers/w25568
Frederic Blavin, Michael Karpman, Genevieve Kenney, and Benjamin Sommers, “Medicaid Versus Marketplace Coverage for Near-Poor Adults: Effects on Out-Of-Pocket Spending and Coverage,” Health Affairs 37 no. 2 (January 2018), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.1166
Michel Boudreaux, Yoon Choi, Liyang Xie, and Daniel Marthey, “Medicaid Expansion at Title X Clinics: Client Volume, Payer Mix, and Contraceptive Method Type,” Medical Care epub ahead of print (April 2019), https://www.ncbi.nlm.nih.gov/pubmed/30973473
Michel Boudreaux, James M. Noon, Brett Fried, and Joanne Pascale, “Medicaid Expansion and the Medicaid Undercount in the American Community Survey,” Health Services Research 54, no. 6 (December 2019): 1263-1272, https://doi.org/10.1111/1475-6773.13213
Khadijah Breathett et al., “The Affordable Care Act Medicaid Expansion Correlated with Increased Heart Transplant Listings in African Americans but Not Hispanics or Caucasians,” JACC: Heart Failure 5 no. 2 (January 2017): 136-147, https://www.ncbi.nlm.nih.gov/pubmed/28109783
Kenneth Brevoort, Daniel Grodzicki, and Martin Hackmann, Medicaid and Financial Health (National Bureau of Economic Research, Working Paper No. 24002, November 2017), http://www.nber.org/papers/w24002
Emily Brown, Michelle Garrison, Hao Bao, Pingping Qu, Carole Jenny, and Ali Rowhani-Rahbar, “Assessment of Rates of Child Maltreatment in States With Medicaid Expansion vs States Without Medicaid Expansion,” JAMA Network Open 2, no. 6 (June 2019), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2735758
Clare Brown et al., “Association of State Medicaid Expansion Status With Low Birth Weight and Preterm Birth” Journal of the American Medical Association 321, no. 16 (April 2019), https://jamanetwork.com/journals/jama/fullarticle/2731179
Elizabeth A. Brown et al., “The Impact of the ACA Medicaid Expansion on Access to Care and Hospitalization Charges for Lupus Patients,” Arthritis Care & Research Epub ahead of print (September 2019), https://doi.org/10.1002/acr.24080
Thomas Buchmueller, Zachary Levinson, Helen Levy, and Barbara Wolfe, “Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage,” American Journal of Public Health (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27196653
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553
Kevin Callison and Paul Sicilian, “Economic Freedom and the Affordable Care Act: Medicaid Expansions and Labor Mobility by Race and Ethnicity,” Public Finance Review 46, no. 2 (March 2018), https://journals.sagepub.com/doi/abs/10.1177/1091142116668254
Colleen M. Carey, Sarah Miller, and Laura R. Wherry, “The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare,” National Bureau of Economic Research Working Paper Series No. 25153 (October 2018), https://www.nber.org/papers/w25153
John Cawley, Aparna Soni, and Kosali Simon, “Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1495-1497, https://link.springer.com/article/10.1007%2Fs11606-018-4537-0
Evan M. Chen et al., “Association of the Affordable Care Act Medicaid Expansion with Dilated Eye Examinations among the United States Population with Diabetes,” Ophthalmology Epub ahead of print (September 2019), https://doi.org/10.1016/j.ophtha.2019.09.010
Fumiko Chino, Gita Suneja, Haley Moss, S. Yousuf Zafar, Laura Havrilesky, and Junzo Chino, “Healthcare Disparities in Cancer Patients Receiving Radiation: Changes in Insurance Status After Medicaid Expansion Under the Affordable Care Act,” International Journal of Radiation Oncology (December 2017), http://www.sciencedirect.com/science/article/pii/S0360301617341883
Sunha Choi, Sungkyu Lee, and Jason Matejkowski, “The Effects of State Medicaid Expansion on Low-Income Individuals’ Access to Health Care: Multilevel Modeling,” Population Health Management epub ahead of print (September 2017), http://online.liebertpub.com/doi/abs/10.1089/pop.2017.0104
Mark Clapp et al., “Association of Medicaid Expansion With Coverage and Access to Care for Pregnant Women,” Obstetrics & Gynecology 134, no. 5 (November 2019): 1066-1074, https://doi.org/10.1097/aog.0000000000003501
Michael Cohen and William Schpero, “Household Immigration Status Had Differential Impact On Medicaid Enrollment In Expansion And Nonexpansion States,” Health Affairs 37, no. 3 (March 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.0978
Robin Cohen, Emily Terlizzi, and Michael Martinez, Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2018 (National Center for Health Statistics, May 2019), https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201905.pdf
Megan Cole, Brad Wright, Ira Wilson, Omar Gallarraga, and Amal Trivedi, “Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.1542
Kelsey L. Corrigan et al., “The Impact of the Patient Protection and Affordable Care Act on Insurance Coverage and Cancer-Directed Treatment in HIV-Infected Patients With Cancer in the United States,” Cancer (November 2019), https://doi.org/10.1002/cncr.32563
Chad Cotti, Erik Nesson, and Nathan Tefft, “Impacts Of The ACA Medicaid Expansion On Health Behaviors: Evidence From Household Panel Data,” Health Economics 28, no. 2 (February 2019): 219-244, https://onlinelibrary.wiley.com/doi/pdf/10.1002/hec.3838
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health (National Bureau of Economic Research, Working Paper no. 23269, March 2017), http://www.nber.org/papers/w23269
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, and Daniela Zapata, Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States (Working Paper No. 22182, The National Bureau of Economic Research, April 2016), http://www.nber.org/papers/w22182
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, and Ishtiaque Fazlul, “The Three‐Year Impact of the Affordable Care Act on Disparities in Insurance Coverage,” Health Services Research (October 2018), https://onlinelibrary.wiley.com/doi/10.1111/1475-6773.13077
Charles J. Courtemanche, James Marton, and Aaron Yelowitz, Medicaid Coverage across the Income Distribution under the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26145, August 2019), http://www.nber.org/papers/w26145
Charles J. Courtemanche et al., The Impact of the ACA on Insurance Coverage Disparities After Four Years (National Bureau of Economic Research, Working Paper No. 26157, August 2019), http://www.nber.org/papers/w26157
Charles A. Daly et al., “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma,” The Journal of Hand Surgery 44, no. 9 (September 2019): 720-727, https://doi.org/10.1016/j.jhsa.2019.05.020
Mathew Davis, Achamyeleh Gebremariam, John Ayanian, “Changes in Insurance Coverage Among Hospitalized Nonelderly Adults After Medicaid Expansion in Michigan,” The Journal of the American Medical Association 315 no. 23 (June 2016): 2617-2618, http://jamanetwork.com/journals/jama/fullarticle/2529615
Sandra Decker, Brandy Lipton, and Benjamin Sommers, “Medicaid Expansion Coverage Effects Grew in 2015 With Continued Improvements in Coverage Quality,” Health Affairs 36 no. 5 (May 2017): 819-825, http://content.healthaffairs.org/content/36/5/819.full
Anne DiGiulio et al., “State Medicaid Expansion Tobacco Cessation Coverage and Number of Adult Smokers Enrolled in Expansion Coverage – United States, 2016,” Morbidity and Mortality Weekly Report 65, no. 48 (December 2016), https://www.cdc.gov/mmwr/volumes/65/wr/mm6548a2.htm
Travis Donahoe et al., “The Affordable Care Act Medicaid Expansion and Smoking Cessation Among Low-Income Smokers,” American Journal of Preventive Medicine 57, no. 6 (December 2019): 203-210, https://doi.org/10.1016/j.amepre.2019.07.004
David Dranove, Craig Garthwaite, and Christopher Ody, “Uncompensated Care Decreased At Hospitals In Medicaid Expansion States But Not At Hospitals In Nonexpansion States,” Health Affairs 35 no. 8 (August 2016): 1471-1479, http://content.healthaffairs.org/content/35/8/1471.full
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf
Michael Dworsky and Christine Eibner, The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults (Santa Monica, CA: Rand Corporation, 2016), https://www.rand.org/pubs/research_reports/RR1736.html
Michael Dworsky, Carrie Farmer, and Mimi Shen, Veterans’ Health Insurance Coverage Under the Affordable Care Act and Implications of Repeal for the Department of Veterans Affairs, (RAND Corporation, 2017), https://www.rand.org/pubs/research_reports/RR1955.html
Emanuel Eguia et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Access to Minimally Invasive Surgical Care,” The American Journal of Surgery Epub ahead of print (July 2019), https://doi.org/10.1016/j.amjsurg.2019.07.003
Emanuel Eguia et al., “The Impact of the Affordable Care Act Medicaid Expansion on Vascular Surgery,” Annals of Vascular Surgery Epub ahead of print (January 2020), https://doi.org/10.1016/j.avsg.2020.01.006
Afshin Ehsan et al., “Utilization of Left Ventricular Assist Devices in Vulnerable Adults Across Medicaid Expansion,” Journal of Surgical Research 243 (November 2019): 503-508, https://doi.org/10.1016/j.jss.2019.05.015
Hawazin W. Elani, Ichiro Kawachi, and Benjamin D. Sommers, “Changes in Emergency Department Dental Visits after Medicaid Expansion,” Health Services Research Epub ahead of print (January 2020), https://doi.org/10.1111/1475-6773.13261
Mohammad Eslami et al., “Impact of Medicaid Expansion of the Affordable Care on the Outcomes of Lower Extremity Bypass for Patients With Peripheral Artery Disease in the Vascular Quality Initiative Database,” Annals of Surgery 270, no. 4 (October 2019): 647-655, https://doi.org/10.1097/sla.0000000000003521
Stacey Fedewa, K. Robin Yabroff, Robert Smith, Ann Goding Sauer, Xuesong Han, and Ahmedin Jemal, “Changes in Breast and Colorectal Cancer Screening After Medicaid Expansion Under the Affordable Care Act,” American Journal of Preventive Medicine epub ahead of print (May 2019), https://www.sciencedirect.com/science/article/pii/S0749379719301163
Laurie Felland, Peter Cunningham, Annie Doubleday, and Cannon Warren, Effects of the Affordable Care Act on Safety Net Hospitals (Washington, DC: Mathematica Policy Research, prepared for the Assistant Secretary for Planning and Evaluation, November 2016), https://aspe.hhs.gov/sites/default/files/pdf/255491/SafetyNetHospital.pdf
Angela Fertig, Caroline Carlin, Scote Ode, and Sharon Long, “Evidence of Pent-Up Demand for Care After Medicaid Expansion,” Medical Care Research and Review epub ahead of print (March 2017), http://journals.sagepub.com/eprint/wDsfA74fuA3BIw5ZWyYT/full
Jacqueline Fiore, The Impact of the Affordable Care Act’s Medicaid Expansion on Medicaid Spending by Health Care Service Category (Tulane University, July 2017), http://econ.tulane.edu/RePEc/pdf/tul1706.pdf
Taressa K. Fraze et al., “Prevalence of Screening for Food Insecurity, Housing Instability, Utility Needs, Transportation Needs, and Interpersonal Violence by US Physician Practices and Hospitals,” JAMA Network Open 2, no. 9 (September 2019), https://doi.org/10.1001/jamanetworkopen.2019.11514
Seth Freedman, Sayeh Nikpay, Aaron Carroll, and Kosali Simon, “Changes in inpatient payer-mix and hospitalizations following Medicaid expansion: Evidence from all-capture hospital discharge data,” PLoS One 12 no. 9 (September 2017), http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0183616
Seth Freedman, Lilliard Richardson, and Kosali Simon, “Learning From Waiver States: Coverage Effects Under Indiana’s HIP Medicaid Expansion,” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1596
Carrie Fry and Benjamin Sommers, “Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression,” Psychiatric Services 69, no. 11 (November 2018), https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800181
Yunwei Gai and John Marthinsen, “Medicaid Expansion, HIV Testing, and HIV-Related Risk Behaviors in the United States, 2010-2017,” American Journal of Public Health 109, no. 10 (October 2019): 1404-1412, https://doi.org/10.2105/ajph.2019.305220
Tong Gan et al., “Impact of the Affordable Care Act on Colorectal Cancer Screening, Incidence, and Survival in Kentucky,” Journal of the American College of Surgeons 228, no. 4 (April 2019): 342-353.e1, https://www.journalacs.org/article/S1072-7515(19)30046-8/fulltext
Craig Garthwaite et al., All Medicaid Expansions Are Not Created Equal: The Geography and Targeting of the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26289, September 2019), http://www.nber.org/papers/w26289
Ausmita Ghosh, Kosali Simon, and Benjamin Sommers, “The Effect of Health Insurance on Prescription Drug Use Among Low-Income Adults: Evidence from Recent Medicaid Expansions,” Journal of Health Economics 63 (January 2019): 64-80, https://www.sciencedirect.com/science/article/pii/S0167629617300206
Susannah Gibbs et al., “Evaluating the Effect of Medicaid Expansion on Access to Preventive Reproductive Care for Women in Oregon,” Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.ypmed.2019.105899
Daniel Gingold, Rachelle Pierre-Mathieu, Brandon Cole, Andrew Miller, and Joneigh Khaldun, “Impact of the Affordable Care Act Medicaid Expansion on Emergency Department High Utilizers with Ambulatory Care Sensitive Conditions: A Cross-Sectional Study,” The American Journal of Emergency Medicine (January 2017), http://www.sciencedirect.com/science/article/pii/S0735675717300141
Anna L. Goldman and Benjamin D. Sommers, “Among Low-Income Adults Enrolled In Medicaid, Churning Decreased After The Affordable Care Act,” Health Affairs 39, no. 1 (January 2020): 85-93, https://doi.org/10.1377/hlthaff.2019.00378
Anna Goldman, Steffie Woolhandler, and David Himmelstein, “Out-of-pocket Spending and Premium Contributions After Implementation of the Affordable Care Act,” Journal of the American Medical Association epub ahead of print (January 2018), https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2669908
Susan Dorr Goold et al., “Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study,” Journal of General Internal Medicine 33, no. 8 (June 2018): 1307-1316, https://link.springer.com/article/10.1007/s11606-018-4487-6
Susan Dorr Goold et al., “Primary Care, Health Promotion, and Disease Prevention with Michigan Medicaid Expansion,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05370-3
Angshuman Gooptu, Asako Moriya, Kosali Simon, and Benjamin Sommers, “Medicaid Expansion Did Not Result in Significant Employment Changes or Job Reductions in 2014,” Health Affairs 35, no. 1 (January 2016): 111-118, 1-12, http://content.healthaffairs.org/content/35/1/111.short
Sarah Gordon, Benjamin Sommers, Ira Wilson, Omar Galarraga, and Amal Trivedi, “The Impact of Medicaid Expansion on Continuous Enrollment: a Two State Analysis,” Journal of General Internal Medicine epub ahead of print (June 2019), https://link.springer.com/article/10.1007/s11606-019-05101-8
Sarah H. Gordon, Benjamin D. Sommers, Ira B. Wilson, and Amal N. Trivedi, “Effects Of Medicaid Expansion On Postpartum Coverage And Outpatient Utilization,” Health Affairs 39, no. 1 (January 2020): 77-84, https://doi.org/10.1377/hlthaff.2019.00547
Hiroshi Gotanda, Gerald Kominski, and Yusuke Tsugawa, “Association Between the ACA Medicaid Expansions and Primary Care and Emergency Department Use During the First 3 Years,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05458-w
Kelsie M. Gould et al., “Bariatric Surgery Among Vulnerable Populations: The Effect of the Affordable Care Act’s Medicaid Expansion,” Surgery 166, no. 5 (November 2019): 820-828, https://doi.org/10.1016/j.surg.2019.05.005
Government Accountability Office, Behavioral Health: Options for Low-Income Adults to Receive Treatment in Selected States (Washington, DC: Government Accountability Office, June 2015), http://www.gao.gov/assets/680/670894.pdf
John A. Graves et al., “Medicaid Expansion Slowed Rates of Health Decline for Low-Income Adults in Southern States,” Health Affairs 39, no. 1 (January 2020): 67-76, https://doi.org/10.1377/hlthaff.2019.00929
Kevin N. Griffith, “Changes in Insurance Coverage and Access to Care for Young Adults in 2017,” Journal of Adolescent Health Epub ahead of print (July 2019), https://doi.org/10.1016/j.jadohealth.2019.05.020
Jevay Grooms and Alberto Ortega, “Examining Medicaid Expansion and the Treatment of Substance Use Disorders,” American Economic Association Papers and Proceedings 109 (May 2019): 187-192, https://www.aeaweb.org/articles?id=10.1257/pandp.20191090
Jean Hall, Adele Shartzer, Noelle Kurth, and Kathleen Thomas, “Medicaid Expansion as an Employment Incentive Program for People With Disabilities,” American Journal of Public Health epub ahead of print (July 2018), https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2018.304536
Xuesong Han, Robin Yabroff, Elizabeth Ward, Otis Brawley, and Ahmedin Jemal, “Comparison of Insurance Status and Diagnosis Stage Among Patients With Newly Diagnosed Cancer Before vs After Implementation of the Patient Protection and Affordable Care Act,” JAMA Oncology 4, no. 12 (August 2018): 1713-1720, https://jamanetwork.com/journals/jamaoncology/article-abstract/2697226
Xuesong Han et al., “Changes in Noninsurance and Care Unaffordability Among Cancer Survivors Following the Affordable Care Act,” Journal of the National Cancer Institute Epub ahead of print (November 2019), https://doi.org/10.1093/jnci/djz218
Micah Hartman et al., “National Health Care Spending in 2016: Spending and Enrollment Growth Slow After Initial Coverage Expansions,” Health Affairs epub ahead of print (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1299
Meera N. Harhay, Ryan M. McKenna, and Michael O. Harhay, “Association Between Medicaid Expansion Under the Affordable Care Act and Medicaid-Covered Pre-emptive Kidney Transplantation,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2322-2325, https://doi.org/10.1007/s11606-019-05279-x
Meera Harhay et al., “Association between Medicaid Expansion under the Affordable Care Act and Preemptive Listings for Kidney Transplantation,” Clinical Journal of the American Society of Nephrology 13 (July 2018), https://cjasn.asnjournals.org/content/13/7/1069
J.W. Awori Hayanga et al., “Lung Transplantation and Affordable Care Act Medicaid Expansion in the Era of Lung Allocation Score” Transplant International epub ahead of print (February 2019), https://onlinelibrary.wiley.com/doi/pdf/10.1111/tri.13420
Qiwei He and Scott Barkowski, “The Effect of Health Insurance on Crime: Evidence from the Affordable Care Act Medicaid Expansion,” Health Economics Epub ahead of print (January 2020): 261-277, https://doi.org/10.1002/hec.3977
John Heintzman, Steffani Bailey, Jennifer DeVoe, Stuart Cowburn, Tanya Kapka, Truc-Vi Duong, and Miguel Marino, “In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon,” Journal of Racial and Ethnic Health Disparities (April 2016), http://www.ncbi.nlm.nih.gov/pubmed/27105630
Gracie Himmelstein, “Effect of the Affordable Care Act’s Medicaid Expansions on Food Security, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1243-1248, https://doi.org/10.2105/ajph.2019.305168
Jesse M. Hinde et al., “Increasing Access to Opioid Use Disorder Treatment: Assessing State Policies and the Evidence Behind Them,” Journal of Studies on Alcohol and Drugs 80, no. 6 (November 2019): 693-697, https://doi.org/10.15288/jsad.2019.80.693
Heather Holderness et al., “Where Do Oregon Medicaid Enrollees Seek Outpatient Care Post-Affordable Care Act Medicaid Expansion?,” Medical Care 57, no. 10 (October 2019): 788-794, https://doi.org/10.1097/mlr.0000000000001189
Jeremy Holzmacher et al., “Association of Expanded Medicaid Coverage with Hospital Length of Stay After Injury,” JAMA Surgery published online (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28658482
Megan Hoopes, Heather Angier, Rachel Gold, Steffani Bailey, Nathalie Huguet, Miguel Marino, and Jennifer DeVoe, “Utilization of Community Health Centers in Medicaid Expansion and Nonexpansion States, 2013-2014,” Journal of Ambulatory Care Management 39 no. 4 (October 2016): 290-298, https://www.ncbi.nlm.nih.gov/pubmed/26765808
Daniel Hopkins and Kalind Parish, “The Medicaid Expansion and Attitudes toward the Affordable Care Act: Testing for a Policy Feedback on Mass Opinion,” Public Opinion Quarterly 83, no. 1 (April 2019): 123-134, https://academic.oup.com/poq/article-abstract/83/1/123/5430239
Jeffrey Horn et al., “New Medicaid Enrollees See Health and Social Benefits in Pennsylvania’s Expansion,” INQUIRY: the Journal of Health Care Organization, Provision, and Financing 53 (October 2016): 1-8, http://journals.sagepub.com/doi/full/10.1177/0046958016671807#
Luojia Hu, Robert Kaestenr, Bhashkar Mazumder, Sarah Miller, and Ashley Wong, “The Effect of the Affordable Care Act Medicaid Expansions on Financial Wellbeing,” Journal of Public Economics 163 (July 2018): 99-112, https://www.sciencedirect.com/science/article/abs/pii/S0047272718300707
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009
Nathalie Huguet et al., “Cervical And Colorectal Cancer Screening Prevalence Before And After Affordable Care Act Medicaid Expansion,” Preventative Medicine (May 2019), https://doi.org/10.1016/j.ypmed.2019.05.003
Nathalie Huguet et al., “Following Uninsured Patients Through Medicaid Expansion: Ambulatory Care Use and Diagnosed Conditions,” Annals of Family Medicine 17, no. 4 (July/August 2019): 336-344, https://doi.org/10.1370/afm.2385
Nathalie Huguet et al., “Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers,” Journal of Primary Care & Community Health epub ahead of print (May 2017), http://journals.sagepub.com/doi/full/10.1177/2150131917709403
Nathalie Huguet et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Visit Rates for Diabetes in Safety Net Health Centers,” Journal of the American Board of Family Medicine 31, no. 6 (November 2018): 905-916, https://www.jabfm.org/content/31/6/905.full
Paul Jacobs, Genevieve Kenney, and Thomas Selden, “Newly Eligible Enrollees In Medicaid Spend Less And Use Less Care Than Those Previously Eligible,” Health Affairs 36, no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0252
Alexander T. Janke, Shooshan Danagoulian, Arjun K. Venkatesh, and Phillip D. Levy, “Medicaid Expansion and Resource Utilization in the Emergency Department,” The American Journal of Emergency Medicine Epub ahead of print (January 2020), https://doi.org/10.1016/j.ajem.2019.12.050
Ahmedin Jemal, Chun Chieh Lin, Amy Davidoff, and Xuesong Han, “Changes in Insurance Coverage and Stage at Diagnosis Among Nonelderly Patients with Cancer after the Affordable Care Act,” Journal of Clinical Oncology 35, no. 35 (December 2017), http://ascopubs.org/doi/pdf/10.1200/JCO.2017.73.7817
Emily Johnston, Andrea Strahan, Peter Joski, Anne Dunlop, and E. Kathleen Adams, “Impacts of the Affordable Care Act’s Medicaid Expansion on Women of Reproductive Age,” Women’s Health Issues, 28, no. 2 (February 2018), http://www.whijournal.com/article/S1049-3867(17)30242-6/pdf
Christine Jones, Serena Scott, Debra Anoff, Read Pierce, Jeffrey Glasheen, “Changes in Payer Mix and Physician Reimbursement After the Affordable Care Act and Medicaid Expansion,” Inquiry: The Journal of Health Care Organization, Provision, and Financing 52 (August 2015), http://inq.sagepub.com/content/52/0046958015602464.full
Robert Kaestner, Bowen Garrett, Anuj Gangopadhyaya, and Caitlyn Fleming, Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply (Working Paper No. 21836, National Bureau of Economic Research, December 2015), http://www.nber.org/papers/w21836
Taylor Kelley, Renuka Tipirneni, and Helen Levy, “Changes in Veterans’ Coverage and Access to Care Following the Affordable Care Act, 2011-2017,” American Journal of Public Health 109, no. 9 (September 2019): 1233-1235, https://doi.org/10.2105/ajph.2019.305160
Sameed Ahmed Khatana et al., “Association of Medicaid Expansion With Cardiovascular Mortality,” JAMA Cardiology 4, no. 7 (July 2019): 671-679, https://doi.org/10.1001/jamacardio.2019.1651
Shiho Kino and Ichiro Kawachi, “Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?,” Health Education & Behavior Epub ahead of print (October 2019), https://doi.org/10.1177/1090198119875998
James Kirby and Jessica Vistnes, “Access to Care Improved for People Who Gained Medicaid or Marketplace Coverage in 2014,” Health Affairs 35 no. 10 (October 2016): 1830-1834, http://content.healthaffairs.org/content/35/10/1830.full
Lindsay C. Kobayashi, Onur Altindag, Yulya Truskinovsky, and Lisa F. Berkman, “Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-Being in the US Adult Population, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1236-1242, https://doi.org/10.2105/ajph.2019.305164
Sanders Korenman, Dahlia K. Remler, and Rosemary T. Hyson, “Medicaid Expansions and Poverty: Comparing Supplemental and Health-Inclusive Poverty Measures,” Social Service Review 93, no. 3 (September 2019): 429-483, https://doi.org/10.1086/705319
Nicole Kravitz-Wirtz et al., “Association of Medicaid Expansion With Opioid Overdose Mortality in the United States,” JAMA Network Open 3, no. 1 (January 2020), https://doi.org/10.1001/jamanetworkopen.2019.19066
Joseph Labrum et al., “Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act?” Clinical Orthopaedics and Related Research 475 no. 6 (June 2017): 1527-1536, https://link.springer.com/article/10.1007%2Fs11999-017-5263-3
Rahul Ladhania, Amelia Haviland, Arvind Venkat, Rahul Telang, and Jesse Pines, “The Effect of Medicaid Expansion on the Nature of New Enrollees’ Emergency Department Use,” Medical Care Research and Review epub ahead of print (May 2019), https://journals.sagepub.com/doi/abs/10.1177/1077558719848270
Nadia Laniado, Avery R. Brow, Eric Tranby, and Victor M. Badner, “Trends in Non-Traumatic Dental Emergency Department Use in New York and New Jersey: A Look at Medicaid Expansion from Both Sides of the Hudson River,” Journal of Public Health Dentistry Epub ahead of print (October 2019), https://doi.org/10.1111/jphd.12343
De-Chih Lee, Leiyu Shi, and Hailun Liang, “Primary Care Utilization And Clinical Quality Performance: A Comparison Between Health Centres In Medicaid Expansion States And Non-Expansion States,” Journal of Health Services Research & Policy 24, no. 1 (January 2019): 19-24, https://journals.sagepub.com/doi/abs/10.1177/1355819618788592
Jusung Lee et al., “The Impact of Medicaid Expansion on Diabetes Management,” Diabetes Care Epub ahead of print (October 2019), https://doi.org/10.2337/dc19-1173
Pauline Leung and Alexandre Mas, Employment Effects of the ACA Medicaid Expansions (Working Paper No. 22540, National Bureau of Economic Research, August 2016), http://www.nber.org/papers/w22540
Helen Levy et al., “Macroeconomic Feedback Effects of Medicaid Expansion: Evidence from Michigan,” Journal of Health Politics, Policy and Law Epub ahead of print (October 2019), https://doi.org/10.1215/03616878-7893555
Helen Levy, Thomas Buchmueller, and Sayeh Nikpay, Health Reform and Health Insurance Coverage of Early Retirees (Ann Arbor, MI: University of Michigan Retirement Research Center Working Paper, September 2016), http://www.mrrc.isr.umich.edu/publications/papers/pdf/wp345.pdf
Donald Likosky, Devraj Sukul, Milan Seth, Chang He, Hitlander Gurm, and Richard Prager, “The Association Between Medicaid Expansion and Cardiovascular Interventions: The Michigan Experience,” Journal of the American College of Cardiology 71, no. 9 (March 2018): 1050-1051, https://www.sciencedirect.com/science/article/pii/S0735109718300056?via%3Dihub
Stephan R. Lindner et al., “Health Care Expenditures Among Adults With Diabetes After Oregon’s Medicaid Expansion,” Diabetes Care Epub ahead of print (December 2019), https://doi.org/10.2337/dc19-1343
Richard Lindrooth, Marcelo Perraillon, Rose Hardy, and Gregory Tung, “Understanding the Relationship Between Medicaid Expansions and Hospital Closures,” Health Affairs epub ahead of print (January 2018), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0976
Brandy Lipton, Sandra Decker, and Benjamin Sommers, “The Affordable Care Act Appears to Have Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Care Among Young Adults” Medical Care Research and Review 76, no.1 (April 2017): 32–55, https://www.ncbi.nlm.nih.gov/pubmed/29148341
Jennifer M. Lobo et al., “Trends in Uninsured Rates Before and After Medicaid Expansion in Counties Within and Outside of the Diabetes Belt,” Diabetes Care Epub ahead of print (January 2020), https://doi.org/10.2337/dc19-0874
Sharon Long, Lea Bart, Michael Karpman, Adele Shartzer, and Stephen Zuckerman, “Sustained Gains in Coverage, Access, and Affordability Under the ACA: A 2017 Update,” Health Affairs 36 no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0798
Huabin Luo, Zhuo Chen, Lei Xu, and Ronny Bell, “Health Care Access and Receipt of Clinical Diabetes Preventive Care for Working-Age Adults With Diabetes in States With and Without Medicaid Expansion: Results from the 2013 and 2015 BRFSS,” Journal of Public Health Management and Practice 25, no. 4 (July/August 2019): 34-43, https://doi.org/10.1097/phh.0000000000000832
Johanna Catherine Maclean, Michael F. Pesko, and Steven C. Hill, “Public Insurance Expansions and Smoking Cessation Medications,” Economic Inquiry 57, no. 4 (October 2019): 1798-1820, https://doi.org/10.1111/ecin.12794
Johanna Maclean and Brendan Saloner, The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act (National Bureau of Economic Research Working Paper No. 23342, April 2017), http://www.nber.org/papers/w23342.pdf
Johanna Maclean and Brendan Saloner, “The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act,” Journal of Policy Analysis and Management 38, no. 2 (Spring 2019): 366-393, https://www.ncbi.nlm.nih.gov/pubmed/30882195
Amandeep R. Mahal et al., “Early Impact of the Affordable Care Act and Medicaid Expansion on Racial and Socioeconomic Disparities in Cancer Care,” American Journal of Clinical Oncology Epub ahead of print (January 2020), https://doi.org/10.1097/coc.0000000000000588
Nirosha Mahendraratnam, Stacie Dusetzina, and Joel Farley, “Prescription Drug Utilization and Reimbursement Increased Following State Medicaid Expansion in 2014,” Journal of Managed Care & Specialty Pharmacy 23 no. 3 (March 2017): 355-363, http://www.jmcp.org/doi/10.18553/jmcp.2017.23.3.355
Elham Mahmoudi, Alicia Cohen, Jason Buxbaum, Caroline Richardson, and Wassim Tarraf, “Gaining Medicaid Coverage During ACA Implementation: Effects on Access to Care and Preventive Services,” Journal of Health Care for the Poor and Underserved 29, no. 4 (November 2018): 1472-1487, https://muse.jhu.edu/article/708253
Ramiro Manzano-Nunez et al., “Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery,” World Journal of Surgery 43, no. 6 (June 2019): 1483-1489, https://link.springer.com/article/10.1007/s00268-019-04932-0
Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019
Dennis McCarty, Yifan Gu, John W. McIlveen, and Bonnie K. Lind, “Medicaid Expansion and Treatment for Opioid Use Disorders in Oregon: An Interrupted Time-Series Analysis,” Addiction Science & Clinical Practice 14 (August 2019), https://doi.org/10.1186/s13722-019-0160-6
Tyler McClintock, Ye Wang, Mahek Shah, Benjamin Chung, and Steven Chang, “How Have Hospital Pricing Practices for Surgical Episodes of Care Responded to Affordable Care Act-Related Medicaid Expansion?” Urology 125 (March 2019): 79-85, https://doi.org/10.1016/j.urology.2018.10.034
Shannon McConville, Maria Raven, Sarah Sabbagh, and Renee Hsia, “Frequent Emergency Department Users: A Statewide Comparison Before And After Affordable Care Act Implementation,” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0784
James McDermott et al., “Affordable Care Act’s Medicaid Expansion and Use of Regionalized Surgery at High-Volume Hospitals,” Journal of the American College of Surgeons 227, no. 5 (November 2018): 507-520.e9, https://www.journalacs.org/article/S1072-7515(18)31993-8/abstract
Stacey McMorrow, Jason Gates, Sharon Long, and Genevieve Kenney, “Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents,” Health Affairs 36 no. 5 (May 2017): 808-818, https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1650
Stacey McMorrow, Genevieve Kenney, Sharon Long, and Nathaniel Anderson, “Uninsurance Among Young Adults Continues to Decline, Particularly in Medicaid Expansion States,” Health Affairs 34, no. 4 (April 2015): 616-620, http://content.healthaffairs.org/content/34/4/616.full
Angelica Meinhofer and Allison Witman, “The Role Of Health Insurance On Treatment For Opioid Use Disorders: Evidence From The Affordable Care Act Medicaid Expansion,” Journal of Health Economics 60 (June 2018): 177-197, https://www.sciencedirect.com/science/article/abs/pii/S0167629617311530
Jose Mesquita-Neto, Peter Cmorej, Hassan Mouzaihem, Donald Weaver, Steve Kim, and Francis Macedo, “Disparities In Access To Cancer Surgery After Medicaid Expansion,” The American Journal of Surgery epub ahead of print (June 2019), https://www.sciencedirect.com/science/article/abs/pii/S0002961019306889
Sarah Miller, Sean Altekruse, Norman Johnson, and Laura R. Wherry, Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data (National Bureau of Economic Research, Working Paper No. 26081, July 2019), http://www.nber.org/papers/w26081
Sarah Miller, Luojia Hu, Robert Kaestner, Bhashkar Mazumder, and Ashley Wong, The ACA Medicaid Expansion in Michigan and Financial Health, (National Bureau of Economic Research, working paper no. 25053, September 2018), https://www.nber.org/papers/w25053.pdf
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “The Affordable Care Act and Opioid Agonist Therapy for Opioid Use Disorder,” Psychiatry Online (April 2019), https://doi.org/10.1176/appi.ps.201900025
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “Medication Treatment For Opioid Use Disorders In Substance Use Treatment Facilities,” Health Affairs 38, no. 1 (January 2019), https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05162
Favel Mondesir et al., “Medicaid Expansion and Hospitalization for Ambulatory Care–Sensitive Conditions Among Nonelderly Adults With Diabetes,” Journal of Ambulatory Care Management epub ahead of print (May 2019), https://insights.ovid.com/pubmed?pmid=31107800
Haley Moss, Laura Havrilesky, and Junzo Chino, “Insurance Coverage Among Women Diagnosed with a Gynecologic Malignancy Before and After Implementation of the Affordable Care Act,” Gynecologic Oncology 146, no. 3 (September 2017), https://www.ncbi.nlm.nih.gov/pubmed/28641821
Jenny Nguyen, Nidharshan Anandasivam, Daniel Cooperman, Richard Pelker, and Daniel Wiznia, “Does Medicaid Insurance Provide Sufficient Access to Pediatric Orthopedic Care Under the Affordable Care Act?,” Global Pediatric Health epub ahead of print (February 2019), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381430/
Sayeh Nikpay, Thomas Buchmueller, and Helen Levy. “Affordable Care Act Medicaid Expansion Reduced Uninsured Hospital Stays in 2014,” Health Affairs 35, no.1 (January 2016): 106-110, http://content.healthaffairs.org/content/35/1/106.full
Sayeh Nikpay, Seth Freedman, Helen Levy, and Tom Buchmueller, “Effect of the Affordable Care Act Medicaid Expansion on Emergency Department Visits: Evidence From State-Level Emergency Department Databases,” Annals of Emergency Medicine 70, no.2 (August 2017), http://www.annemergmed.com/article/S0196-0644(17)30319-0/pdf
Office of the Assistant Secretary for Planning and Evaluation (ASPE), Impacts of the Affordable Care Act’s Medicaid Expansion on Insurance Coverage and Access to Care (Office of the Assistant Secretary for Planning and Evaluation, June 2016), https://aspe.hhs.gov/sites/default/files/pdf/205141/medicaidexpansion.pdf
Mark Olfson, Melanie Wall, Colleen Barry, Christine Mauro, and Ramin Mojtabai, “Impact Of Medicaid Expansion On Coverage And Treatment Of Low-Income Adults With Substance Use Disorders,” Health Affairs 37, no. 8 (August 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.0124
Mark Olfson et al., “A National Survey of Trends in Health Insurance Coverage of Low-Income Adults Following Medicaid Expansion,” Journal of General Internal Medicine Epub ahead of print (October 2019), https://doi.org/10.1007/s11606-019-05409-5
John J. Park et al., “Medicaid and Private Insurance Coverage for Low-Income Asian Americans, Native Hawaiians, and Pacific Islanders, 2010-16,” Health Affairs 38, no. 11 (November 2019): 1911-1917, https://doi.org/10.1377/hlthaff.2019.00316
Lizhong Peng, Xiaohui Guo, and Chad D. Meyerhoefer, “The Effects of Medicaid Expansion on Labor Market Outcomes: Evidence from Border Counties,” Health Economics Epub ahead of print (December 2019), https://doi.org/10.1002/hec.3976
Gary Pickens et al., “Changes in Hospital Inpatient Utilization Following Health Care Reform,” Health Services Research epub ahead of print (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28664983
Gary Pickens et al., “Changes In Hospital Service Demand, Cost, And Patient Illness Severity Following Health Reform,” Health Services Research (May 2019), https://doi.org/10.1111/1475-6773.13165
Jesse Pines, Rahul Ladhania BTech, Bernard Black , Christopher Corbit, Jestin Carlson, and Arvind Venkat, “Changes in Reimbursement to Emergency Physicians After Medicaid Expansion Under the Patient Protection and Affordable Care Act,” Annals of Emergency Medicine 73, no. 3 (March 2019): 213-224, https://www.sciencedirect.com/science/article/pii/S019606441831374X
Jesse M. Pines, Mark Zocchi, Ali Moghtaderi, Bernard Black, Steven A. Farmer, Greg Hufstetler, Kevin Klauer and Randy Pilgrim, “Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix,” Health Affairs 35, no. 8 (August 2016), http://content.healthaffairs.org/content/35/8/1480.full
Matthew Present, Aviva Nathan, Sandra Ham, Robert Sargis, Michael Quinn, and Elbert Huang, “The Impact of the Affordable Care Act Medicaid Expansion on Type 2 Diabetes Diagnosis and Treatment: A National Survey of Physicians,” Journal of Community Health epub ahead of print (May 2019), https://link.springer.com/article/10.1007%2Fs10900-019-00637-6
Beatrice D. Probst, Luther Walls, Michael Cirone, and Talar Markossian, “Examining the Effect of the Affordable Care Act on Two Illinois Emergency Departments,” Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health 20, no. 5 (September 2019): 710-716, https://doi.org/10.5811/westjem.2019.6.41943
Jordan Rhodes, Thomas Buchmueller, Helen Levy, and Sayeh Nikpay, “Heterogeneous Effects Of The Aca Medicaid Expansion On Hospital Financial Outcomes,” Contemporary Economic Policy epub ahead of print (April 2019), https://onlinelibrary.wiley.com/doi/full/10.1111/coep.12428
Ann-Marie Rosland et al., “Diagnosis and Care of Chronic Health Conditions Among Medicaid Expansion Enrollees: a Mixed-Methods Observational Study,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2549-2558, https://doi.org/10.1007/s11606-019-05323-w
Brendan Saloner, Sachini Bandara, Emma McGinty, and Colleen Barry, “Justice-Involved Adults With Substance Use Disorders: Coverage Increased but Rates of Treatment Did Not in 2014,” Health Affairs 35 no. 6 (June 2016), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0005
Brendan Saloner, Rachel Landis, Bradley Stein, and Colleen Barry, “The Affordable Care Act in the Heart of the Opioid Crisis: Evidence from West Virginia,” Health Affairs 38, no. 4 (April 2019), https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.05049
Brendan Saloner, Jonathan Levin, Hsien-Yen Chang, Christopher Jones, and G. Caleb Alexander, “Changes in Buprenorphine-Naloxone and Opioid Pain Reliever Prescriptions After the Affordable Care Act Medicaid Expansion,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2696873
Michael Sances and Joshua Clinton, New Policy, New Politics? The Effect of Medicaid Expansion on Public Support for the Affordable Care Act, (University of Memphis and Vanderbilt University, February 2017), https://csap.yale.edu/sites/default/files/files/apppw_jc2_3-8-17.pdf
Scott R. Sanders et al., “Infants Without Health Insurance: Racial/Ethnic and Rural/Urban Disparities in Infant Households’ Insurance Coverage,” PLoS One 15, no. 1 (January 2020), https://doi.org/10.1371/journal.pone.0222387
Robert Sandstrom, “Increased Utilization of Ambulatory Occupational Therapy and Physical Therapy After Medicaid Expansion” Archives of Physical Medicine and Rehabilitation epub ahead of print (March 2019), https://www.archives-pmr.org/article/S0003-9993(19)30161-3/fulltext
Lucie Schmidt, Lara Shore-Sheppard, and Tara Watson, The Impact of the ACA Medicaid Expansion on Disability Program Applications (National Bureau of Economic Research, Working Paper No. 26192, August 2019), http://www.nber.org/papers/w26192
John Scott et al., “Lifting the Burden: State Medicaid Expansion Reduces Financial Risk for the Injured,” Journal of Trauma and Acute Care Surgery Epub ahead of print (September 2019), https://doi.org/10.1097/ta.0000000000002493
Olga Scrivner et al., “Job Postings in the Substance Use Disorder Treatment Related Sector During the First Five Years of Medicaid Expansion,” PLoS One 15, no. 1 (January 2020), https://doi.org/10.1371/journal.pone.0228394
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830
Aditi Sen and Thomas DeLeire, “How Does Expansion Of Public Health Insurance Affect Risk Pools And Premiums In The Market For Private Health Insurance? Evidence From Medicaid And The Affordable Care Act Marketplaces,” Health Economics 27 (July 2018): 1877–1903, https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3809
Aabha Sharma, Scott Dresden, Emilie Powell, Raymond Kang, Joe Feinglass, “Emergency Department Visits and Hospitalizations for the Uninsured in Illinois Before and After Affordable Care Act Insurance Expansion,” Journal of Community Health 42 no. 3 (June 2017): 591-597, https://link.springer.com/article/10.1007/s10900-016-0293-4
Alana Sharp, Austin Jones, Jennifer Sherwood, Oksana Kutsa, Brian Honermann, and Gregorio Millett, “Impact of Medicaid Expansion on Access to Opioid Analgesic Medications and Medication-Assisted Treatment,” American Journal of Public Health 108, no. 5 (May 2018): 642-648, https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018.304338?journalCode=ajph
Adele Shartzer, Frederic Blavin, and John Holohan, “Employer-Sponsored Insurance Stable For Low-Income Workers In Medicaid Expansion States,” Health Affairs 37, no. 4 (April 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1205
Chelsea L. Shover et al., “The Relationship of Medicaid Expansion to Psychiatric Comorbidity Care within Substance Use Disorder Treatment Programs,” Journal of Substance Abuse Treatment 105 (October 2019): 44-50, https://doi.org/10.1016/j.jsat.2019.07.012
Kosali Simon, Aparna Soni, and John Cawley, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions” Journal of Policy Analysis and Management 36, no. 2 (March 2017), https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21972
Helmneh M. Sineshaw et al., “Association of Medicaid Expansion Under the Affordable Care Act With Stage at Diagnosis and Time to Treatment Initiation for Patients With Head and Neck Squamous Cell Carcinoma,” JAMA Otolaryngology–Head & Neck Surgery Epub ahead of print (January 2020), https://doi.org/10.1001/jamaoto.2019.4310
Astha Singhal, Peter Damiano, and Lindsay Sabik, “Medicaid Adult Dental Benefits Increase Use Of Dental Care, But Impact Of Expansion On Dental Services Use Was Mixed,” Health Affairs 36 no. 4 (April 2017): 723-732, http://content.healthaffairs.org/content/36/4/723.short
Benjamin Sommers, Robert Blendon, and E. John Orav, “Both the ‘Private Option’ And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults,” Health Affairs 35, no. 1 (January 2016): 96-105, http://content.healthaffairs.org/content/35/1/96.abstract
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420
Benjamin Sommers, Carrie Fry, Robert Blendon, and Arnold Epstein, “New Approaches in Medicaid: Work Requirements, Health Savings Accounts, and Health Care Access,” Health Affairs 37, no. 7 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0331
Benjamin Sommers, Anna Goldman, Robert Blendon, E. John Orav, and Arnold Epstein, “Medicaid Work Requirements – Results from the First Year in Arkansas,” The New England Journal of Medicine Special Report (June 2019), https://www.nejm.org/doi/full/10.1056/NEJMsr1901772
Benjamin Sommers, Munira Gunja, Kenneth Finegold, and Thomas Musco, “Changes in Self-Reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act,” The Journal of the American Medical Association 314 no. 4 (July 2015): 366-374, http://jama.jamanetwork.com/article.aspx?articleid=2411283&resultClick=3
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293
Benjamin Sommers, Thomas Musco, Kenneth Finegold, Munira Gunja, Amy Burke, and Audrey McDowell, “Health Reform and Changes in Health Insurance Coverage in 2014” The New England Journal of Medicine 371 (August 2014): 867-874, http://www.nejm.org/doi/full/10.1056/NEJMsr1406753
Aparna Soni, Michael Hendryx, and Kosali Simon, “Medicaid Expansion under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas,” The Journal of Rural Health epub ahead of print (January 2017), http://onlinelibrary.wiley.com/doi/10.1111/jrh.12234/full
Aparna Soni, Kosali Simon, John Cawley, and Lindsay Sabik, “Effect of Medicaid Expansions of 2014 on Overall and Early-Stage Cancer Diagnoses,” American Journal of Public Health epub ahead of print (December 2017), http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2017.304166
Jim P. Stimpson, Jessie Kemmick Pintor, and Fernando A. Wilson, “Association of Medicaid Expansion with Health Insurance Coverage by Marital Status and Sex,” PLoS One 14, no. 10 (October 2019), https://doi.org/10.1371/journal.pone.0223556
Jim P. Stimpson et al., “Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability,” JAMA Network Open 2, no. 7 (July 2019), https://doi.org/10.1001/jamanetworkopen.2019.7136
James A. Swartz and Susanny J. Beltran, “Prescription Opioid Availability and Opioid Overdose-Related Mortality Rates in Medicaid Expansion and Non-Expansion States,” Addiction 114, no. 11 (November 2019): 2016-2025, https://doi.org/10.1111/add.14741
Renuka Tipirneni et al., “Association of Expanded Medicaid Coverage With Health and Job-Related Outcomes Among Enrollees With Behavioral Health Disorders,” Psychiatric Services Epub ahead of print (September 2019), https://doi.org/10.1176/appi.ps.201900179
Renuka Tipirneni et al., “Association of Medicaid Expansion With Enrollee Employment and Student Status in Michigan,” JAMA Network Open 3, no. 1 (January 2020), https://doi.org/10.1001/jamanetworkopen.2019.20316
Renuka Tipirneni et al., “Changes in Health and Ability to Work Among Medicaid Expansion Enrollees: a Mixed Methods Study,” Journal of General Internal Medicine 34, no. 2 (February 2019): 272-280, https://link.springer.com/article/10.1007/s11606-018-4736-8
Dmitry Tumin et al., “Medicaid Participation among Liver Transplant Candidates after the Affordable Care Act Medicaid Expansion” Journal of the American College of Surgeons 225, no. 2 (August 2017): 173-180.e2, https://www.journalacs.org/article/S1072-7515(17)30454-4/fulltext
Dmitry Tumin, Don Hayes Jr., Kenneth Washburn, Joseph Tobias, and Sylvester Black, “Medicaid Enrollment after Liver Transplantation: Effects of Medicaid Expansion,” Liver Transplantation (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27152888
Sri Lekha Tummalapalli, Samuel Leonard, Michelle M. Estrella, and Salomeh Keyhani, “The Effect of Medicaid Expansion on Self-Reported Kidney Disease,” Clinical Journal of American Society of Nephrology 14, no. 8 (August 2019): 1238-1240, https://doi.org/10.2215/cjn.02310219
United States Government Accountability Office (GAO), Medicaid Expansion: Behavioral Health Treatment Use in Selected States in 2014 (Washington, DC: GAO Report to Congressional Requesters, June 2017), https://www.gao.gov/assets/690/685415.pdf
The University of Michigan Institute for Healthcare Policy & Innovation, The Healthy Michigan Plan: 2015 Report on Uncompensated Care and Insurance Rates (The University of Michigan Institute for Healthcare Policy & Innovation, prepared for the Michigan Department of Health and Human Services and the Michigan Department of Insurance and Financial Services, December 2016), http://www.michigan.gov/documents/mdhhs/2015_Report_on_Uncompensated_Care_and_Insurance_Rates-HMP_547720_7.pdf
Rishi Wadhera et al., “Association of the Affordable Care Act’s Medicaid Expansion With Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure,” Circulation: Cardiovascular Quality and Outcomes 11, no. 7 (June 2018), https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.118.004729
Steven Wallace, Maria-Elena Young, Michael Rodriguez, Amy Bonilla, and Nadereh Pourat, Community Health Centers Play a Critical Role in Caring for the Remaining Uninsured in the Affordable Care Act Era (UCLA Center for Health Policy Research, October 2016), http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/FQHC_PB-oct2016.pdf
George Wehby and Wei Lyu, “The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender” Health Services Research epub ahead of print (May 2017), http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12711/abstract
Hefei Wen, Tyrone Borders, and Benjamin Druss, ”Number of Medicaid Prescriptions Grew, Drug Spending was Steady in Medicaid Expansion States,” Health Affairs 35, no. 12 (September 2016): 1604-1607, http://content.healthaffairs.org/content/35/9/1604.full
Hefei Wen, Kenton J. Johnston, Lindsay Allen, and Teresa M. Waters, “Medicaid Expansion Associated With Reductions In Preventable Hospitalizations,” Health Affairs 38, no. 11 (November 2019): 1845-1849, https://doi.org/10.1377/hlthaff.2019.00483
Laura Wherry and Sarah Miller, “Early Coverage, Access, Utilization, and Health Effects Associated with the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study,” Annals of Internal Medicine, Epub ahead of print (April 2016), http://annals.org/article.aspx?articleid=2513980
Tyler Winkelman and Virginia Chang, “Medicaid Expansion, Mental Health, and Access to Care Among Childless Adults With and Without Chronic Conditions,” Journal of General Internal Medicine epub ahead of print (November 2017), https://www.ncbi.nlm.nih.gov/pubmed/29181792
Tyler Winkelman, Edith Kieffer, Susan Goold, Jeffrey Morenoff, Kristen Cross, and John Ayanian, “Health Insurance Trends and Access to Behavioral Health Care Among Justice-Involved Individuals,” Journal of General Internal Medicine 31, no. 12 (December 2016): 1523-1529, https://www.ncbi.nlm.nih.gov/pubmed/27638837
Joanna Woronkowicz, Aparna Soni, Seth Freedman, and Kosali Simon, “How Have Recent Health Insurance Expansions Affected Coverage Among Artist Occupations In The USA?,” Journal of Cultural Economics (May 2019), https://link.springer.com/article/10.1007/s10824-019-09352-5
Deborah Yip et al., “Association of Medicaid Expansion and Health Insurance with Receipt of Smoking Cessation Services and Smoking Behaviors in Substance Use Disorder Treatment,” The Journal of Behavioral Health Services & Research (July 2019), https://doi.org/10.1007/s11414-019-09669-1
Gary Young, Stephen Flaherty, E. Zepeda, Simone Singh, and Sara Rosenbaum, “Impact of ACA Medicaid Expansion on Hospitals’ Financial Status” Journal of Healthcare Management 64, no. 2 (March 2019): 91–102, https://insights.ovid.com/crossref?an=00115514-201904000-00007
Naomi Zewde, Erica Eliason, Heidi Allen, and Tal Gross, “The Effects of the ACA Medicaid Expansion on Nationwide Home Evictions and Eviction-Court Initiations: United States, 2000-2016,” American Journal of Public Health 109, no. 10 (October 2019): 1379-1383, https://doi.org/10.2105/ajph.2019.305230
Cheryl Zogg et al., “Impact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision,” Journal of the American College of Surgeons 228, no. 1 (January 2019): 29-43, https://www.journalacs.org/article/S1072-7515(18)32078-7/fulltext
This is an update to four earlier versions of this issue brief that covered studies published through May 2016, January 2017, June 2017, February 2018, and June 2019. ↩︎
Mark Olfson et al., “A National Survey of Trends in Health Insurance Coverage of Low-Income Adults Following Medicaid Expansion,” Journal of General Internal Medicine Epub ahead of print (October 2019), https://doi.org/10.1007/s11606-019-05409-5↩︎
John A. Graves et al., “Medicaid Expansion Slowed Rates of Health Decline for Low-Income Adults in Southern States,” Health Affairs 39, no. 1 (January 2020): 67-76, https://doi.org/10.1377/hlthaff.2019.00929↩︎
Jim P. Stimpson, Jessie Kemmick Pintor, and Fernando A. Wilson, “Association of Medicaid Expansion with Health Insurance Coverage by Marital Status and Sex,” PLoS One 14, no. 10 (October 2019), https://doi.org/10.1371/journal.pone.0223556↩︎
Jim P. Stimpson et al., “Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability,” JAMA Network Open 2, no. 7 (July 2019), https://doi.org/10.1001/jamanetworkopen.2019.7136↩︎
Gracie Himmelstein, “Effect of the Affordable Care Act’s Medicaid Expansions on Food Security, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1243-1248, https://doi.org/10.2105/ajph.2019.305168↩︎
Sumit D. Agarwal, Anna L. Goldman, and Benjamin D. Sommers, “Blue-Collar Workers Had Greatest Insurance Gains After ACA Implementation,” Health Affairs 38, no. 7 (July 2019): 1140-1144, https://doi.org/10.1377/hlthaff.2018.05454↩︎
Michel Boudreaux, James M. Noon, Brett Fried, and Joanne Pascale, “Medicaid Expansion and the Medicaid Undercount in the American Community Survey,” Health Services Research 54, no. 6 (December 2019): 1263-1272, https://doi.org/10.1111/1475-6773.13213↩︎
Hiroshi Gotanda, Gerald Kominski, and Yusuke Tsugawa, “Association Between the ACA Medicaid Expansions and Primary Care and Emergency Department Use During the First 3 Years,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05458-w↩︎
Lucie Schmidt, Lara Shore-Sheppard, and Tara Watson, The Impact of the ACA Medicaid Expansion on Disability Program Applications (National Bureau of Economic Research, Working Paper No. 26192, August 2019), http://www.nber.org/papers/w26192↩︎
Charles J. Courtemanche et al., The Impact of the ACA on Insurance Coverage Disparities After Four Years (National Bureau of Economic Research, Working Paper No. 26157, August 2019), http://www.nber.org/papers/w26157↩︎
Charles J. Courtemanche, James Marton, and Aaron Yelowitz, Medicaid Coverage across the Income Distribution under the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26145, August 2019), http://www.nber.org/papers/w26145↩︎
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, and Ishtiaque Fazlul, “The Three‐Year Impact of the Affordable Care Act on Disparities in Insurance Coverage,” Health Services Research (October 2018), https://onlinelibrary.wiley.com/doi/10.1111/1475-6773.13077↩︎
Abeer Alharbi, M. Mahmud Khan, Ronnie Horner, Heather Brandt, and Cole Chapman, “Impact Of Medicaid Coverage Expansion Under The Affordable Care Act On Mammography And Pap Tests Utilization Among Low-Income Women,” PLOS One (April 2019), https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214886↩︎
Kevin Callison and Paul Sicilian, “Economic Freedom and the Affordable Care Act: Medicaid Expansions and Labor Mobility by Race and Ethnicity,” Public Finance Review 46, no. 2 (March 2018), https://journals.sagepub.com/doi/abs/10.1177/1091142116668254↩︎
Michael Dworsky and Christine Eibner, The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults (Santa Monica, CA: Rand Corporation, 2016), https://www.rand.org/pubs/research_reports/RR1736.html↩︎
Colleen M. Carey, Sarah Miller, and Laura R. Wherry, The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare, (National Bureau of Economic Research, Working Paper Series No. 25153, October 2018), https://www.nber.org/papers/w25153↩︎
Frederic Blavin, Michael Karpman, Genevieve Kenney, and Benjamin Sommers, “Medicaid Versus Marketplace Coverage for Near-Poor Adults: Effects on Out-Of-Pocket Spending and Coverage,” Health Affairs 37 no. 2 (January 2018), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.1166↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
Sandra Decker, Brandy Lipton, and Benjamin Sommers, “Medicaid Expansion Coverage Effects Grew in 2015 With Continued Improvements in Coverage Quality,” Health Affairs 36 no. 5 (May 2017): 819-825, http://content.healthaffairs.org/content/36/5/819.full↩︎
George Wehby and Wei Lyu, “The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender” Health Services Research epub ahead of print (May 2017), http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12711/abstract↩︎
Laura Wherry and Sarah Miller, “Early Coverage, Access, Utilization, and Health Effects Associated with the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study,” Annals of Internal Medicine, Epub ahead of print (April 2016), http://annals.org/article.aspx?articleid=2513980↩︎
Benjamin Sommers, Robert Blendon, and E. John Orav, “Both the ‘Private Option’ And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults,” Health Affairs 35, no. 1 (January 2016): 96-105, http://content.healthaffairs.org/content/35/1/96.abstract↩︎
Pauline Leung and Alexandre Mas, Employment Effects of the ACA Medicaid Expansions (Working Paper No. 22540, National Bureau of Economic Research, August 2016), http://www.nber.org/papers/w22540↩︎
Aparna Soni, Michael Hendryx, and Kosali Simon, “Medicaid Expansion under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas,” The Journal of Rural Health epub ahead of print (January 2017), http://onlinelibrary.wiley.com/doi/10.1111/jrh.12234/full↩︎
Sarah Gordon, Benjamin Sommers, Ira Wilson, Omar Galarraga, and Amal Trivedi, “The Impact of Medicaid Expansion on Continuous Enrollment: a Two State Analysis,” Journal of General Internal Medicine epub ahead of print (June 2019), https://link.springer.com/article/10.1007/s11606-019-05101-8↩︎
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562↩︎
Benjamin Sommers, Carrie Fry, Robert Blendon, and Arnold Epstein, “New Approaches in Medicaid: Work Requirements, Health Savings Accounts, and Health Care Access,” Health Affairs 37, no. 7 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0331↩︎
Mark Olfson et al., “A National Survey of Trends in Health Insurance Coverage of Low-Income Adults Following Medicaid Expansion,” Journal of General Internal Medicine Epub ahead of print (October 2019), https://doi.org/10.1007/s11606-019-05409-5↩︎
Anna L. Goldman and Benjamin D. Sommers, “Among Low-Income Adults Enrolled In Medicaid, Churning Decreased After The Affordable Care Act,” Health Affairs 39, no. 1 (January 2020): 85-93, https://doi.org/10.1377/hlthaff.2019.00378↩︎
Amandeep R. Mahal et al., “Early Impact of the Affordable Care Act and Medicaid Expansion on Racial and Socioeconomic Disparities in Cancer Care,” American Journal of Clinical Oncology Epub ahead of print (January 2020), https://doi.org/10.1097/coc.0000000000000588↩︎
Jennifer M. Lobo et al., “Trends in Uninsured Rates Before and After Medicaid Expansion in Counties Within and Outside of the Diabetes Belt,” Diabetes Care Epub ahead of print (January 2020), https://doi.org/10.2337/dc19-0874↩︎
John A. Graves et al., “Medicaid Expansion Slowed Rates of Health Decline for Low-Income Adults in Southern States,” Health Affairs 39, no. 1 (January 2020): 67-76, https://doi.org/10.1377/hlthaff.2019.00929↩︎
Lizhong Peng, Xiaohui Guo, and Chad D. Meyerhoefer, “The Effects of Medicaid Expansion on Labor Market Outcomes: Evidence from Border Counties,” Health Economics Epub ahead of print (December 2019), https://doi.org/10.1002/hec.3976↩︎
Deborah Yip et al., “Association of Medicaid Expansion and Health Insurance with Receipt of Smoking Cessation Services and Smoking Behaviors in Substance Use Disorder Treatment,” The Journal of Behavioral Health Services & Research (July 2019), https://doi.org/10.1007/s11414-019-09669-1↩︎
Shiho Kino and Ichiro Kawachi, “Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?,” Health Education & Behavior Epub ahead of print (October 2019), https://doi.org/10.1177/1090198119875998↩︎
Jim P. Stimpson, Jessie Kemmick Pintor, and Fernando A. Wilson, “Association of Medicaid Expansion with Health Insurance Coverage by Marital Status and Sex,” PLoS One 14, no. 10 (October 2019), https://doi.org/10.1371/journal.pone.0223556↩︎
Jim P. Stimpson et al., “Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability,” JAMA Network Open 2, no. 7 (July 2019), https://doi.org/10.1001/jamanetworkopen.2019.7136↩︎
Aparna Soni, Michael Hendryx, and Kosali Simon, “Medicaid Expansion under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas,” The Journal of Rural Health epub ahead of print (January 2017), http://onlinelibrary.wiley.com/doi/10.1111/jrh.12234/full↩︎
Lindsay C. Kobayashi, Onur Altindag, Yulya Truskinovsky, and Lisa F. Berkman, “Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-Being in the US Adult Population, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1236-1242, https://doi.org/10.2105/ajph.2019.305164↩︎
Hiroshi Gotanda, Gerald Kominski, and Yusuke Tsugawa, “Association Between the ACA Medicaid Expansions and Primary Care and Emergency Department Use During the First 3 Years,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05458-w↩︎
Sri Lekha Tummalapalli, Samuel Leonard, Michelle M. Estrella, and Salomeh Keyhani, “The Effect of Medicaid Expansion on Self-Reported Kidney Disease,” Clinical Journal of American Society of Nephrology 14, no. 8 (August 2019): 1238-1240, https://doi.org/10.2215/cjn.02310219↩︎
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, and Ishtiaque Fazlul, “The Three‐Year Impact of the Affordable Care Act on Disparities in Insurance Coverage,” Health Services Research (October 2018), https://onlinelibrary.wiley.com/doi/10.1111/1475-6773.13077↩︎
Robin Cohen, Emily Terlizzi, and Michael Martinez, Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2018 (National Center for Health Statistics, May 2019), https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201905.pdf↩︎
John Cawley, Aparna Soni, and Kosali Simon, “Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1495-1497, https://link.springer.com/article/10.1007%2Fs11606-018-4537-0↩︎
Kosali Simon, Aparna Soni, and John Cawley, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions” Journal of Policy Analysis and Management 36, no. 2 (March 2017), https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21972↩︎
Michael Dworsky and Christine Eibner, The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults (Santa Monica, CA: Rand Corporation, 2016), https://www.rand.org/pubs/research_reports/RR1736.html↩︎
Frederic Blavin, Michael Karpman, Genevieve Kenney, and Benjamin Sommers, “Medicaid Versus Marketplace Coverage for Near-Poor Adults: Effects on Out-Of-Pocket Spending and Coverage,” Health Affairs 37 no. 2 (January 2018), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.1166↩︎
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830↩︎
Sharon Long, Lea Bart, Michael Karpman, Adele Shartzer, and Stephen Zuckerman, “Sustained Gains in Coverage, Access, and Affordability Under the ACA: A 2017 Update,” Health Affairs 36 no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0798↩︎
Sunha Choi, Sungkyu Lee, and Jason Matejkowski, “The Effects of State Medicaid Expansion on Low-Income Individuals’ Access to Health Care: Multilevel Modeling,” Population Health Management epub ahead of print (September 2017), http://online.liebertpub.com/doi/abs/10.1089/pop.2017.0104↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Sandra Decker, Brandy Lipton, and Benjamin Sommers, “Medicaid Expansion Coverage Effects Grew in 2015 With Continued Improvements in Coverage Quality,” Health Affairs 36 no. 5 (May 2017): 819-825, http://content.healthaffairs.org/content/36/5/819.full↩︎
George Wehby and Wei Lyu, “The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender” Health Services Research epub ahead of print (May 2017), http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12711/abstract↩︎
Office of the Assistant Secretary for Planning and Evaluation (ASPE), Impacts of the Affordable Care Act’s Medicaid Expansion on Insurance Coverage and Access to Care (Office of the Assistant Secretary for Planning and Evaluation, June 2016), https://aspe.hhs.gov/sites/default/files/pdf/205141/medicaidexpansion.pdf↩︎
Benjamin Sommers, Robert Blendon, and E. John Orav, “Both the ‘Private Option’ And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults,” Health Affairs 35, no. 1 (January 2016): 96-105, http://content.healthaffairs.org/content/35/1/96.abstract↩︎
Benjamin Sommers, Munira Gunja, Kenneth Finegold, and Thomas Musco, “Changes in Self-Reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act,” The Journal of the American Medical Association 314 no. 4 (July 2015): 366-374, http://jama.jamanetwork.com/article.aspx?articleid=2411283&resultClick=3↩︎
Thomas Buchmueller, Zachary Levinson, Helen Levy, and Barbara Wolfe, “Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage,” American Journal of Public Health (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27196653↩︎
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420↩︎
Benjamin Sommers, Thomas Musco, Kenneth Finegold, Munira Gunja, Amy Burke, and Audrey McDowell, “Health Reform and Changes in Health Insurance Coverage in 2014” The New England Journal of Medicine 371 (August 2014): 867-874, http://www.nejm.org/doi/full/10.1056/NEJMsr1406753↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, and Daniela Zapata, Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States (Working Paper No. 22182, The National Bureau of Economic Research, April 2016), http://www.nber.org/papers/w22182↩︎
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562↩︎
Laura Wherry and Sarah Miller, “Early Coverage, Access, Utilization, and Health Effects Associated with the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study,” Annals of Internal Medicine, Epub ahead of print (April 2016), http://annals.org/article.aspx?articleid=2513980↩︎
Benjamin Sommers, Carrie Fry, Robert Blendon, and Arnold Epstein, “New Approaches in Medicaid: Work Requirements, Health Savings Accounts, and Health Care Access,” Health Affairs 37, no. 7 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0331↩︎
Pauline Leung and Alexandre Mas, Employment Effects of the ACA Medicaid Expansions (Working Paper No. 22540, National Bureau of Economic Research, August 2016), http://www.nber.org/papers/w22540↩︎
John Heintzman, Steffani Bailey, Jennifer DeVoe, Stuart Cowburn, Tanya Kapka, Truc-Vi Duong, and Miguel Marino, “In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon,” Journal of Racial and Ethnic Health Disparities (April 2016), http://www.ncbi.nlm.nih.gov/pubmed/27105630↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health (National Bureau of Economic Research, Working Paper no. 23269, March 2017), http://www.nber.org/papers/w23269↩︎
Stacey McMorrow, Genevieve Kenney, Sharon Long, and Jason Gates, “Marketplaces Helped Drive Coverage Gains in 2015; Affordability Problems Remained,” Health Affairs 35 no. 10 (October 2016): 1810-1815, http://content.healthaffairs.org/content/35/10/1810.full↩︎
Dennis McCarty, Yifan Gu, John W. McIlveen, and Bonnie K. Lind, “Medicaid expansion and treatment for opioid use disorders in Oregon: an interrupted time-series analysis,” Addiction Science & Clinical Practice 14 (August 2019), https://doi.org/10.1186/s13722-019-0160-6↩︎
Sarah H. Gordon, Benjamin D. Sommers, Ira B. Wilson, and Amal N. Trivedi, “Effects Of Medicaid Expansion On Postpartum Coverage And Outpatient Utilization,” Health Affairs 39, no. 1 (January 2020): 77-84, https://doi.org/10.1377/hlthaff.2019.00547↩︎
Helmneh M. Sineshaw et al., “Association of Medicaid Expansion Under the Affordable Care Act With Stage at Diagnosis and Time to Treatment Initiation for Patients With Head and Neck Squamous Cell Carcinoma,” JAMA Otolaryngology–Head & Neck Surgery Epub ahead of print (January 2020), https://doi.org/10.1001/jamaoto.2019.4310↩︎
Scott R. Sanders et al., “Infants Without Health Insurance: Racial/Ethnic and Rural/Urban Disparities in Infant Households’ Insurance Coverage,” PLoS One 15, no. 1 (January 2020), https://doi.org/10.1371/journal.pone.0222387↩︎
John J. Park et al., “Medicaid and Private Insurance Coverage for Low-Income Asian Americans, Native Hawaiians, and Pacific Islanders, 2010-16,” Health Affairs 38, no. 11 (November 2019): 1911-1917, https://doi.org/10.1377/hlthaff.2019.00316↩︎
Kevin N. Griffith, “Changes in Insurance Coverage and Access to Care for Young Adults in 2017,” Journal of Adolescent Health Epub ahead of print (July 2019), https://doi.org/10.1016/j.jadohealth.2019.05.020↩︎
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553↩︎
Kelsey L. Corrigan et al., “The Impact of the Patient Protection and Affordable Care Act on Insurance Coverage and Cancer-Directed Treatment in HIV-Infected Patients With Cancer in the United States,” Cancer (November 2019), https://doi.org/10.1002/cncr.32563↩︎
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009↩︎
Jim P. Stimpson et al., “Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability,” JAMA Network Open 2, no. 7 (July 2019), https://doi.org/10.1001/jamanetworkopen.2019.7136↩︎
Huabin Luo, Zhuo Chen, Lei Xu, and Ronny Bell, “Health Care Access and Receipt of Clinical Diabetes Preventive Care for Working-Age Adults With Diabetes in States With and Without Medicaid Expansion: Results from the 2013 and 2015 BRFSS,” Journal of Public Health Management and Practice 25, no. 4 (July/August 2019): 34-43, https://doi.org/10.1097/phh.0000000000000832↩︎
Sarah Miller, Sean Altekruse, Norman Johnson, and Laura R. Wherry, Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data (National Bureau of Economic Research, Working Paper No. 26081, July 2019), http://www.nber.org/papers/w26081↩︎
Sameed Ahmed Khatana et al., “Association of Medicaid Expansion With Cardiovascular Mortality,” JAMA Cardiology 4, no. 7 (July 2019): 671-679, https://doi.org/10.1001/jamacardio.2019.1651↩︎
Carrie Fry and Benjamin Sommers, “Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression,” Psychiatric Services 69, no. 11 (November 2018), https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800181↩︎
Xuesong Han et al., “Changes in Noninsurance and Care Unaffordability Among Cancer Survivors Following the Affordable Care Act,” Journal of the National Cancer Institute Epub ahead of print (November 2019), https://doi.org/10.1093/jnci/djz218↩︎
Xuesong Han, Robin Yabroff, Elizabeth Ward, Otis Brawley, and Ahmedin Jemal, “Comparison of Insurance Status and Diagnosis Stage Among Patients With Newly Diagnosed Cancer Before vs After Implementation of the Patient Protection and Affordable Care Act,” JAMA Oncology 4, no. 12 (August 2018): 1713-1720, https://jamanetwork.com/journals/jamaoncology/article-abstract/2697226↩︎
Tyler Winkelman, Edith Kieffer, Susan Goold, Jeffrey Morenoff, Kristen Cross, and John Ayanian, “Health Insurance Trends and Access to Behavioral Health Care Among Justice-Involved Individuals,” Journal of General Internal Medicine 31, no. 12 (December 2016): 1523-1529, https://www.ncbi.nlm.nih.gov/pubmed/27638837↩︎
Brendan Saloner, Sachini Bandara, Emma McGinty, and Colleen Barry, “Justice-Involved Adults With Substance Use Disorders: Coverage Increased but Rates of Treatment Did Not in 2014,” Health Affairs 35 no. 6 (June 2016), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0005↩︎
Ankit Agarwal, Aaron Katz, and Ronald Chen, “The Impact of the Affordable Care Act on Disparities in Private and Medicaid Insurance Coverage among Patients Under 65 with Newly Diagnosed Cancer,” International Journal of Radiation Oncology, Biology, Physics (May 2019), https://www.redjournal.org/article/S0360-3016(19)30783-7/pdf↩︎
Ameen Barghi, Hugo Torres, Nancy Kressin, and Danny McCormick, “Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study,” Journal of General Internal Medicine epub ahead of print (June 2019), https://link.springer.com/article/10.1007%2Fs11606-019-05108-1↩︎
Emily Brown, Michelle Garrison, Hao Bao, Pingping Qu, Carole Jenny, and Ali Rowhani-Rahbar, “Assessment of Rates of Child Maltreatment in States With Medicaid Expansion vs States Without Medicaid Expansion,” JAMA Network Open 2, no. 6 (June 2019), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2735758↩︎
Brandy Lipton, Sandra Decker, and Benjamin Sommers, “The Affordable Care Act Appears to Have Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Care Among Young Adults” Medical Care Research and Review 76, no.1 (April 2017): 32–55, https://www.ncbi.nlm.nih.gov/pubmed/29148341↩︎
Jose Mesquita-Neto, Peter Cmorej, Hassan Mouzaihem, Donald Weaver, Steve Kim, and Francis Macedo, “Disparities In Access To Cancer Surgery After Medicaid Expansion,” The American Journal of Surgery epub ahead of print (June 2019), https://www.sciencedirect.com/science/article/abs/pii/S0002961019306889↩︎
Fumiko Chino, Gita Suneja, Haley Moss, S. Yousuf Zafar, Laura Havrilesky, and Junzo Chino, “Healthcare Disparities in Cancer Patients Receiving Radiation: Changes in Insurance Status After Medicaid Expansion Under the Affordable Care Act,” International Journal of Radiation Oncology (December 2017), http://www.sciencedirect.com/science/article/pii/S0360301617341883↩︎
Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019↩︎
Emily Johnston, Andrea Strahan, Peter Joski, Anne Dunlop, and E. Kathleen Adams, “Impacts of the Affordable Care Act’s Medicaid Expansion on Women of Reproductive Age,” Women’s Health Issues, 28, no. 2 (February 2018), http://www.whijournal.com/article/S1049-3867(17)30242-6/pdf↩︎
Ahmedin Jemal, Chun Chieh Lin, Amy Davidoff, and Xuesong Han, “Changes in Insurance Coverage and Stage at Diagnosis Among Nonelderly Patients with Cancer after the Affordable Care Act,” Journal of Clinical Oncology 35, no. 35 (December 2017), http://ascopubs.org/doi/pdf/10.1200/JCO.2017.73.7817↩︎
Haley Moss, Laura Havrilesky, and Junzo Chino, “Insurance Coverage Among Women Diagnosed with a Gynecologic Malignancy Before and After Implementation of the Affordable Care Act,” Gynecologic Oncology 146, no. 3 (September 2017), https://www.ncbi.nlm.nih.gov/pubmed/28641821↩︎
A. Taylor Kelley, Renuka Tipirneni, and Helen Levy, “Changes in Veterans’ Coverage and Access to Care Following the Affordable Care Act, 2011-2017,” American Journal of Public Health 109, no. 9 (September 2019): 1233-1235, https://doi.org/10.2105/ajph.2019.305160↩︎
Michael Dworsky, Carrie Farmer, and Mimi Shen, Veterans’ Health Insurance Coverage Under the Affordable Care Act and Implications of Repeal for the Department of Veterans Affairs, (RAND Corporation, 2017), https://www.rand.org/pubs/research_reports/RR1955.html↩︎
Stephen Berry et al., “Healthcare Coverage for HIV Provider Visits before and after Implementation of the Affordable Care Act,” Clinical Infectious Diseases, (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27143660↩︎
George Wehby and Wei Lyu, “The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender” Health Services Research epub ahead of print (May 2017), http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12711/abstract↩︎
Stacey McMorrow, Genevieve Kenney, Sharon Long, and Nathaniel Anderson, “Uninsurance Among Young Adults Continues to Decline, Particularly in Medicaid Expansion States,” Health Affairs 34, no. 4 (April 2015): 616-620, http://content.healthaffairs.org/content/34/4/616.full↩︎
Helen Levy, Thomas Buchmueller, and Sayeh Nikpay, Health Reform and Health Insurance Coverage of Early Retirees (Ann Arbor, MI: University of Michigan Retirement Research Center Working Paper, September 2016),
http://www.mrrc.isr.umich.edu/publications/papers/pdf/wp345.pdf↩︎
Robert Kaestner, Bowen Garrett, Anuj Gangopadhyaya, and Caitlyn Fleming, Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply (Working Paper No. 21836, National Bureau of Economic Research, December 2015), http://www.nber.org/papers/w21836↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, and Ishtiaque Fazlul, “The Three‐Year Impact of the Affordable Care Act on Disparities in Insurance Coverage,” Health Services Research (October 2018), https://onlinelibrary.wiley.com/doi/10.1111/1475-6773.13077↩︎
Aparna Soni, Michael Hendryx, and Kosali Simon, “Medicaid Expansion under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas,” The Journal of Rural Health epub ahead of print (January 2017), http://onlinelibrary.wiley.com/doi/10.1111/jrh.12234/full↩︎
Ankit Agarwal, Aaron Katz, and Ronald Chen, “The Impact of the Affordable Care Act on Disparities in Private and Medicaid Insurance Coverage among Patients Under 65 with Newly Diagnosed Cancer,” International Journal of Radiation Oncology, Biology, Physics (May 2019), https://www.redjournal.org/article/S0360-3016(19)30783-7/pdf↩︎
Charles J. Courtemanche et al., The Impact of the ACA on Insurance Coverage Disparities After Four Years (National Bureau of Economic Research, Working Paper No. 26157, August 2019), http://www.nber.org/papers/w26157↩︎
Amandeep R. Mahal et al., “Early Impact of the Affordable Care Act and Medicaid Expansion on Racial and Socioeconomic Disparities in Cancer Care,” American Journal of Clinical Oncology Epub ahead of print (January 2020), https://doi.org/10.1097/coc.0000000000000588↩︎
Anna L. Goldman and Benjamin D. Sommers, “Among Low-Income Adults Enrolled In Medicaid, Churning Decreased After The Affordable Care Act,” Health Affairs 39, no. 1 (January 2020): 85-93, https://doi.org/10.1377/hlthaff.2019.00378↩︎
Scott R. Sanders et al., “Infants Without Health Insurance: Racial/Ethnic and Rural/Urban Disparities in Infant Households’ Insurance Coverage,” PLoS One 15, no. 1 (January 2020), https://doi.org/10.1371/journal.pone.0222387↩︎
Xuesong Han et al., “Changes in Noninsurance and Care Unaffordability Among Cancer Survivors Following the Affordable Care Act,” Journal of the National Cancer Institute Epub ahead of print (November 2019), https://doi.org/10.1093/jnci/djz218↩︎
Jim P. Stimpson et al., “Association of Medicaid Expansion With Health Insurance Coverage Among Persons With a Disability,” JAMA Network Open 2, no. 7 (July 2019), https://doi.org/10.1001/jamanetworkopen.2019.7136↩︎
Sandra Decker, Brandy Lipton, and Benjamin Sommers, “Medicaid Expansion Coverage Effects Grew in 2015 With Continued Improvements in Coverage Quality,” Health Affairs 36 no. 5 (May 2017): 819-825, http://content.healthaffairs.org/content/36/5/819.full↩︎
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, and Ishtiaque Fazlul, “The Three‐Year Impact of the Affordable Care Act on Disparities in Insurance Coverage,” Health Services Research (October 2018), https://onlinelibrary.wiley.com/doi/10.1111/1475-6773.13077↩︎
Xuesong Han, Robin Yabroff, Elizabeth Ward, Otis Brawley, and Ahmedin Jemal, “Comparison of Insurance Status and Diagnosis Stage Among Patients With Newly Diagnosed Cancer Before vs After Implementation of the Patient Protection and Affordable Care Act,” JAMA Oncology 4, no. 12 (August 2018): 1713-1720, https://jamanetwork.com/journals/jamaoncology/article-abstract/2697226↩︎
Fumiko Chino, Gita Suneja, Haley Moss, S. Yousuf Zafar, Laura Havrilesky, and Junzo Chino, “Healthcare Disparities in Cancer Patients Receiving Radiation: Changes in Insurance Status After Medicaid Expansion Under the Affordable Care Act,” International Journal of Radiation Oncology (December 2017), http://www.sciencedirect.com/science/article/pii/S0360301617341883↩︎
George Wehby and Wei Lyu, “The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender” Health Services Research epub ahead of print (May 2017), http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12711/abstract↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, and Daniela Zapata, Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States (Working Paper No. 22182, The National Bureau of Economic Research, April 2016), http://www.nber.org/papers/w22182↩︎
Thomas Buchmueller, Zachary Levinson, Helen Levy, and Barbara Wolfe, “Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage,” American Journal of Public Health (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27196653↩︎
Ankit Agarwal, Aaron Katz, and Ronald Chen, “The Impact of the Affordable Care Act on Disparities in Private and Medicaid Insurance Coverage among Patients Under 65 with Newly Diagnosed Cancer,” International Journal of Radiation Oncology, Biology, Physics (May 2019), https://www.redjournal.org/article/S0360-3016(19)30783-7/pdf↩︎
John Heintzman, Steffani Bailey, Jennifer DeVoe, Stuart Cowburn, Tanya Kapka, Truc-Vi Duong, and Miguel Marino, “In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon,” Journal of Racial and Ethnic Health Disparities (April 2016), http://www.ncbi.nlm.nih.gov/pubmed/27105630↩︎
Michael Dworsky and Christine Eibner, The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults (Santa Monica, CA: Rand Corporation, 2016), https://www.rand.org/pubs/research_reports/RR1736.html↩︎
Brandy Lipton, Sandra Decker, and Benjamin Sommers, “The Affordable Care Act Appears to Have Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Care Among Young Adults” Medical Care Research and Review 76, no.1 (April 2017): 32–55, https://www.ncbi.nlm.nih.gov/pubmed/29148341↩︎
Aparna Soni, Michael Hendryx, and Kosali Simon, “Medicaid Expansion under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas,” The Journal of Rural Health epub ahead of print (January 2017), http://onlinelibrary.wiley.com/doi/10.1111/jrh.12234/full↩︎
Scott R. Sanders et al., “Infants Without Health Insurance: Racial/Ethnic and Rural/Urban Disparities in Infant Households’ Insurance Coverage,” PLoS One 15, no. 1 (January 2020), https://doi.org/10.1371/journal.pone.0222387↩︎
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009↩︎
Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019↩︎
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553↩︎
Kevin N. Griffith, “Changes in Insurance Coverage and Access to Care for Young Adults in 2017,” Journal of Adolescent Health Epub ahead of print (July 2019), https://doi.org/10.1016/j.jadohealth.2019.05.020↩︎
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830↩︎
George Wehby and Wei Lyu, “The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender” Health Services Research epub ahead of print (May 2017), http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12711/abstract↩︎
Charles J. Courtemanche et al., The Impact of the ACA on Insurance Coverage Disparities After Four Years (National Bureau of Economic Research, Working Paper No. 26157, August 2019), http://www.nber.org/papers/w26157↩︎
Sumit D. Agarwal, Anna L. Goldman, and Benjamin D. Sommers, “Blue-Collar Workers Had Greatest Insurance Gains After ACA Implementation,” Health Affairs 38, no. 7 (July 2019): 1140-1144, https://doi.org/10.1377/hlthaff.2018.05454↩︎
Kelsey L. Corrigan et al., “The Impact of the Patient Protection and Affordable Care Act on Insurance Coverage and Cancer-Directed Treatment in HIV-Infected Patients With Cancer in the United States,” Cancer (November 2019), https://doi.org/10.1002/cncr.32563↩︎
John J. Park et al., “Medicaid and Private Insurance Coverage for Low-Income Asian Americans, Native Hawaiians, and Pacific Islanders, 2010-16,” Health Affairs 38, no. 11 (November 2019): 1911-1917, https://doi.org/10.1377/hlthaff.2019.00316↩︎
Jim P. Stimpson, Jessie Kemmick Pintor, and Fernando A. Wilson, “Association of Medicaid Expansion with Health Insurance Coverage by Marital Status and Sex,” PLoS One 14, no. 10 (October 2019), https://doi.org/10.1371/journal.pone.0223556↩︎
Xuesong Han et al., “Changes in Noninsurance and Care Unaffordability Among Cancer Survivors Following the Affordable Care Act,” Journal of the National Cancer Institute Epub ahead of print (November 2019), https://doi.org/10.1093/jnci/djz218↩︎
Michael Dworsky and Christine Eibner, The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults (Santa Monica, CA: Rand Corporation, 2016), https://www.rand.org/pubs/research_reports/RR1736.html↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, and Ishtiaque Fazlul, “The Three‐Year Impact of the Affordable Care Act on Disparities in Insurance Coverage,” Health Services Research (October 2018), https://onlinelibrary.wiley.com/doi/10.1111/1475-6773.13077↩︎
Mark Olfson et al., “A National Survey of Trends in Health Insurance Coverage of Low-Income Adults Following Medicaid Expansion,” Journal of General Internal Medicine Epub ahead of print (October 2019), https://doi.org/10.1007/s11606-019-05409-5↩︎
John J. Park et al., “Medicaid and Private Insurance Coverage for Low-Income Asian Americans, Native Hawaiians, and Pacific Islanders, 2010-16,” Health Affairs 38, no. 11 (November 2019): 1911-1917, https://doi.org/10.1377/hlthaff.2019.00316↩︎
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009↩︎
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553↩︎
Stephen Berry et al., “Healthcare Coverage for HIV Provider Visits before and after Implementation of the Affordable Care Act,” Clinical Infectious Diseases, (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27143660↩︎
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830↩︎
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562↩︎
Jean M. Abraham, Anne B. Royalty, and Coleman Drake, “The Impact of Medicaid Expansion on Employer Provision of Health Insurance,” International Journal of Health Economics and Management 19, no. 3-4 (December 2019): 317-340, https://doi.org/10.1007/s10754-018-9256-x↩︎
Kelsey L. Corrigan et al., “The Impact of the Patient Protection and Affordable Care Act on Insurance Coverage and Cancer-Directed Treatment in HIV-Infected Patients With Cancer in the United States,” Cancer (November 2019), https://doi.org/10.1002/cncr.32563↩︎
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046↩︎
Michael Dworsky and Christine Eibner, The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults (Santa Monica, CA: Rand Corporation, 2016), https://www.rand.org/pubs/research_reports/RR1736.html↩︎
Stacey McMorrow, Genevieve Kenney, Sharon Long, and Nathaniel Anderson, “Uninsurance Among Young Adults Continues to Decline, Particularly in Medicaid Expansion States,” Health Affairs 34, no. 4 (April 2015): 616-620, http://content.healthaffairs.org/content/34/4/616.full↩︎
Sandra Decker, Brandy Lipton, and Benjamin Sommers, “Medicaid Expansion Coverage Effects Grew in 2015 With Continued Improvements in Coverage Quality,” Health Affairs 36 no. 5 (May 2017): 819-825, http://content.healthaffairs.org/content/36/5/819.full↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
Pauline Leung and Alexandre Mas, Employment Effects of the ACA Medicaid Expansions (Working Paper No. 22540, National Bureau of Economic Research, August 2016), http://www.nber.org/papers/w22540↩︎
George Wehby and Wei Lyu, “The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender” Health Services Research epub ahead of print (May 2017), http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12711/abstract↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, and Daniela Zapata, Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States (Working Paper No. 22182, The National Bureau of Economic Research, April 2016), http://www.nber.org/papers/w22182↩︎
Joanna Woronkowicz, Aparna Soni, Seth Freedman, and Kosali Simon, “How Have Recent Health Insurance Expansions Affected Coverage Among Artist Occupations In The USA?,” Journal of Cultural Economics (May 2019), https://link.springer.com/article/10.1007/s10824-019-09352-5↩︎
Ankit Agarwal, Aaron Katz, and Ronald Chen, “The Impact of the Affordable Care Act on Disparities in Private and Medicaid Insurance Coverage among Patients Under 65 with Newly Diagnosed Cancer,” International Journal of Radiation Oncology, Biology, Physics (May 2019), https://www.redjournal.org/article/S0360-3016(19)30783-7/pdf↩︎
Aparna Soni, Michael Hendryx, and Kosali Simon, “Medicaid Expansion under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas,” The Journal of Rural Health epub ahead of print (January 2017), http://onlinelibrary.wiley.com/doi/10.1111/jrh.12234/full↩︎
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420↩︎
Benjamin Sommers, Robert Blendon, and E. John Orav, “Both the ‘Private Option’ And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults,” Health Affairs 35, no. 1 (January 2016): 96-105, http://content.healthaffairs.org/content/35/1/96.abstract↩︎
Anna L. Goldman and Benjamin D. Sommers, “Among Low-Income Adults Enrolled In Medicaid, Churning Decreased After The Affordable Care Act,” Health Affairs 39, no. 1 (January 2020): 85-93, https://doi.org/10.1377/hlthaff.2019.00378↩︎
Benjamin Sommers, Carrie Fry, Robert Blendon, and Arnold Epstein, “New Approaches in Medicaid: Work Requirements, Health Savings Accounts, and Health Care Access,” Health Affairs 37, no. 7 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0331↩︎
Benjamin Sommers, Anna Goldman, Robert Blendon, E. John Orav, and Arnold Epstein, “Medicaid Work Requirements – Results from the First Year in Arkansas,” The New England Journal of Medicine Special Report (June 2019), https://www.nejm.org/doi/full/10.1056/NEJMsr1901772↩︎
Amandeep R. Mahal et al., “Early Impact of the Affordable Care Act and Medicaid Expansion on Racial and Socioeconomic Disparities in Cancer Care,” American Journal of Clinical Oncology Epub ahead of print (January 2020), https://doi.org/10.1097/coc.0000000000000588↩︎
Benjamin Sommers, Carrie Fry, Robert Blendon, and Arnold Epstein, “New Approaches in Medicaid: Work Requirements, Health Savings Accounts, and Health Care Access,” Health Affairs 37, no. 7 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0331↩︎
Jusung Lee et al., “The Impact of Medicaid Expansion on Diabetes Management,” Diabetes Care Epub ahead of print (October 2019), https://doi.org/10.2337/dc19-1173↩︎
Emanuel Eguia et al., “The Impact of the Affordable Care Act Medicaid Expansion on Vascular Surgery,” Annals of Vascular Surgery Epub ahead of print (January 2020), https://doi.org/10.1016/j.avsg.2020.01.006↩︎
Alexander T. Janke, Shooshan Danagoulian, Arjun K. Venkatesh, and Phillip D. Levy, “Medicaid Expansion and Resource Utilization in the Emergency Department,” The American Journal of Emergency Medicine Epub ahead of print (January 2020), https://doi.org/10.1016/j.ajem.2019.12.050↩︎
Helmneh M. Sineshaw et al., “Association of Medicaid Expansion Under the Affordable Care Act With Stage at Diagnosis and Time to Treatment Initiation for Patients With Head and Neck Squamous Cell Carcinoma,” JAMA Otolaryngology–Head & Neck Surgery Epub ahead of print (January 2020), https://doi.org/10.1001/jamaoto.2019.4310↩︎
Anna L. Goldman and Benjamin D. Sommers, “Among Low-Income Adults Enrolled In Medicaid, Churning Decreased After The Affordable Care Act,” Health Affairs 39, no. 1 (January 2020): 85-93, https://doi.org/10.1377/hlthaff.2019.00378↩︎
Sarah H. Gordon, Benjamin D. Sommers, Ira B. Wilson, and Amal N. Trivedi, “Effects Of Medicaid Expansion On Postpartum Coverage And Outpatient Utilization,” Health Affairs 39, no. 1 (January 2020): 77-84, https://doi.org/10.1377/hlthaff.2019.00547↩︎
Emanuel Eguia et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Access to Minimally Invasive Surgical Care,” The American Journal of Surgery Epub ahead of print (July 2019), https://doi.org/10.1016/j.amjsurg.2019.07.003↩︎
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009↩︎
Nathalie Huguet et al., “Following Uninsured Patients Through Medicaid Expansion: Ambulatory Care Use and Diagnosed Conditions,” Annals of Family Medicine 17, no. 4 (July/August 2019): 336-344, https://doi.org/10.1370/afm.2385↩︎
Kelsie M. Gould et al., “Bariatric Surgery Among Vulnerable Populations: The Effect of the Affordable Care Act’s Medicaid Expansion,” Surgery 166, no. 5 (November 2019): 820-828, https://doi.org/10.1016/j.surg.2019.05.005↩︎
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553↩︎
Afshin Ehsan et al., “Utilization of Left Ventricular Assist Devices in Vulnerable Adults Across Medicaid Expansion,” Journal of Surgical Research 243 (November 2019): 503-508, https://doi.org/10.1016/j.jss.2019.05.015↩︎
Susannah Gibbs et al., “Evaluating the Effect of Medicaid Expansion on Access to Preventive Reproductive Care for Women in Oregon,” Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.ypmed.2019.105899↩︎
Hefei Wen, Tyrone Borders, and Benjamin Druss, ”Number of Medicaid Prescriptions Grew, Drug Spending was Steady in Medicaid Expansion States,” Health Affairs 35, no. 12 (September 2016): 1604-1607, http://content.healthaffairs.org/content/35/9/1604.full↩︎
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf↩︎
Nathalie Huguet et al., “Cervical And Colorectal Cancer Screening Prevalence Before And After Affordable Care Act Medicaid Expansion,” Preventative Medicine (May 2019), https://doi.org/10.1016/j.ypmed.2019.05.003↩︎
Paul Jacobs, Genevieve Kenney, and Thomas Selden, “Newly Eligible Enrollees In Medicaid Spend Less And Use Less Care Than Those Previously Eligible,” Health Affairs 36, no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0252↩︎
Ahmedin Jemal, Chun Chieh Lin, Amy Davidoff, and Xuesong Han, “Changes in Insurance Coverage and Stage at Diagnosis Among Nonelderly Patients with Cancer after the Affordable Care Act,” Journal of Clinical Oncology 35, no. 35 (December 2017), http://ascopubs.org/doi/pdf/10.1200/JCO.2017.73.7817↩︎
Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019↩︎
Emily Johnston, Andrea Strahan, Peter Joski, Anne Dunlop, and E. Kathleen Adams, “Impacts of the Affordable Care Act’s Medicaid Expansion on Women of Reproductive Age,” Women’s Health Issues, 28, no. 2 (February 2018), http://www.whijournal.com/article/S1049-3867(17)30242-6/pdf↩︎
Heather Holderness et al., “Where Do Oregon Medicaid Enrollees Seek Outpatient Care Post-Affordable Care Act Medicaid Expansion?,” Medical Care 57, no. 10 (October 2019): 788-794, https://doi.org/10.1097/mlr.0000000000001189↩︎
Johanna Maclean and Brendan Saloner, The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act (National Bureau of Economic Research Working Paper No. 23342, April 2017), http://www.nber.org/papers/w23342.pdf↩︎
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “Medication Treatment For Opioid Use Disorders In Substance Use Treatment Facilities,” Health Affairs 38, no. 1 (January 2019), https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05162↩︎
Yunwei Gai and John Marthinsen, “Medicaid Expansion, HIV Testing, and HIV-Related Risk Behaviors in the United States, 2010-2017,” American Journal of Public Health 109, no. 10 (October 2019): 1404-1412, https://doi.org/10.2105/ajph.2019.305220↩︎
Johanna Catherine Maclean, Michael F. Pesko, and Steven C. Hill, “Public Insurance Expansions and Smoking Cessation Medications,” Economic Inquiry 57, no. 4 (October 2019): 1798-1820, https://doi.org/10.1111/ecin.12794↩︎
Dennis McCarty, Yifan Gu, John W. McIlveen, and Bonnie K. Lind, “Medicaid Expansion and Treatment for Opioid Use Disorders in Oregon: An Interrupted Time-Series Analysis,” Addiction Science & Clinical Practice 14 (August 2019), https://doi.org/10.1186/s13722-019-0160-6↩︎
Huabin Luo, Zhuo Chen, Lei Xu, and Ronny Bell, “Health Care Access and Receipt of Clinical Diabetes Preventive Care for Working-Age Adults With Diabetes in States With and Without Medicaid Expansion: Results from the 2013 and 2015 BRFSS,” Journal of Public Health Management and Practice 25, no. 4 (July/August 2019): 34-43, https://doi.org/10.1097/phh.0000000000000832↩︎
Lindsay C. Kobayashi, Onur Altindag, Yulya Truskinovsky, and Lisa F. Berkman, “Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-Being in the US Adult Population, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1236-1242, https://doi.org/10.2105/ajph.2019.305164↩︎
A. Taylor Kelley, Renuka Tipirneni, and Helen Levy, “Changes in Veterans’ Coverage and Access to Care Following the Affordable Care Act, 2011-2017,” American Journal of Public Health 109, no. 9 (September 2019): 1233-1235, https://doi.org/10.2105/ajph.2019.305160↩︎
Shiho Kino and Ichiro Kawachi, “Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?,” Health Education & Behavior Epub ahead of print (October 2019), https://doi.org/10.1177/1090198119875998↩︎
Hiroshi Gotanda, Gerald Kominski, and Yusuke Tsugawa, “Association Between the ACA Medicaid Expansions and Primary Care and Emergency Department Use During the First 3 Years,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05458-w↩︎
Evan M. Chen et al., “Association of the Affordable Care Act Medicaid Expansion with Dilated Eye Examinations among the United States Population with Diabetes,” Ophthalmology Epub ahead of print (September 2019), https://doi.org/10.1016/j.ophtha.2019.09.010↩︎
Susan Dorr Goold et al., “Primary Care, Health Promotion, and Disease Prevention with Michigan Medicaid Expansion,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05370-3↩︎
Jesse M. Hinde et al., “Increasing Access to Opioid Use Disorder Treatment: Assessing State Policies and the Evidence Behind Them,” Journal of Studies on Alcohol and Drugs 80, no. 6 (November 2019): 693-697, https://doi.org/10.15288/jsad.2019.80.693↩︎
Ann-Marie Rosland et al., “Diagnosis and Care of Chronic Health Conditions Among Medicaid Expansion Enrollees: a Mixed-Methods Observational Study,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2549-2558, https://doi.org/10.1007/s11606-019-05323-w↩︎
Sri Lekha Tummalapalli, Samuel Leonard, Michelle M. Estrella, and Salomeh Keyhani, “The Effect of Medicaid Expansion on Self-Reported Kidney Disease,” Clinical Journal of American Society of Nephrology 14, no. 8 (August 2019): 1238-1240, https://doi.org/10.2215/cjn.02310219↩︎
Chelsea L. Shover et al., “The Relationship of Medicaid Expansion to Psychiatric Comorbidity Care within Substance Use Disorder Treatment Programs,” Journal of Substance Abuse Treatment 105 (October 2019): 44-50, https://doi.org/10.1016/j.jsat.2019.07.012↩︎
Ameen Barghi, Hugo Torres, Nancy Kressin, and Danny McCormick, “Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study,” Journal of General Internal Medicine epub ahead of print (June 2019), https://link.springer.com/article/10.1007%2Fs11606-019-05108-1↩︎
Carrie Fry and Benjamin Sommers, “Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression,” Psychiatric Services 69, no. 11 (November 2018), https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800181↩︎
Elham Mahmoudi, Alicia Cohen, Jason Buxbaum, Caroline Richardson, and Wassim Tarraf, “Gaining Medicaid Coverage During ACA Implementation: Effects on Access to Care and Preventive Services,” Journal of Health Care for the Poor and Underserved 29, no. 4 (November 2018): 1472-1487, https://muse.jhu.edu/article/708253↩︎
Ausmita Ghosh, Kosali Simon, and Benjamin Sommers, “The Effect of Health Insurance on Prescription Drug Use Among Low-Income Adults: Evidence from Recent Medicaid Expansions,” Journal of Health Economics 63 (January 2019): 64-80, https://www.sciencedirect.com/science/article/pii/S0167629617300206↩︎
Alana Sharp, Austin Jones, Jennifer Sherwood, Oksana Kutsa, Brian Honermann, and Gregorio Millett, “Impact of Medicaid Expansion on Access to Opioid Analgesic Medications and Medication-Assisted Treatment,” American Journal of Public Health 108, no. 5 (May 2018): 642-648, https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018.304338?journalCode=ajph↩︎
Angelica Meinhofer and Allison Witman, “The Role Of Health Insurance On Treatment For Opioid Use Disorders: Evidence From The Affordable Care Act Medicaid Expansion,” Journal of Health Economics 60 (June 2018): 177-197, https://www.sciencedirect.com/science/article/abs/pii/S0167629617311530↩︎
Chad Cotti, Erik Nesson, and Nathan Tefft, “Impacts Of The ACA Medicaid Expansion On Health Behaviors: Evidence From Household Panel Data,” Health Economics 28, no. 2 (February 2019): 219-244, https://onlinelibrary.wiley.com/doi/pdf/10.1002/hec.3838↩︎
Brendan Saloner, Jonathan Levin, Hsien-Yen Chang, Christopher Jones, and G. Caleb Alexander, “Changes in Buprenorphine-Naloxone and Opioid Pain Reliever Prescriptions After the Affordable Care Act Medicaid Expansion,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2696873↩︎
Cheryl Zogg et al., “Impact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision,” Journal of the American College of Surgeons 228, no. 1 (January 2019): 29-43, https://www.journalacs.org/article/S1072-7515(18)32078-7/fulltext↩︎
Xuesong Han, Robin Yabroff, Elizabeth Ward, Otis Brawley, and Ahmedin Jemal, “Comparison of Insurance Status and Diagnosis Stage Among Patients With Newly Diagnosed Cancer Before vs After Implementation of the Patient Protection and Affordable Care Act,” JAMA Oncology 4, no. 12 (August 2018): 1713-1720, https://jamanetwork.com/journals/jamaoncology/article-abstract/2697226↩︎
J.W. Awori Hayanga et al., “Lung Transplantation and Affordable Care Act Medicaid Expansion in the Era of Lung Allocation Score” Transplant International epub ahead of print (February 2019), https://onlinelibrary.wiley.com/doi/pdf/10.1111/tri.13420↩︎
Susan Dorr Goold et al., “Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study,” Journal of General Internal Medicine 33, no. 8 (June 2018): 1307-1316, https://link.springer.com/article/10.1007/s11606-018-4487-6↩︎
Matthew Present, Aviva Nathan, Sandra Ham, Robert Sargis, Michael Quinn, and Elbert Huang, “The Impact of the Affordable Care Act Medicaid Expansion on Type 2 Diabetes Diagnosis and Treatment: A National Survey of Physicians,” Journal of Community Health epub ahead of print (May 2019), https://link.springer.com/article/10.1007%2Fs10900-019-00637-6↩︎
Tong Gan et al., “Impact of the Affordable Care Act on Colorectal Cancer Screening, Incidence, and Survival in Kentucky,” Journal of the American College of Surgeons 228, no. 4 (April 2019): 342-353.e1, https://www.journalacs.org/article/S1072-7515(19)30046-8/fulltext↩︎
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “The Affordable Care Act and Opioid Agonist Therapy for Opioid Use Disorder,” Psychiatry Online (April 2019), https://doi.org/10.1176/appi.ps.201900025↩︎
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046↩︎
Jose Mesquita-Neto, Peter Cmorej, Hassan Mouzaihem, Donald Weaver, Steve Kim, and Francis Macedo, “Disparities In Access To Cancer Surgery After Medicaid Expansion,” The American Journal of Surgery epub ahead of print (June 2019), https://www.sciencedirect.com/science/article/abs/pii/S0002961019306889↩︎
Sunha Choi, Sungkyu Lee, and Jason Matejkowski, “The Effects of State Medicaid Expansion on Low-Income Individuals’ Access to Health Care: Multilevel Modeling,” Population Health Management epub ahead of print (September 2017), http://online.liebertpub.com/doi/abs/10.1089/pop.2017.0104↩︎
Aparna Soni, Kosali Simon, John Cawley, and Lindsay Sabik, “Effect of Medicaid Expansions of 2014 on Overall and Early-Stage Cancer Diagnoses,” American Journal of Public Health epub ahead of print (December 2017), http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2017.304166↩︎
Tyler Winkelman and Virginia Chang, “Medicaid Expansion, Mental Health, and Access to Care Among Childless Adults With and Without Chronic Conditions,” Journal of General Internal Medicine epub ahead of print (November 2017), https://www.ncbi.nlm.nih.gov/pubmed/29181792↩︎
Michael Dworsky, Carrie Farmer, and Mimi Shen, Veterans’ Health Insurance Coverage Under the Affordable Care Act and Implications of Repeal for the Department of Veterans Affairs, (RAND Corporation, 2017), https://www.rand.org/pubs/research_reports/RR1955.html↩︎
Jacqueline Fiore, The Impact of the Affordable Care Act’s Medicaid Expansion on Medicaid Spending by Health Care Service Category (Tulane University, July 2017), http://econ.tulane.edu/RePEc/pdf/tul1706.pdf↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Nirosha Mahendraratnam, Stacie Dusetzina, and Joel Farley, “Prescription Drug Utilization and Reimbursement Increased Following State Medicaid Expansion in 2014,” Journal of Managed Care & Specialty Pharmacy 23 no. 3 (March 2017): 355-363, http://www.jmcp.org/doi/10.18553/jmcp.2017.23.3.355↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
James Kirby and Jessica Vistnes, “Access to Care Improved for People Who Gained Medicaid or Marketplace Coverage in 2014,” Health Affairs 35 no. 10 (October 2016): 1830-1834, http://content.healthaffairs.org/content/35/10/1830.full↩︎
Khadijah Breathett et al., “The Affordable Care Act Medicaid Expansion Correlated with Increased Heart Transplant Listings in African Americans but Not Hispanics or Caucasians,” JACC: Heart Failure 5 no. 2 (January 2017): 136-147, https://www.ncbi.nlm.nih.gov/pubmed/28109783↩︎
United States Government Accountability Office (GAO), Medicaid Expansion: Behavioral Health Treatment Use in Selected States in 2014 (Washington, DC: GAO Report to Congressional Requesters, June 2017), https://www.gao.gov/assets/690/685415.pdf↩︎
Aabha Sharma, Scott Dresden, Emilie Powell, Raymond Kang, Joe Feinglass, “Emergency Department Visits and Hospitalizations for the Uninsured in Illinois Before and After Affordable Care Act Insurance Expansion,” Journal of Community Health 42 no. 3 (June 2017): 591-597, https://link.springer.com/article/10.1007/s10900-016-0293-4↩︎
Daniel Gingold, Rachelle Pierre-Mathieu, Brandon Cole, Andrew Miller, and Joneigh Khaldun, “Impact of the Affordable Care Act Medicaid Expansion on Emergency Department High Utilizers with Ambulatory Care Sensitive Conditions: A Cross-Sectional Study,” The American Journal of Emergency Medicine (January 2017), http://www.sciencedirect.com/science/article/pii/S0735675717300141↩︎
Gary Pickens et al., “Changes in Hospital Inpatient Utilization Following Health Care Reform,” Health Services Research epub ahead of print (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28664983↩︎
Jeremy Holzmacher et al., “Association of Expanded Medicaid Coverage with Hospital Length of Stay After Injury,” JAMA Surgery published online (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28658482↩︎
Mary Anderson, Jeffrey Glasheen, and Debra Anoff, “Impact of State Medicaid Expansion Status on Length of Stay and In-Hospital Mortality for General Medicine Patients at US Academic Medical Centers,” Journal of Hospital Medicine Epub ahead of print (August 2016), http://onlinelibrary.wiley.com/wol1/doi/10.1002/jhm.2649/citedby↩︎
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420↩︎
Megan Hoopes, Heather Angier, Rachel Gold, Steffani Bailey, Nathalie Huguet, Miguel Marino, and Jennifer DeVoe, “Utilization of Community Health Centers in Medicaid Expansion and Nonexpansion States, 2013-2014,” Journal of Ambulatory Care Management 39 no. 4 (October 2016): 290-298, https://www.ncbi.nlm.nih.gov/pubmed/26765808↩︎
Astha Singhal, Peter Damiano, and Lindsay Sabik, “Medicaid Adult Dental Benefits Increase Use Of Dental Care, But Impact Of Expansion On Dental Services Use Was Mixed,” Health Affairs 36 no. 4 (April 2017): 723-732, http://content.healthaffairs.org/content/36/4/723.short↩︎
Angela Fertig, Caroline Carlin, Scote Ode, and Sharon Long, “Evidence of Pent-Up Demand for Care After Medicaid Expansion,” Medical Care Research and Review epub ahead of print (March 2017), http://journals.sagepub.com/eprint/wDsfA74fuA3BIw5ZWyYT/full↩︎
Anne DiGiulio et al., “State Medicaid Expansion Tobacco Cessation Coverage and Number of Adult Smokers Enrolled in Expansion Coverage – United States, 2016,” Morbidity and Mortality Weekly Report 65, no. 48 (December 2016), https://www.cdc.gov/mmwr/volumes/65/wr/mm6548a2.htm↩︎
Jeffrey Horn et al., “New Medicaid Enrollees See Health and Social Benefits in Pennsylvania’s Expansion,” INQUIRY: the Journal of Health Care Organization, Provision, and Financing 53 (October 2016): 1-8, http://journals.sagepub.com/doi/full/10.1177/0046958016671807#↩︎
Benjamin Sommers, Munira Gunja, Kenneth Finegold, and Thomas Musco, “Changes in Self-Reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act,” The Journal of the American Medical Association 314 no. 4 (July 2015): 366-374, http://jama.jamanetwork.com/article.aspx?articleid=2411283&resultClick=3↩︎
Government Accountability Office, Behavioral Health: Options for Low-Income Adults to Receive Treatment in Selected States (Washington, DC: Government Accountability Office, June 2015), http://www.gao.gov/assets/680/670894.pdf↩︎
Laura Wherry and Sarah Miller, “Early Coverage, Access, Utilization, and Health Effects Associated with the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study,” Annals of Internal Medicine, Epub ahead of print (April 2016), http://annals.org/article.aspx?articleid=2513980↩︎
John Cawley, Aparna Soni, and Kosali Simon, “Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1495-1497, https://link.springer.com/article/10.1007%2Fs11606-018-4537-0↩︎
Kosali Simon, Aparna Soni, and John Cawley, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions” Journal of Policy Analysis and Management 36, no. 2 (March 2017), https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21972↩︎
De-Chih Lee, Leiyu Shi, and Hailun Liang, “Primary Care Utilization And Clinical Quality Performance: A Comparison Between Health Centres In Medicaid Expansion States And Non-Expansion States,” Journal of Health Services Research & Policy 24, no. 1 (January 2019): 19-24, https://journals.sagepub.com/doi/abs/10.1177/1355819618788592↩︎
Aparna Soni, Kosali Simon, John Cawley, and Lindsay Sabik, “Effect of Medicaid Expansions of 2014 on Overall and Early-Stage Cancer Diagnoses,” American Journal of Public Health epub ahead of print (December 2017), http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2017.304166↩︎
Helmneh M. Sineshaw et al., “Association of Medicaid Expansion Under the Affordable Care Act With Stage at Diagnosis and Time to Treatment Initiation for Patients With Head and Neck Squamous Cell Carcinoma,” JAMA Otolaryngology–Head & Neck Surgery Epub ahead of print (January 2020), https://doi.org/10.1001/jamaoto.2019.4310↩︎
Xuesong Han, Robin Yabroff, Elizabeth Ward, Otis Brawley, and Ahmedin Jemal, “Comparison of Insurance Status and Diagnosis Stage Among Patients With Newly Diagnosed Cancer Before vs After Implementation of the Patient Protection and Affordable Care Act,” JAMA Oncology 4, no. 12 (August 2018): 1713-1720, https://jamanetwork.com/journals/jamaoncology/article-abstract/2697226↩︎
Jose Mesquita-Neto, Peter Cmorej, Hassan Mouzaihem, Donald Weaver, Steve Kim, and Francis Macedo, “Disparities In Access To Cancer Surgery After Medicaid Expansion,” The American Journal of Surgery epub ahead of print (June 2019), https://www.sciencedirect.com/science/article/abs/pii/S0002961019306889↩︎
Tong Gan et al., “Impact of the Affordable Care Act on Colorectal Cancer Screening, Incidence, and Survival in Kentucky,” Journal of the American College of Surgeons 228, no. 4 (April 2019): 342-353.e1, https://www.journalacs.org/article/S1072-7515(19)30046-8/fulltext↩︎
Ahmedin Jemal, Chun Chieh Lin, Amy Davidoff, and Xuesong Han, “Changes in Insurance Coverage and Stage at Diagnosis Among Nonelderly Patients with Cancer after the Affordable Care Act,” Journal of Clinical Oncology 35, no. 35 (December 2017), http://ascopubs.org/doi/pdf/10.1200/JCO.2017.73.7817↩︎
Khadijah Breathett et al., “The Affordable Care Act Medicaid Expansion Correlated with Increased Heart Transplant Listings in African Americans but Not Hispanics or Caucasians,” JACC: Heart Failure 5 no. 2 (January 2017): 136-147, https://www.ncbi.nlm.nih.gov/pubmed/28109783↩︎
J.W. Awori Hayanga et al., “Lung Transplantation and Affordable Care Act Medicaid Expansion in the Era of Lung Allocation Score” Transplant International epub ahead of print (February 2019), https://onlinelibrary.wiley.com/doi/pdf/10.1111/tri.13420↩︎
Johanna Catherine Maclean, Michael F. Pesko, and Steven C. Hill, “Public Insurance Expansions and Smoking Cessation Medications,” Economic Inquiry 57, no. 4 (October 2019): 1798-1820, https://doi.org/10.1111/ecin.12794↩︎
Deborah Yip et al., “Association of Medicaid Expansion and Health Insurance with Receipt of Smoking Cessation Services and Smoking Behaviors in Substance Use Disorder Treatment,” The Journal of Behavioral Health Services & Research (July 2019), https://doi.org/10.1007/s11414-019-09669-1↩︎
Chad Cotti, Erik Nesson, and Nathan Tefft, “Impacts Of The ACA Medicaid Expansion On Health Behaviors: Evidence From Household Panel Data,” Health Economics 28, no. 2 (February 2019): 219-244, https://onlinelibrary.wiley.com/doi/pdf/10.1002/hec.3838↩︎
Anne DiGiulio et al., “State Medicaid Expansion Tobacco Cessation Coverage and Number of Adult Smokers Enrolled in Expansion Coverage – United States, 2016,” Morbidity and Mortality Weekly Report 65, no. 48 (December 2016), https://www.cdc.gov/mmwr/volumes/65/wr/mm6548a2.htm↩︎
Kosali Simon, Aparna Soni, and John Cawley, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions” Journal of Policy Analysis and Management 36, no. 2 (March 2017), https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21972↩︎
Dennis McCarty, Yifan Gu, John W. McIlveen, and Bonnie K. Lind, “Medicaid Expansion and Treatment for Opioid Use Disorders in Oregon: An Interrupted Time-Series Analysis,” Addiction Science & Clinical Practice 14 (August 2019), https://doi.org/10.1186/s13722-019-0160-6↩︎
Jesse M. Hinde et al., “Increasing Access to Opioid Use Disorder Treatment: Assessing State Policies and the Evidence Behind Them,” Journal of Studies on Alcohol and Drugs 80, no. 6 (November 2019): 693-697, https://doi.org/10.15288/jsad.2019.80.693↩︎
Chelsea L. Shover et al., “The Relationship of Medicaid Expansion to Psychiatric Comorbidity Care within Substance Use Disorder Treatment Programs,” Journal of Substance Abuse Treatment 105 (October 2019): 44-50, https://doi.org/10.1016/j.jsat.2019.07.012↩︎
Alana Sharp, Austin Jones, Jennifer Sherwood, Oksana Kutsa, Brian Honermann, and Gregorio Millett, “Impact of Medicaid Expansion on Access to Opioid Analgesic Medications and Medication-Assisted Treatment,” American Journal of Public Health 108, no. 5 (May 2018): 642-648, https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018.304338?journalCode=ajph↩︎
Angelica Meinhofer and Allison Witman, “The Role Of Health Insurance On Treatment For Opioid Use Disorders: Evidence From The Affordable Care Act Medicaid Expansion,” Journal of Health Economics 60 (June 2018): 177-197, https://www.sciencedirect.com/science/article/abs/pii/S0167629617311530↩︎
Brendan Saloner, Jonathan Levin, Hsien-Yen Chang, Christopher Jones, and G. Caleb Alexander, “Changes in Buprenorphine-Naloxone and Opioid Pain Reliever Prescriptions After the Affordable Care Act Medicaid Expansion,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2696873↩︎
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “The Affordable Care Act and Opioid Agonist Therapy for Opioid Use Disorder,” Psychiatry Online (April 2019), https://doi.org/10.1176/appi.ps.201900025↩︎
Carrie Fry and Benjamin Sommers, “Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression,” Psychiatric Services 69, no. 11 (November 2018), https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800181↩︎
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “Medication Treatment For Opioid Use Disorders In Substance Use Treatment Facilities,” Health Affairs 38, no. 1 (January 2019), https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05162↩︎
United States Government Accountability Office (GAO), Medicaid Expansion: Behavioral Health Treatment Use in Selected States in 2014 (Washington, DC: GAO Report to Congressional Requesters, June 2017), https://www.gao.gov/assets/690/685415.pdf↩︎
Brendan Saloner, Sachini Bandara, Emma McGinty, and Colleen Barry, “Justice-Involved Adults With Substance Use Disorders: Coverage Increased but Rates of Treatment Did Not in 2014,” Health Affairs 35 no. 6 (June 2016), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0005↩︎
Government Accountability Office, Behavioral Health: Options for Low-Income Adults to Receive Treatment in Selected States (Washington, DC: Government Accountability Office, June 2015), http://www.gao.gov/assets/680/670894.pdf↩︎
Johanna Maclean and Brendan Saloner, “The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act,” Journal of Policy Analysis and Management 38, no. 2 (2019): 366-393, https://www.ncbi.nlm.nih.gov/pubmed/30882195↩︎
Alana Sharp, Austin Jones, Jennifer Sherwood, Oksana Kutsa, Brian Honermann, and Gregorio Millett, “Impact of Medicaid Expansion on Access to Opioid Analgesic Medications and Medication-Assisted Treatment,” American Journal of Public Health 108, no. 5 (May 2018): 642-648, https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018.304338?journalCode=ajph↩︎
Brendan Saloner, Jonathan Levin, Hsien-Yen Chang, Christopher Jones, and G. Caleb Alexander, “Changes in Buprenorphine-Naloxone and Opioid Pain Reliever Prescriptions After the Affordable Care Act Medicaid Expansion,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2696873↩︎
Angelica Meinhofer and Allison Witman, “The Role Of Health Insurance On Treatment For Opioid Use Disorders: Evidence From The Affordable Care Act Medicaid Expansion,” Journal of Health Economics 60 (June 2018): 177-197, https://www.sciencedirect.com/science/article/abs/pii/S0167629617311530↩︎
Johanna Maclean and Brendan Saloner, “The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act,” Journal of Policy Analysis and Management 38, no. 2 (2019): 366-393, https://www.ncbi.nlm.nih.gov/pubmed/30882195↩︎
A. Taylor Kelley, Renuka Tipirneni, and Helen Levy, “Changes in Veterans’ Coverage and Access to Care Following the Affordable Care Act, 2011-2017,” American Journal of Public Health 109, no. 9 (September 2019): 1233-1235, https://doi.org/10.2105/ajph.2019.305160↩︎
Kelsie M. Gould et al., “Bariatric Surgery Among Vulnerable Populations: The Effect of the Affordable Care Act’s Medicaid Expansion,” Surgery 166, no. 5 (November 2019): 820-828, https://doi.org/10.1016/j.surg.2019.05.005↩︎
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562↩︎
Cheryl Zogg et al., “Impact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision,” Journal of the American College of Surgeons 228, no. 1 (January 2019): 29-43, https://www.journalacs.org/article/S1072-7515(18)32078-7/fulltext↩︎
Hiroshi Gotanda, Gerald Kominski, and Yusuke Tsugawa, “Association Between the ACA Medicaid Expansions and Primary Care and Emergency Department Use During the First 3 Years,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05458-w↩︎
Alexander T. Janke, Shooshan Danagoulian, Arjun K. Venkatesh, and Phillip D. Levy, “Medicaid Expansion and Resource Utilization in the Emergency Department,” The American Journal of Emergency Medicine Epub ahead of print (January 2020), https://doi.org/10.1016/j.ajem.2019.12.050↩︎
Hawazin W. Elani, Ichiro Kawachi, and Benjamin D. Sommers, “Changes in Emergency Department Dental Visits after Medicaid Expansion,” Health Services Research Epub ahead of print (January 2020), https://doi.org/10.1111/1475-6773.13261↩︎
Craig Garthwaite et al., All Medicaid Expansions Are Not Created Equal: The Geography and Targeting of the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26289, September 2019), http://www.nber.org/papers/w26289↩︎
Heather Holderness et al., “Where Do Oregon Medicaid Enrollees Seek Outpatient Care Post-Affordable Care Act Medicaid Expansion?,” Medical Care 57, no. 10 (October 2019): 788-794, https://doi.org/10.1097/mlr.0000000000001189↩︎
Aabha Sharma, Scott Dresden, Emilie Powell, Raymond Kang, Joe Feinglass, “Emergency Department Visits and Hospitalizations for the Uninsured in Illinois Before and After Affordable Care Act Insurance Expansion,” Journal of Community Health 42 no. 3 (June 2017): 591-597, https://link.springer.com/article/10.1007/s10900-016-0293-4↩︎
Rahul Ladhania, Amelia Haviland, Arvind Venkat, Rahul Telang, and Jesse Pines, “The Effect of Medicaid Expansion on the Nature of New Enrollees’ Emergency Department Use,” Medical Care Research and Review epub ahead of print (May 2019), https://journals.sagepub.com/doi/abs/10.1177/1077558719848270↩︎
Gary Pickens et al., “Changes In Hospital Service Demand, Cost, And Patient Illness Severity Following Health Reform,” Health Services Research (May 2019), https://doi.org/10.1111/1475-6773.13165↩︎
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf↩︎
Jesse M. Pines, Mark Zocchi, Ali Moghtaderi, Bernard Black, Steven A. Farmer, Greg Hufstetler, Kevin Klauer and Randy Pilgrim, “Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix,” Health Affairs 35, no. 8 (August 2016), http://content.healthaffairs.org/content/35/8/1480.full↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Stacey McMorrow, Jason Gates, Sharon Long, and Genevieve Kenney, “Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents,” Health Affairs 36 no. 5 (May 2017): 808-818, https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1650↩︎
Shannon McConville, Maria Raven, Sarah Sabbagh, and Renee Hsia, “Frequent Emergency Department Users: A Statewide Comparison Before And After Affordable Care Act Implementation,” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0784↩︎
Daniel Gingold, Rachelle Pierre-Mathieu, Brandon Cole, Andrew Miller, and Joneigh Khaldun, “Impact of the Affordable Care Act Medicaid Expansion on Emergency Department High Utilizers with Ambulatory Care Sensitive Conditions: A Cross-Sectional Study,” The American Journal of Emergency Medicine (January 2017), http://www.sciencedirect.com/science/article/pii/S0735675717300141↩︎
Benjamin Sommers, Robert Blendon, E. John Orav, Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420↩︎
Paul Jacobs, Genevieve Kenney, and Thomas Selden, “Newly Eligible Enrollees In Medicaid Spend Less And Use Less Care Than Those Previously Eligible,” Health Affairs 36, no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0252↩︎
Elizabeth A. Brown et al., “The Impact of the ACA Medicaid Expansion on Access to Care and Hospitalization Charges for Lupus Patients,” Arthritis Care & Research Epub ahead of print (September 2019), https://doi.org/10.1002/acr.24080↩︎
Charles A. Daly et al., “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma,” The Journal of Hand Surgery 44, no. 9 (September 2019): 720-727, https://doi.org/10.1016/j.jhsa.2019.05.020↩︎
Craig Garthwaite et al., All Medicaid Expansions Are Not Created Equal: The Geography and Targeting of the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26289, September 2019), http://www.nber.org/papers/w26289↩︎
Benjamin Sommers, Carrie Fry, Robert Blendon, and Arnold Epstein, “New Approaches in Medicaid: Work Requirements, Health Savings Accounts, and Health Care Access,” Health Affairs 37, no. 7 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0331↩︎
Natoshia Askelson, Brad Wright, Suzanne Bentler, Elizabeth Momany, and Peter Damiano, “Iowa’s Medicaid Expansion Promoted Healthy Behaviors But Was Challenging to Implement and Attracted Few Participants,” Health Affairs 36 no. 5, (May 2017): 799-807, http://content.healthaffairs.org/content/36/5/799.full↩︎
Shiho Kino and Ichiro Kawachi, “Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?,” Health Education & Behavior Epub ahead of print (October 2019), https://doi.org/10.1177/1090198119875998↩︎
Helmneh M. Sineshaw et al., “Association of Medicaid Expansion Under the Affordable Care Act With Stage at Diagnosis and Time to Treatment Initiation for Patients With Head and Neck Squamous Cell Carcinoma,” JAMA Otolaryngology–Head & Neck Surgery Epub ahead of print (January 2020), https://doi.org/10.1001/jamaoto.2019.4310↩︎
Emanuel Eguia et al., “The Impact of the Affordable Care Act Medicaid Expansion on Vascular Surgery,” Annals of Vascular Surgery Epub ahead of print (January 2020), https://doi.org/10.1016/j.avsg.2020.01.006↩︎
Dennis McCarty, Yifan Gu, John W. McIlveen, and Bonnie K. Lind, “Medicaid Expansion and Treatment for Opioid Use Disorders in Oregon: An Interrupted Time-Series Analysis,” Addiction Science & Clinical Practice 14 (August 2019), https://doi.org/10.1186/s13722-019-0160-6↩︎
Anna L. Goldman and Benjamin D. Sommers, “Among Low-Income Adults Enrolled In Medicaid, Churning Decreased After The Affordable Care Act,” Health Affairs 39, no. 1 (January 2020): 85-93, https://doi.org/10.1377/hlthaff.2019.00378↩︎
Emanuel Eguia et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Access to Minimally Invasive Surgical Care,” The American Journal of Surgery Epub ahead of print (July 2019), https://doi.org/10.1016/j.amjsurg.2019.07.003↩︎
Afshin Ehsan et al., “Utilization of Left Ventricular Assist Devices in Vulnerable Adults Across Medicaid Expansion,” Journal of Surgical Research 243 (November 2019): 503-508, https://doi.org/10.1016/j.jss.2019.05.015↩︎
Kevin N. Griffith, “Changes in Insurance Coverage and Access to Care for Young Adults in 2017,” Journal of Adolescent Health Epub ahead of print (July 2019), https://doi.org/10.1016/j.jadohealth.2019.05.020↩︎
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009↩︎
Kelsie M. Gould et al., “Bariatric Surgery Among Vulnerable Populations: The Effect of the Affordable Care Act’s Medicaid Expansion,” Surgery 166, no. 5 (November 2019): 820-828, https://doi.org/10.1016/j.surg.2019.05.005↩︎
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553↩︎
Jacqueline Fiore, The Impact of the Affordable Care Act’s Medicaid Expansion on Medicaid Spending by Health Care Service Category (Tulane University, July 2017), http://econ.tulane.edu/RePEc/pdf/tul1706.pdf↩︎
Emily Johnston, Andrea Strahan, Peter Joski, Anne Dunlop, and E. Kathleen Adams, “Impacts of the Affordable Care Act’s Medicaid Expansion on Women of Reproductive Age,” Women’s Health Issues, 28, no. 2 (February 2018), http://www.whijournal.com/article/S1049-3867(17)30242-6/pdf↩︎
Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019↩︎
Elham Mahmoudi, Alicia Cohen, Jason Buxbaum, Caroline Richardson, and Wassim Tarraf, “Gaining Medicaid Coverage During ACA Implementation: Effects on Access to Care and Preventive Services,” Journal of Health Care for the Poor and Underserved 29, no. 4 (November 2018): 1472-1487, https://muse.jhu.edu/article/708253↩︎
Stacey McMorrow, Jason Gates, Sharon Long, and Genevieve Kenney, “Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents,” Health Affairs 36 no. 5 (May 2017): 808-818, https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1650↩︎
Haley Moss, Laura Havrilesky, and Junzo Chino, “Insurance Coverage Among Women Diagnosed with a Gynecologic Malignancy Before and After Implementation of the Affordable Care Act,” Gynecologic Oncology 146, no. 3 (September 2017), https://www.ncbi.nlm.nih.gov/pubmed/28641821↩︎
Susannah Gibbs et al., “Evaluating the Effect of Medicaid Expansion on Access to Preventive Reproductive Care for Women in Oregon,” Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.ypmed.2019.105899↩︎
Nadia Laniado, Avery R. Brow, Eric Tranby, and Victor M. Badner, “Trends in Non-Traumatic Dental Emergency Department Use in New York and New Jersey: A Look at Medicaid Expansion from Both Sides of the Hudson River,” Journal of Public Health Dentistry Epub ahead of print (October 2019), https://doi.org/10.1111/jphd.12343↩︎
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830↩︎
Mark Clapp et al., “Association of Medicaid Expansion With Coverage and Access to Care for Pregnant Women,” Obstetrics & Gynecology 134, no. 5 (November 2019): 1066-1074, https://doi.org/10.1097/aog.0000000000003501↩︎
Charles A. Daly et al., “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma,” The Journal of Hand Surgery 44, no. 9 (September 2019): 720-727, https://doi.org/10.1016/j.jhsa.2019.05.020↩︎
Yunwei Gai and John Marthinsen, “Medicaid Expansion, HIV Testing, and HIV-Related Risk Behaviors in the United States, 2010-2017,” American Journal of Public Health 109, no. 10 (October 2019): 1404-1412, https://doi.org/10.2105/ajph.2019.305220↩︎
Huabin Luo, Zhuo Chen, Lei Xu, and Ronny Bell, “Health Care Access and Receipt of Clinical Diabetes Preventive Care for Working-Age Adults With Diabetes in States With and Without Medicaid Expansion: Results from the 2013 and 2015 BRFSS,” Journal of Public Health Management and Practice 25, no. 4 (July/August 2019): 34-43, https://doi.org/10.1097/phh.0000000000000832↩︎
A. Taylor Kelley, Renuka Tipirneni, and Helen Levy, “Changes in Veterans’ Coverage and Access to Care Following the Affordable Care Act, 2011-2017,” American Journal of Public Health 109, no. 9 (September 2019): 1233-1235, https://doi.org/10.2105/ajph.2019.305160↩︎
J. Travis Donahoe et al., “The Affordable Care Act Medicaid Expansion and Smoking Cessation Among Low-Income Smokers,” American Journal of Preventive Medicine 57, no. 6 (December 2019): 203-210, https://doi.org/10.1016/j.amepre.2019.07.004↩︎
Hiroshi Gotanda, Gerald Kominski, and Yusuke Tsugawa, “Association Between the ACA Medicaid Expansions and Primary Care and Emergency Department Use During the First 3 Years,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05458-w↩︎
Evan M. Chen et al., “Association of the Affordable Care Act Medicaid Expansion with Dilated Eye Examinations among the United States Population with Diabetes,” Ophthalmology Epub ahead of print (September 2019), https://doi.org/10.1016/j.ophtha.2019.09.010↩︎
Ann-Marie Rosland et al., “Diagnosis and Care of Chronic Health Conditions Among Medicaid Expansion Enrollees: a Mixed-Methods Observational Study,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2549-2558, https://doi.org/10.1007/s11606-019-05323-w↩︎
Chelsea L. Shover et al., “The Relationship of Medicaid Expansion to Psychiatric Comorbidity Care within Substance Use Disorder Treatment Programs,” Journal of Substance Abuse Treatment 105 (October 2019): 44-50, https://doi.org/10.1016/j.jsat.2019.07.012↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
Laura Wherry and Sarah Miller, “Early Coverage, Access, Utilization, and Health Effects Associated with the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study,” Annals of Internal Medicine, Epub ahead of print (April 2016), http://annals.org/article.aspx?articleid=2513980↩︎
Benjamin Sommers, Robert Blendon, and E. John Orav, “Both the ‘Private Option’ And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults,” Health Affairs 35, no. 1 (January 2016): 96-105, http://content.healthaffairs.org/content/35/1/96.abstract↩︎
Mark Olfson, Melanie Wall, Colleen Barry, Christine Mauro, and Ramin Mojtabai, “Impact Of Medicaid Expansion On Coverage And Treatment Of Low-Income Adults With Substance Use Disorders,” Health Affairs 37, no. 8 (August 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.0124↩︎
Abeer Alharbi, M. Mahmud Khan, Ronnie Horner, Heather Brandt, and Cole Chapman, “Impact Of Medicaid Coverage Expansion Under The Affordable Care Act On Mammography And Pap Tests Utilization Among Low-Income Women,” PLOS One (April 2019), https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214886↩︎
Jevay Grooms and Alberto Ortega, “Examining Medicaid Expansion and the Treatment of Substance Use Disorders,” American Economic Association Papers and Proceedings 109 (May 2019): 187-192, https://www.aeaweb.org/articles?id=10.1257/pandp.20191090↩︎
Nathalie Huguet et al., “Cervical And Colorectal Cancer Screening Prevalence Before And After Affordable Care Act Medicaid Expansion,” Preventative Medicine (May 2019), https://doi.org/10.1016/j.ypmed.2019.05.003↩︎
John Cawley, Aparna Soni, and Kosali Simon, “Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1495-1497, https://link.springer.com/article/10.1007%2Fs11606-018-4537-0↩︎
Kosali Simon, Aparna Soni, and John Cawley, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions” Journal of Policy Analysis and Management 36, no. 2 (March 2017), https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21972↩︎
Carrie Fry and Benjamin Sommers, “Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression,” Psychiatric Services 69, no. 11 (November 2018), https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800181↩︎
Xuesong Han, Robin Yabroff, Elizabeth Ward, Otis Brawley, and Ahmedin Jemal, “Comparison of Insurance Status and Diagnosis Stage Among Patients With Newly Diagnosed Cancer Before vs After Implementation of the Patient Protection and Affordable Care Act,” JAMA Oncology 4, no. 12 (August 2018): 1713-1720, https://jamanetwork.com/journals/jamaoncology/article-abstract/2697226↩︎
Brandy Lipton, Sandra Decker, and Benjamin Sommers, “The Affordable Care Act Appears to Have Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Care Among Young Adults” Medical Care Research and Review 76, no.1 (April 2017): 32–55, https://www.ncbi.nlm.nih.gov/pubmed/29148341↩︎
Stacey Fedewa, K. Robin Yabroff, Robert Smith, Ann Goding Sauer, Xuesong Han, and Ahmedin Jemal, “Changes in Breast and Colorectal Cancer Screening After Medicaid Expansion Under the Affordable Care Act,” American Journal of Preventive Medicine epub ahead of print (May 2019), https://www.sciencedirect.com/science/article/pii/S0749379719301163↩︎
Tong Gan et al., “Impact of the Affordable Care Act on Colorectal Cancer Screening, Incidence, and Survival in Kentucky,” Journal of the American College of Surgeons 228, no. 4 (April 2019): 342-353.e1, https://www.journalacs.org/article/S1072-7515(19)30046-8/fulltext↩︎
Dmitry Tumin et al., “Medicaid Participation among Liver Transplant Candidates after the Affordable Care Act Medicaid Expansion” Journal of the American College of Surgeons 225, no. 2 (August 2017): 173-180.e2, https://www.journalacs.org/article/S1072-7515(17)30454-4/fulltext↩︎
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562↩︎
James McDermott et al., “Affordable Care Act’s Medicaid Expansion and Use of Regionalized Surgery at High-Volume Hospitals,” Journal of the American College of Surgeons 227, no. 5 (November 2018): 507-520.e9, https://www.journalacs.org/article/S1072-7515(18)31993-8/abstract↩︎
Emanuel Eguia et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Access to Minimally Invasive Surgical Care,” The American Journal of Surgery Epub ahead of print (July 2019), https://doi.org/10.1016/j.amjsurg.2019.07.003↩︎
Taressa K. Fraze et al., “Prevalence of Screening for Food Insecurity, Housing Instability, Utility Needs, Transportation Needs, and Interpersonal Violence by US Physician Practices and Hospitals,” JAMA Network Open 2, no. 9 (September 2019), https://doi.org/10.1001/jamanetworkopen.2019.11514↩︎
Kelsey L. Corrigan et al., “The Impact of the Patient Protection and Affordable Care Act on Insurance Coverage and Cancer-Directed Treatment in HIV-Infected Patients With Cancer in the United States,” Cancer (November 2019), https://doi.org/10.1002/cncr.32563↩︎
Megan Cole, Brad Wright, Ira Wilson, Omar Gallarraga, and Amal Trivedi, “Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.1542↩︎
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Hefei Wen, Kenton J. Johnston, Lindsay Allen, and Teresa M. Waters, “Medicaid Expansion Associated With Reductions In Preventable Hospitalizations,” Health Affairs 38, no. 11 (November 2019): 1845-1849, https://doi.org/10.1377/hlthaff.2019.00483↩︎
Mohammad Eslami et al., “Impact of Medicaid Expansion of the Affordable Care on the Outcomes of Lower Extremity Bypass for Patients With Peripheral Artery Disease in the Vascular Quality Initiative Database,” Annals of Surgery 270, no. 4 (October 2019): 647-655, https://doi.org/10.1097/sla.0000000000003521↩︎
John Scott et al., “Lifting the Burden: State Medicaid Expansion Reduces Financial Risk for the Injured,” Journal of Trauma and Acute Care Surgery Epub ahead of print (September 2019), https://doi.org/10.1097/ta.0000000000002493↩︎
Gary Pickens et al., “Changes in Hospital Inpatient Utilization Following Health Care Reform,” Health Services Research epub ahead of print (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28664983↩︎
Jeremy Holzmacher et al., “Association of Expanded Medicaid Coverage with Hospital Length of Stay After Injury,” JAMA Surgery published online (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28658482↩︎
Andrew Admon, Michael Sjoding, Sarah Lyon, John Ayanian, Theodore Iwashyna, and Colin Cooke, “Medicaid Expansion and Mechanical Ventilation in Asthma, Chronic Obstructive Pulmonary Disease, and Heart Failure,” Annals of the American Thoracic Society epub ahead of print (February 2019), https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201811-777OC↩︎
Neal Bhutiani, Brian Harbrecht, Charles Scoggins, and Matthew Bozeman, “Evaluating The Early Impact Of Medicaid Expansion On Trends In Diagnosis And Treatment Of Benign Gallbladder Disease In Kentucky,” The American Journal of Surgery (January 2019), https://www.americanjournalofsurgery.com/article/S0002-9610(18)30894-8/fulltext↩︎
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562↩︎
Ramiro Manzano-Nunez et al., “Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery,” World Journal of Surgery 43, no. 6 (June 2019): 1483-1489, https://link.springer.com/article/10.1007/s00268-019-04932-0↩︎
De-Chih Lee, Leiyu Shi, and Hailun Liang, “Primary Care Utilization And Clinical Quality Performance: A Comparison Between Health Centres In Medicaid Expansion States And Non-Expansion States,” Journal of Health Services Research & Policy 24, no. 1 (January 2019): 19-24, https://journals.sagepub.com/doi/abs/10.1177/1355819618788592↩︎
Jusung Lee et al., “The Impact of Medicaid Expansion on Diabetes Management,” Diabetes Care Epub ahead of print (October 2019), https://doi.org/10.2337/dc19-1173↩︎
John A. Graves et al., “Medicaid Expansion Slowed Rates of Health Decline for Low-Income Adults in Southern States,” Health Affairs 39, no. 1 (January 2020): 67-76, https://doi.org/10.1377/hlthaff.2019.00929↩︎
Renuka Tipirneni et al., “Association of Expanded Medicaid Coverage With Health and Job-Related Outcomes Among Enrollees With Behavioral Health Disorders,” Psychiatric Services Epub ahead of print (September 2019), https://doi.org/10.1176/appi.ps.201900179↩︎
Susan Dorr Goold et al., “Primary Care, Health Promotion, and Disease Prevention with Michigan Medicaid Expansion,” Journal of General Internal Medicine Epub ahead of print (December 2019), https://doi.org/10.1007/s11606-019-05370-3↩︎
Ann-Marie Rosland et al., “Diagnosis and Care of Chronic Health Conditions Among Medicaid Expansion Enrollees: a Mixed-Methods Observational Study,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2549-2558, https://doi.org/10.1007/s11606-019-05323-w↩︎
Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019↩︎
Renuka Tipirneni et al., “Changes in Health and Ability to Work Among Medicaid Expansion Enrollees: a Mixed Methods Study,” Journal of General Internal Medicine 34, no. 2 (February 2019): 272-280, https://link.springer.com/article/10.1007/s11606-018-4736-8↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420↩︎
Stacey McMorrow, Jason Gates, Sharon Long, and Genevieve Kenney, “Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents,” Health Affairs 36 no. 5 (May 2017): 808-818, https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1650↩︎
John Cawley, Aparna Soni, and Kosali Simon, “Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1495-1497, https://link.springer.com/article/10.1007%2Fs11606-018-4537-0↩︎
Kosali Simon, Aparna Soni, and John Cawley, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions” Journal of Policy Analysis and Management 36, no. 2 (March 2017), https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21972↩︎
Tyler Winkelman and Virginia Chang, “Medicaid Expansion, Mental Health, and Access to Care Among Childless Adults With and Without Chronic Conditions,” Journal of General Internal Medicine epub ahead of print (November 2017), https://www.ncbi.nlm.nih.gov/pubmed/29181792↩︎
Susan Dorr Goold et al., “Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study,” Journal of General Internal Medicine 33, no. 8 (June 2018): 1307-1316, https://link.springer.com/article/10.1007/s11606-018-4487-6↩︎
Tong Gan et al., “Impact of the Affordable Care Act on Colorectal Cancer Screening, Incidence, and Survival in Kentucky,” Journal of the American College of Surgeons 228, no. 4 (April 2019): 342-353.e1, https://www.journalacs.org/article/S1072-7515(19)30046-8/fulltext↩︎
Cheryl Zogg et al., “Impact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision,” Journal of the American College of Surgeons 228, no. 1 (January 2019): 29-43, https://www.journalacs.org/article/S1072-7515(18)32078-7/fulltext↩︎
Clare Brown et al., “Association of State Medicaid Expansion Status With Low Birth Weight and Preterm Birth” Journal of the American Medical Association 321, no. 16 (April 2019), https://jamanetwork.com/journals/jama/fullarticle/2731179↩︎
Jonathan Koma, Julie Donohue, Colleen Barry, Haiden Huskamp, and Marian Jarlenski, “Medicaid Coverage Expansions and Cigarette Smoking Cessation Among Low-Income Adults,” Medical Care 55, no. 12 (December 2017): 1023-1029, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688008/↩︎
Sarah Miller, Sean Altekruse, Norman Johnson, and Laura R. Wherry, Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data (National Bureau of Economic Research, Working Paper No. 26081, July 2019), http://www.nber.org/papers/w26081↩︎
Nicole Kravitz-Wirtz et al., “Association of Medicaid Expansion With Opioid Overdose Mortality in the United States,” JAMA Network Open 3, no. 1 (January 2020), https://doi.org/10.1001/jamanetworkopen.2019.19066↩︎
Emanuel Eguia et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Access to Minimally Invasive Surgical Care,” The American Journal of Surgery Epub ahead of print (July 2019), https://doi.org/10.1016/j.amjsurg.2019.07.003↩︎
Taressa K. Fraze et al., “Prevalence of Screening for Food Insecurity, Housing Instability, Utility Needs, Transportation Needs, and Interpersonal Violence by US Physician Practices and Hospitals,” JAMA Network Open 2, no. 9 (September 2019), https://doi.org/10.1001/jamanetworkopen.2019.11514↩︎
Kelsey L. Corrigan et al., “The Impact of the Patient Protection and Affordable Care Act on Insurance Coverage and Cancer-Directed Treatment in HIV-Infected Patients With Cancer in the United States,” Cancer (November 2019), https://doi.org/10.1002/cncr.32563↩︎
Mohammad Eslami et al., “Impact of Medicaid Expansion of the Affordable Care on the Outcomes of Lower Extremity Bypass for Patients With Peripheral Artery Disease in the Vascular Quality Initiative Database,” Annals of Surgery 270, no. 4 (October 2019): 647-655, https://doi.org/10.1097/sla.0000000000003521↩︎
Megan Cole, Brad Wright, Ira Wilson, Omar Gallarraga, and Amal Trivedi, “Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.1542↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Rishi Wadhera et al., “Association of the Affordable Care Act’s Medicaid Expansion With Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure,” Circulation: Cardiovascular Quality and Outcomes 11, no. 7 (June 2018), https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.118.004729↩︎
De-Chih Lee, Leiyu Shi, and Hailun Liang, “Primary Care Utilization And Clinical Quality Performance: A Comparison Between Health Centres In Medicaid Expansion States And Non-Expansion States,” Journal of Health Services Research & Policy 24, no. 1 (January 2019): 19-24, https://journals.sagepub.com/doi/abs/10.1177/1355819618788592↩︎
John Scott et al., “Lifting the Burden: State Medicaid Expansion Reduces Financial Risk for the Injured,” Journal of Trauma and Acute Care Surgery Epub ahead of print (September 2019), https://doi.org/10.1097/ta.0000000000002493↩︎
Gary Pickens et al., “Changes in Hospital Inpatient Utilization Following Health Care Reform,” Health Services Research epub ahead of print (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28664983↩︎
Jeremy Holzmacher et al., “Association of Expanded Medicaid Coverage with Hospital Length of Stay After Injury,” JAMA Surgery published online (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28658482↩︎
Mary Anderson, Jeffrey Glasheen, and Debra Anoff, “Impact of State Medicaid Expansion Status on Length of Stay and In-Hospital Mortality for General Medicine Patients at US Academic Medical Centers,” Journal of Hospital Medicine Epub ahead of print (August 2016), http://onlinelibrary.wiley.com/wol1/doi/10.1002/jhm.2649/citedby↩︎
Andrew Admon, Michael Sjoding, Sarah Lyon, John Ayanian, Theodore Iwashyna, and Colin Cooke, “Medicaid Expansion and Mechanical Ventilation in Asthma, Chronic Obstructive Pulmonary Disease, and Heart Failure,” Annals of the American Thoracic Society epub ahead of print (February 2019), https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201811-777OC↩︎
Ehimare Akhabue, Lindsay Pool, Clyde Yancy, Philip Greenland, and Donald Lloyd-Jones, “Association of State Medicaid Expansion With Rate of Uninsured Hospitalizations for Major Cardiovascular Events, 2009-2014,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2698077↩︎
Donald Likosky, Devraj Sukul, Milan Seth, Chang He, Hitlander Gurm, and Richard Prager, “The Association Between Medicaid Expansion and Cardiovascular Interventions: The Michigan Experience,” Journal of the American College of Cardiology 71, no. 9 (March 2018): 1050-1051, https://www.sciencedirect.com/science/article/pii/S0735109718300056?via%3Dihub↩︎
Neal Bhutiani, Brian Harbrecht, Charles Scoggins, and Matthew Bozeman, “Evaluating The Early Impact Of Medicaid Expansion On Trends In Diagnosis And Treatment Of Benign Gallbladder Disease In Kentucky,” The American Journal of Surgery (January 2019), https://www.americanjournalofsurgery.com/article/S0002-9610(18)30894-8/fulltext↩︎
Rishi Wadhera et al., “Association of the Affordable Care Act’s Medicaid Expansion With Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure,” Circulation: Cardiovascular Quality and Outcomes 11, no. 7 (June 2018), https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.118.004729↩︎
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562↩︎
Ramiro Manzano-Nunez et al., “Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery,” World Journal of Surgery 43, no. 6 (June 2019): 1483-1489, https://link.springer.com/article/10.1007/s00268-019-04932-0↩︎
Mark Clapp et al., “Association of Medicaid Expansion With Coverage and Access to Care for Pregnant Women,” Obstetrics & Gynecology 134, no. 5 (November 2019): 1066-1074, https://doi.org/10.1097/aog.0000000000003501↩︎
John A. Graves et al., “Medicaid Expansion Slowed Rates of Health Decline for Low-Income Adults in Southern States,” Health Affairs 39, no. 1 (January 2020): 67-76, https://doi.org/10.1377/hlthaff.2019.00929↩︎
Nicole Kravitz-Wirtz et al., “Association of Medicaid Expansion With Opioid Overdose Mortality in the United States,” JAMA Network Open 3, no. 1 (January 2020), https://doi.org/10.1001/jamanetworkopen.2019.19066↩︎
James A. Swartz and Susanny J. Beltran, “Prescription Opioid Availability and Opioid Overdose-Related Mortality Rates in Medicaid Expansion and Non-Expansion States,” Addiction 114, no. 11 (November 2019): 2016-2025, https://doi.org/10.1111/add.14741↩︎
Jusung Lee et al., “The Impact of Medicaid Expansion on Diabetes Management,” Diabetes Care Epub ahead of print (October 2019), https://doi.org/10.2337/dc19-1173↩︎
Yunwei Gai and John Marthinsen, “Medicaid Expansion, HIV Testing, and HIV-Related Risk Behaviors in the United States, 2010-2017,” American Journal of Public Health 109, no. 10 (October 2019): 1404-1412, https://doi.org/10.2105/ajph.2019.305220↩︎
Lindsay C. Kobayashi, Onur Altindag, Yulya Truskinovsky, and Lisa F. Berkman, “Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-Being in the US Adult Population, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1236-1242, https://doi.org/10.2105/ajph.2019.305164↩︎
Ann-Marie Rosland et al., “Diagnosis and Care of Chronic Health Conditions Among Medicaid Expansion Enrollees: a Mixed-Methods Observational Study,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2549-2558, https://doi.org/10.1007/s11606-019-05323-w↩︎
Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019↩︎
Sri Lekha Tummalapalli, Samuel Leonard, Michelle M. Estrella, and Salomeh Keyhani, “The Effect of Medicaid Expansion on Self-Reported Kidney Disease,” Clinical Journal of American Society of Nephrology 14, no. 8 (August 2019): 1238-1240, https://doi.org/10.2215/cjn.02310219↩︎
Stacey McMorrow, Jason Gates, Sharon Long, and Genevieve Kenney, “Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents,” Health Affairs 36 no. 5 (May 2017): 808-818, https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1650↩︎
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046↩︎
Tyler Winkelman and Virginia Chang, “Medicaid Expansion, Mental Health, and Access to Care Among Childless Adults With and Without Chronic Conditions,” Journal of General Internal Medicine epub ahead of print (November 2017), https://www.ncbi.nlm.nih.gov/pubmed/29181792↩︎
Laura Wherry and Sarah Miller, “Early Coverage, Access, Utilization, and Health Effects Associated with the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study,” Annals of Internal Medicine, Epub ahead of print (April 2016), http://annals.org/article.aspx?articleid=2513980↩︎
Benjamin Sommers, Munira Gunja, Kenneth Finegold, and Thomas Musco, “Changes in Self-Reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act,” The Journal of the American Medical Association 314 no. 4 (July 2015): 366-374, http://jama.jamanetwork.com/article.aspx?articleid=2411283&resultClick=3↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health (National Bureau of Economic Research, Working Paper no. 23269, March 2017), http://www.nber.org/papers/w23269↩︎
Manzilat Akande, Peter Minneci, Katherine Deans, Henry Xiang, Deena Chisolm, and Jennifer Cooper, “Effects Of Medicaid Expansion On Disparities In Trauma Care And Outcomes In Young Adults,” Journal of Surgical Research 228 (August 2018): 42-53, https://www.sciencedirect.com/science/article/pii/S0022480418301562↩︎
John Cawley, Aparna Soni, and Kosali Simon, “Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1495-1497, https://link.springer.com/article/10.1007%2Fs11606-018-4537-0↩︎
Kosali Simon, Aparna Soni, and John Cawley, “The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions” Journal of Policy Analysis and Management 36, no. 2 (March 2017), https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21972↩︎
Bernard Black, Alex Hollingsworth, Leticia Nunes, and Kosali Simon, The Effect of Health Insurance on Mortality: Power Analysis and What We Can Learn from the Affordable Care Act Coverage Expansions, (National Bureau of Economic Research, Working Paper Series No. 25568, February 2019), https://www.nber.org/papers/w25568↩︎
Susan L. Averett, Julie K. Smith, and Yang Wang, “Medicaid Expansion and Opioid Deaths,” Health Economics 28, no. 12 (December 2019): 1491-1496, https://doi.org/10.1002/hec.3945↩︎
Johanna Maclean and Brendan Saloner, The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act (National Bureau of Economic Research Working Paper No. 23342, April 2017), http://www.nber.org/papers/w23342.pdf↩︎
Jesse M. Hinde et al., “Increasing Access to Opioid Use Disorder Treatment: Assessing State Policies and the Evidence Behind Them,” Journal of Studies on Alcohol and Drugs 80, no. 6 (November 2019): 693-697, https://doi.org/10.15288/jsad.2019.80.693↩︎
Angelica Meinhofer and Allison Witman, “The Role Of Health Insurance On Treatment For Opioid Use Disorders: Evidence From The Affordable Care Act Medicaid Expansion,” Journal of Health Economics 60 (June 2018): 177-197, https://www.sciencedirect.com/science/article/abs/pii/S0167629617311530↩︎
Susan Dorr Goold et al., “Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study,” Journal of General Internal Medicine 33, no. 8 (June 2018): 1307-1316, https://link.springer.com/article/10.1007/s11606-018-4487-6↩︎
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420↩︎
Nathalie Huguet et al., “Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers,” Journal of Primary Care & Community Health epub ahead of print (May 2017), http://journals.sagepub.com/doi/full/10.1177/2150131917709403↩︎
Government Accountability Office, Behavioral Health: Options for Low-Income Adults to Receive Treatment in Selected States (Washington, DC: Government Accountability Office, June 2015), http://www.gao.gov/assets/680/670894.pdf↩︎
De-Chih Lee, Leiyu Shi, and Hailun Liang, “Primary Care Utilization And Clinical Quality Performance: A Comparison Between Health Centres In Medicaid Expansion States And Non-Expansion States,” Journal of Health Services Research & Policy 24, no. 1 (January 2019): 19-24, https://journals.sagepub.com/doi/abs/10.1177/1355819618788592↩︎
Adam M. Almaguer et al., “Do Geographic Region, Medicaid Status, and Academic Affiliation Affect Access to Care Among Medicaid and Privately Insured Total Hip Arthroplasty Patients?,” Journal of Arthroplasty 34, no. 12 (December 2019): 2866-2871, https://doi.org/10.1016/j.arth.2019.07.030↩︎
Colleen M. Carey, Sarah Miller, and Laura R. Wherry, The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare, (National Bureau of Economic Research, Working Paper Series No. 25153, October 2018), https://www.nber.org/papers/w25153↩︎
Carrie Fry and Benjamin Sommers, “Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression,” Psychiatric Services 69, no. 11 (November 2018), https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800181↩︎
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830↩︎
Joseph Labrum et al., “Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act?” Clinical Orthopaedics and Related Research 475 no. 6 (June 2017): 1527-1536, https://link.springer.com/article/10.1007%2Fs11999-017-5263-3↩︎
Jevay Grooms and Alberto Ortega, “Examining Medicaid Expansion and the Treatment of Substance Use Disorders,” American Economic Association Papers and Proceedings 109 (May 2019): 187-192, https://www.aeaweb.org/articles?id=10.1257/pandp.20191090↩︎
Nathalie Huguet et al., “Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers,” Journal of Primary Care & Community Health epub ahead of print (May 2017), http://journals.sagepub.com/doi/full/10.1177/2150131917709403↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Hilary Barnes, Michael Richards, Matthew McHugh, and Grant Martsolf, “Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners,” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.1158↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
Jenny Nguyen, Nidharshan Anandasivam, Daniel Cooperman, Richard Pelker, and Daniel Wiznia, “Does Medicaid Insurance Provide Sufficient Access to Pediatric Orthopedic Care Under the Affordable Care Act?,” Global Pediatric Health epub ahead of print (February 2019), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381430/↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830↩︎
Government Accountability Office, Behavioral Health: Options for Low-Income Adults to Receive Treatment in Selected States (Washington, DC: Government Accountability Office, June 2015), http://www.gao.gov/assets/680/670894.pdf↩︎
John Scott et al., “Lifting the Burden: State Medicaid Expansion Reduces Financial Risk for the Injured,” Journal of Trauma and Acute Care Surgery Epub ahead of print (September 2019), https://doi.org/10.1097/ta.0000000000002493↩︎
Xuesong Han et al., “Changes in Noninsurance and Care Unaffordability Among Cancer Survivors Following the Affordable Care Act,” Journal of the National Cancer Institute Epub ahead of print (November 2019), https://doi.org/10.1093/jnci/djz218↩︎
Lindsay C. Kobayashi, Onur Altindag, Yulya Truskinovsky, and Lisa F. Berkman, “Effects of the Affordable Care Act Medicaid Expansion on Subjective Well-Being in the US Adult Population, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1236-1242, https://doi.org/10.2105/ajph.2019.305164↩︎
Kevin N. Griffith, “Changes in Insurance Coverage and Access to Care for Young Adults in 2017,” Journal of Adolescent Health Epub ahead of print (July 2019), https://doi.org/10.1016/j.jadohealth.2019.05.020↩︎
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553↩︎
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009↩︎
Claire E. Margerison et al., “Impacts of Medicaid Expansion on Health Among Women of Reproductive Age,” American Journal of Preventive Medicine Epub ahead of print (November 2019), https://doi.org/10.1016/j.amepre.2019.08.019↩︎
Stacey McMorrow, Genevieve Kenney, Sharon Long, and Jason Gates, “Marketplaces Helped Drive Coverage Gains in 2015; Affordability Problems Remained,” Health Affairs 35 no. 10 (October 2016): 1810-1815, http://content.healthaffairs.org/content/35/10/1810.full↩︎
Kenneth Brevoort, Daniel Grodzicki, and Martin Hackmann, Medicaid and Financial Health (National Bureau of Economic Research, Working Paper No. 24002, November 2017), http://www.nber.org/papers/w24002↩︎
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata, Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health (National Bureau of Economic Research, Working Paper no. 23269, March 2017), http://www.nber.org/papers/w23269↩︎
Tyler Winkelman and Virginia Chang, “Medicaid Expansion, Mental Health, and Access to Care Among Childless Adults With and Without Chronic Conditions,” Journal of General Internal Medicine epub ahead of print (November 2017), https://www.ncbi.nlm.nih.gov/pubmed/29181792↩︎
Stacey McMorrow, Jason Gates, Sharon Long, and Genevieve Kenney, “Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents,” Health Affairs 36 no. 5 (May 2017): 808-818, https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1650↩︎
Sarah Miller, Luojia Hu, Robert Kaestner, Bhashkar Mazumder, and Ashley Wong, The ACA Medicaid Expansion in Michigan and Financial Health, (National Bureau of Economic Research, working paper no. 25053, September 2018), https://www.nber.org/papers/w25053.pdf↩︎
Shiho Kino and Ichiro Kawachi, “Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?,” Health Education & Behavior Epub ahead of print (October 2019), https://doi.org/10.1177/1090198119875998↩︎
Ann-Marie Rosland et al., “Diagnosis and Care of Chronic Health Conditions Among Medicaid Expansion Enrollees: a Mixed-Methods Observational Study,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2549-2558, https://doi.org/10.1007/s11606-019-05323-w↩︎
Carrie Fry and Benjamin Sommers, “Effect of Medicaid Expansion on Health Insurance Coverage and Access to Care Among Adults With Depression,” Psychiatric Services 69, no. 11 (November 2018), https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800181↩︎
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046↩︎
Sunha Choi, Sungkyu Lee, and Jason Matejkowski, “The Effects of State Medicaid Expansion on Low-Income Individuals’ Access to Health Care: Multilevel Modeling,” Population Health Management epub ahead of print (September 2017), http://online.liebertpub.com/doi/abs/10.1089/pop.2017.0104↩︎
Emily Johnston, Andrea Strahan, Peter Joski, Anne Dunlop, and E. Kathleen Adams, “Impacts of the Affordable Care Act’s Medicaid Expansion on Women of Reproductive Age,” Women’s Health Issues, 28, no. 2 (February 2018), http://www.whijournal.com/article/S1049-3867(17)30242-6/pdf↩︎
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830↩︎
Sharon Long, Lea Bart, Michael Karpman, Adele Shartzer, and Stephen Zuckerman, “Sustained Gains in Coverage, Access, and Affordability Under the ACA: A 2017 Update,” Health Affairs 36 no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0798↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Ameen Barghi, Hugo Torres, Nancy Kressin, and Danny McCormick, “Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study,” Journal of General Internal Medicine epub ahead of print (June 2019), https://link.springer.com/article/10.1007%2Fs11606-019-05108-1↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
Benjamin Sommers, Robert Blendon, and E. John Orav, “Both the ‘Private Option’ And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults,” Health Affairs 35, no. 1 (January 2016): 96-105, http://content.healthaffairs.org/content/35/1/96.abstract↩︎
John Cawley, Aparna Soni, and Kosali Simon, “Third Year of Survey Data Shows Continuing Benefits of Medicaid Expansions for Low-Income Childless Adults in the U.S.,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1495-1497, https://link.springer.com/article/10.1007%2Fs11606-018-4537-0↩︎
Frederic Blavin, Michael Karpman, Genevieve Kenney, and Benjamin Sommers, “Medicaid Versus Marketplace Coverage for Near-Poor Adults: Effects on Out-Of-Pocket Spending and Coverage,” Health Affairs 37 no. 2 (January 2018), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.1166↩︎
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420↩︎
Anna Goldman, Steffie Woolhandler, and David Himmelstein, “Out-of-pocket Spending and Premium Contributions After Implementation of the Affordable Care Act,” Journal of the American Medical Association epub ahead of print (January 2018), https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2669908↩︎
Sarah Miller and Laura Wherry, “Four Years Later: Insurance Coverage and Access to Care Continue to Diverge between ACA Medicaid Expansion and Non-Expansion States,” American Economic Association Papers and Proceedings 109 (May 2019): 327-333, https://www.aeaweb.org/articles?id=10.1257/pandp.20191046↩︎
Kenneth Brevoort, Daniel Grodzicki, and Martin Hackmann, Medicaid and Financial Health (National Bureau of Economic Research, Working Paper No. 24002, November 2017), http://www.nber.org/papers/w24002↩︎
Sharon Long, Lea Bart, Michael Karpman, Adele Shartzer, and Stephen Zuckerman, “Sustained Gains in Coverage, Access, and Affordability Under the ACA: A 2017 Update,” Health Affairs 36 no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0798↩︎
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830↩︎
Benjamin Sommers, Bethany Maylone, Robert Blendon, E. John Orav, and Arnold Epstein, “Three-Year Impacts of the Affordable Care Act: Improved Medical Care and Health Among Low-Income Adults,” Health Affairs epub ahead of print (May 2017), http://content.healthaffairs.org/content/early/2017/05/15/hlthaff.2017.0293↩︎
Stacey McMorrow, Jason Gates, Sharon Long, and Genevieve Kenney, “Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents,” Health Affairs 36 no. 5 (May 2017): 808-818, https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1650↩︎
Benjamin Sommers, Robert Blendon, E. John Orav, and Arnold Epstein, “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” The Journal of the American Medical Association 176 no. 10 (October 2016): 1501-1509, http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2542420↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
Sarah Miller, Luojia Hu, Robert Kaestner, Bhashkar Mazumder, and Ashley Wong, The ACA Medicaid Expansion in Michigan and Financial Health, (National Bureau of Economic Research, working paper no. 25053, September 2018), https://www.nber.org/papers/w25053.pdf↩︎
Sarah Miller, Luojia Hu, Robert Kaestner, Bhashkar Mazumder, and Ashley Wong, The ACA Medicaid Expansion in Michigan and Financial Health, (National Bureau of Economic Research, working paper no. 25053, September 2018), https://www.nber.org/papers/w25053.pdf↩︎
Gracie Himmelstein, “Effect of the Affordable Care Act’s Medicaid Expansions on Food Security, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1243-1248, https://doi.org/10.2105/ajph.2019.305168↩︎
Sanders Korenman, Dahlia K. Remler, and Rosemary T. Hyson, “Medicaid Expansions and Poverty: Comparing Supplemental and Health-Inclusive Poverty Measures,” Social Service Review 93, no. 3 (September 2019): 429-483, https://doi.org/10.1086/705319↩︎
Kenneth Brevoort, Daniel Grodzicki, and Martin Hackmann, Medicaid and Financial Health (National Bureau of Economic Research, Working Paper No. 24002, November 2017), http://www.nber.org/papers/w24002↩︎
Sarah Miller, Luojia Hu, Robert Kaestner, Bhashkar Mazumder, and Ashley Wong, The ACA Medicaid Expansion in Michigan and Financial Health, (National Bureau of Economic Research, working paper no. 25053, September 2018), https://www.nber.org/papers/w25053.pdf↩︎
Gracie Himmelstein, “Effect of the Affordable Care Act’s Medicaid Expansions on Food Security, 2010-2016,” American Journal of Public Health 109, no. 9 (September 2019): 1243-1248, https://doi.org/10.2105/ajph.2019.305168↩︎
Sanders Korenman, Dahlia K. Remler, and Rosemary T. Hyson, “Medicaid Expansions and Poverty: Comparing Supplemental and Health-Inclusive Poverty Measures,” Social Service Review 93, no. 3 (September 2019): 429-483, https://doi.org/10.1086/705319↩︎
Naomi Zewde, Erica Eliason, Heidi Allen, and Tal Gross, “The Effects of the ACA Medicaid Expansion on Nationwide Home Evictions and Eviction-Court Initiations: United States, 2000-2016,” American Journal of Public Health 109, no. 10 (October 2019): 1379-1383, https://doi.org/10.2105/ajph.2019.305230↩︎
Sarah Miller, Luojia Hu, Robert Kaestner, Bhashkar Mazumder, and Ashley Wong, The ACA Medicaid Expansion in Michigan and Financial Health, (National Bureau of Economic Research, working paper no. 25053, September 2018), https://www.nber.org/papers/w25053.pdf↩︎
Kenneth Brevoort, Daniel Grodzicki, and Martin Hackmann, Medicaid and Financial Health (National Bureau of Economic Research, Working Paper No. 24002, November 2017), http://www.nber.org/papers/w24002↩︎
Sarah Miller, Luojia Hu, Robert Kaestner, Bhashkar Mazumder, and Ashley Wong, The ACA Medicaid Expansion in Michigan and Financial Health, (National Bureau of Economic Research, working paper no. 25053, September 2018), https://www.nber.org/papers/w25053.pdf↩︎
Xuesong Han et al., “Changes in Noninsurance and Care Unaffordability Among Cancer Survivors Following the Affordable Care Act,” Journal of the National Cancer Institute Epub ahead of print (November 2019), https://doi.org/10.1093/jnci/djz218↩︎
Naomi Zewde, Erica Eliason, Heidi Allen, and Tal Gross, “The Effects of the ACA Medicaid Expansion on Nationwide Home Evictions and Eviction-Court Initiations: United States, 2000-2016,” American Journal of Public Health 109, no. 10 (October 2019): 1379-1383, https://doi.org/10.2105/ajph.2019.305230↩︎
A. Taylor Kelley, Renuka Tipirneni, and Helen Levy, “Changes in Veterans’ Coverage and Access to Care Following the Affordable Care Act, 2011-2017,” American Journal of Public Health 109, no. 9 (September 2019): 1233-1235, https://doi.org/10.2105/ajph.2019.305160↩︎
Xuesong Han et al., “Changes in Noninsurance and Care Unaffordability Among Cancer Survivors Following the Affordable Care Act,” Journal of the National Cancer Institute Epub ahead of print (November 2019), https://doi.org/10.1093/jnci/djz218↩︎
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553↩︎
Kevin N. Griffith, “Changes in Insurance Coverage and Access to Care for Young Adults in 2017,” Journal of Adolescent Health Epub ahead of print (July 2019), https://doi.org/10.1016/j.jadohealth.2019.05.020↩︎
Jin Huang and Shirley L. Porterfield, “Changes in Health Insurance Coverage and Health Care Access as Teens with Disabilities Transition to Adulthood,” Disability and Health Journal 12, no. 4 (October 2019): 551-556, https://doi.org/10.1016/j.dhjo.2019.06.009↩︎
Sanders Korenman, Dahlia K. Remler, and Rosemary T. Hyson, “Medicaid Expansions and Poverty: Comparing Supplemental and Health-Inclusive Poverty Measures,” Social Service Review 93, no. 3 (September 2019): 429-483, https://doi.org/10.1086/705319↩︎
Jean M. Abraham, Anne B. Royalty, and Coleman Drake, “The Impact of Medicaid Expansion on Employer Provision of Health Insurance,” International Journal of Health Economics and Management 19, no. 3-4 (December 2019): 317-340, https://doi.org/10.1007/s10754-018-9256-x↩︎
Thomas Selden, Brandy Lipton, and Sandra Decker, “Medicaid Expansion and Marketplace Eligibility Both Increased Coverage, With Trade-Offs in Access, Affordability,” Health Affairs 36 no. 12 (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0830↩︎
Sarah Miller and Laura Wherry, “Health and Access to Care During the First 2 Years of the ACA Medicaid Expansions,” The New England Journal of Medicine 376 no. 10 (March 2017), http://www.nejm.org/doi/full/10.1056/NEJMsa1612890↩︎
Laura Wherry and Sarah Miller, “Early Coverage, Access, Utilization, and Health Effects Associated with the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study,” Annals of Internal Medicine, Epub ahead of print (April 2016), http://annals.org/article.aspx?articleid=2513980↩︎
Benjamin Sommers, Munira Gunja, Kenneth Finegold, and Thomas Musco, “Changes in Self-Reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act,” The Journal of the American Medical Association 314 no. 4 (July 2015): 366-374, http://jama.jamanetwork.com/article.aspx?articleid=2411283&resultClick=3↩︎
Kenneth Brevoort, Daniel Grodzicki, and Martin Hackmann, Medicaid and Financial Health (National Bureau of Economic Research, Working Paper No. 24002, November 2017), http://www.nber.org/papers/w24002↩︎
Helen Levy et al., “Macroeconomic Feedback Effects of Medicaid Expansion: Evidence from Michigan,” Journal of Health Politics, Policy and Law Epub ahead of print (October 2019), https://doi.org/10.1215/03616878-7893555↩︎
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf↩︎
Deborah Bachrach, Patricia Boozang, Avi Herring, and Dori Glanz Reyneri, States Expanding Medicaid See Significant Budget Savings and Revenue Gains, (Manatt Health Solutions, prepared by the Robert Wood Johnson Foundation’s State Health Reform Assistance Network, March 2016), http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2016/rwjf419097↩︎
Micah Hartman et al., “National Health Care Spending in 2016: Spending and Enrollment Growth Slow After Initial Coverage Expansions,” Health Affairs epub ahead of print (December 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1299↩︎
Jacqueline Fiore, The Impact of the Affordable Care Act’s Medicaid Expansion on Medicaid Spending by Health Care Service Category (Tulane University, July 2017), http://econ.tulane.edu/RePEc/pdf/tul1706.pdf↩︎
Helen Levy et al., “Macroeconomic Feedback Effects of Medicaid Expansion: Evidence from Michigan,” Journal of Health Politics, Policy and Law Epub ahead of print (October 2019), https://doi.org/10.1215/03616878-7893555↩︎
Qiwei He and Scott Barkowski, “The Effect of Health Insurance on Crime: Evidence from the Affordable Care Act Medicaid Expansion,” Health Economics Epub ahead of print (January 2020): 261-277, https://doi.org/10.1002/hec.3977↩︎
Jesse M. Hinde et al., “Increasing Access to Opioid Use Disorder Treatment: Assessing State Policies and the Evidence Behind Them,” Journal of Studies on Alcohol and Drugs 80, no. 6 (November 2019): 693-697, https://doi.org/10.15288/jsad.2019.80.693↩︎
Deborah Bachrach, Patricia Boozang, Avi Herring, and Dori Glanz Reyneri, States Expanding Medicaid See Significant Budget Savings and Revenue Gains, (Manatt Health Solutions, prepared by the Robert Wood Johnson Foundation’s State Health Reform Assistance Network, March 2016), http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2016/rwjf419097↩︎
Johanna Maclean and Brendan Saloner, “The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act,” Journal of Policy Analysis and Management 38, no. 2 (2019): 366-393, https://www.ncbi.nlm.nih.gov/pubmed/30882195↩︎
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf↩︎
Paul Jacobs, Genevieve Kenney, and Thomas Selden, “Newly Eligible Enrollees In Medicaid Spend Less And Use Less Care Than Those Previously Eligible,” Health Affairs 36, no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0252↩︎
Stephan R. Lindner et al., “Health Care Expenditures Among Adults With Diabetes After Oregon’s Medicaid Expansion,” Diabetes Care Epub ahead of print (December 2019), https://doi.org/10.2337/dc19-1343↩︎
Heather Holderness et al., “Where Do Oregon Medicaid Enrollees Seek Outpatient Care Post-Affordable Care Act Medicaid Expansion?,” Medical Care 57, no. 10 (October 2019): 788-794, https://doi.org/10.1097/mlr.0000000000001189↩︎
Paul Jacobs, Genevieve Kenney, and Thomas Selden, “Newly Eligible Enrollees In Medicaid Spend Less And Use Less Care Than Those Previously Eligible,” Health Affairs 36, no. 9 (September 2017), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0252↩︎
Aditi Sen and Thomas DeLeire, “How Does Expansion Of Public Health Insurance Affect Risk Pools And Premiums In The Market For Private Health Insurance? Evidence From Medicaid And The Affordable Care Act Marketplaces,” Health Economics 27 (July 2018): 1877–1903, https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3809↩︎
Hefei Wen, Kenton J. Johnston, Lindsay Allen, and Teresa M. Waters, “Medicaid Expansion Associated With Reductions In Preventable Hospitalizations,” Health Affairs 38, no. 11 (November 2019): 1845-1849, https://doi.org/10.1377/hlthaff.2019.00483↩︎
Alexander T. Janke, Shooshan Danagoulian, Arjun K. Venkatesh, and Phillip D. Levy, “Medicaid Expansion and Resource Utilization in the Emergency Department,” The American Journal of Emergency Medicine Epub ahead of print (January 2020), https://doi.org/10.1016/j.ajem.2019.12.050↩︎
Hawazin W. Elani, Ichiro Kawachi, and Benjamin D. Sommers, “Changes in Emergency Department Dental Visits after Medicaid Expansion,” Health Services Research Epub ahead of print (January 2020), https://doi.org/10.1111/1475-6773.13261↩︎
Emanuel Eguia et al., “The Impact of the Affordable Care Act Medicaid Expansion on Vascular Surgery,” Annals of Vascular Surgery Epub ahead of print (January 2020), https://doi.org/10.1016/j.avsg.2020.01.006↩︎
Mark Clapp et al., “Association of Medicaid Expansion With Coverage and Access to Care for Pregnant Women,” Obstetrics & Gynecology 134, no. 5 (November 2019): 1066-1074, https://doi.org/10.1097/aog.0000000000003501↩︎
Charles A. Daly et al., “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma,” The Journal of Hand Surgery 44, no. 9 (September 2019): 720-727, https://doi.org/10.1016/j.jhsa.2019.05.020↩︎
John Scott et al., “Lifting the Burden: State Medicaid Expansion Reduces Financial Risk for the Injured,” Journal of Trauma and Acute Care Surgery Epub ahead of print (September 2019), https://doi.org/10.1097/ta.0000000000002493↩︎
Craig Garthwaite et al., All Medicaid Expansions Are Not Created Equal: The Geography and Targeting of the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26289, September 2019), http://www.nber.org/papers/w26289↩︎
Shannon McConville, Maria Raven, Sarah Sabbagh, and Renee Hsia, “Frequent Emergency Department Users: A Statewide Comparison Before And After Affordable Care Act Implementation,” Health Affairs 37, no. 6, (June 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0784↩︎
Rahul Ladhania, Amelia Haviland, Arvind Venkat, Rahul Telang, and Jesse Pines, “The Effect of Medicaid Expansion on the Nature of New Enrollees’ Emergency Department Use,” Medical Care Research and Review epub ahead of print (May 2019), https://journals.sagepub.com/doi/abs/10.1177/1077558719848270↩︎
Beatrice D. Probst, Luther Walls, Michael Cirone, and Talar Markossian, “Examining the Effect of the Affordable Care Act on Two Illinois Emergency Departments,” Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health 20, no. 5 (September 2019): 710-716, https://doi.org/10.5811/westjem.2019.6.41943↩︎
Richard Lindrooth, Marcelo Perraillon, Rose Hardy, and Gregory Tung, “Understanding the Relationship Between Medicaid Expansions and Hospital Closures,” Health Affairs epub ahead of print (January 2018), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0976↩︎
Sayeh Nikpay, Seth Freedman, Helen Levy, and Tom Buchmueller, “Effect of the Affordable Care Act Medicaid Expansion on Emergency Department Visits: Evidence From State-Level Emergency Department Databases,” Annals of Emergency Medicine 70, no.2 (August 2017), http://www.annemergmed.com/article/S0196-0644(17)30319-0/pdf↩︎
Johanna Maclean and Brendan Saloner, “The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act,” Journal of Policy Analysis and Management 38, no. 2 (2019): 366-393, https://www.ncbi.nlm.nih.gov/pubmed/30882195↩︎
Aabha Sharma, Scott Dresden, Emilie Powell, Raymond Kang, Joe Feinglass, “Emergency Department Visits and Hospitalizations for the Uninsured in Illinois Before and After Affordable Care Act Insurance Expansion,” Journal of Community Health 42 no. 3 (June 2017): 591-597, https://link.springer.com/article/10.1007/s10900-016-0293-4↩︎
Nathalie Huguet et al., “Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers,” Journal of Primary Care & Community Health epub ahead of print (May 2017), http://journals.sagepub.com/doi/full/10.1177/2150131917709403↩︎
Mary Anderson, Jeffrey Glasheen, and Debra Anoff, “Impact of State Medicaid Expansion Status on Length of Stay and In-Hospital Mortality for General Medicine Patients at US Academic Medical Centers,” Journal of Hospital Medicine Epub ahead of print (August 2016), http://onlinelibrary.wiley.com/wol1/doi/10.1002/jhm.2649/citedby↩︎
The University of Michigan Institute for Healthcare Policy & Innovation, The Healthy Michigan Plan: 2015 Report on Uncompensated Care and Insurance Rates (The University of Michigan Institute for Healthcare Policy & Innovation, prepared for the Michigan Department of Health and Human Services and the Michigan Department of Insurance and Financial Services, December 2016), http://www.michigan.gov/documents/mdhhs/2015_Report_on_Uncompensated_Care_and_Insurance_Rates-HMP_547720_7.pdf↩︎
Laurie Felland, Peter Cunningham, Annie Doubleday, and Cannon Warren, Effects of the Affordable Care Act on Safety Net Hospitals (Washington, DC: Mathematica Policy Research, prepared for the Assistant Secretary for Planning and Evaluation, November 2016), https://aspe.hhs.gov/sites/default/files/pdf/255491/SafetyNetHospital.pdf↩︎
Sayeh Nikpay, Thomas Buchmueller, and Helen Levy. “Affordable Care Act Medicaid Expansion Reduced Uninsured Hospital Stays in 2014,” Health Affairs 35, no.1 (January 2016): 106-110, http://content.healthaffairs.org/content/35/1/106.full↩︎
David Dranove, Craig Garthwaite, and Christopher Ody, “Uncompensated Care Decreased At Hospitals In Medicaid Expansion States But Not At Hospitals In Nonexpansion States,” Health Affairs 35 no. 8 (August 2016): 1471-1479, http://content.healthaffairs.org/content/35/8/1471.full↩︎
Christine Jones, Serena Scott, Debra Anoff, Read Pierce, and Jeffrey Glasheen, “Changes in Payer Mix and Physician Reimbursement After the Affordable Care Act and Medicaid Expansion,” Inquiry: The Journal of Health Care Organization, Provision, and Financing 52 (August 2015), http://inq.sagepub.com/content/52/0046958015602464.full↩︎
Nadia Laniado, Avery R. Brow, Eric Tranby, and Victor M. Badner, “Trends in Non-Traumatic Dental Emergency Department Use in New York and New Jersey: A Look at Medicaid Expansion from Both Sides of the Hudson River,” Journal of Public Health Dentistry Epub ahead of print (October 2019), https://doi.org/10.1111/jphd.12343↩︎
Jordan Rhodes, Thomas Buchmueller, Helen Levy, and Sayeh Nikpay, “Heterogeneous Effects Of The Aca Medicaid Expansion On Hospital Financial Outcomes,” Contemporary Economic Policy epub ahead of print (April 2019), https://onlinelibrary.wiley.com/doi/full/10.1111/coep.12428↩︎
Gary Young, Stephen Flaherty, E. Zepeda, Simone Singh, and Sara Rosenbaum, “Impact of ACA Medicaid Expansion on Hospitals’ Financial Status” Journal of Healthcare Management 64, no. 2 (March 2019): 91–102, https://insights.ovid.com/crossref?an=00115514-201904000-00007↩︎
Nathalie Huguet et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Visit Rates for Diabetes in Safety Net Health Centers,” Journal of the American Board of Family Medicine 31, no. 6 (November 2018): 905-916, https://www.jabfm.org/content/31/6/905.full↩︎
Susan Dorr Goold et al., “Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study,” Journal of General Internal Medicine 33, no. 8 (June 2018): 1307-1316, https://link.springer.com/article/10.1007/s11606-018-4487-6↩︎
Megan Cole, Brad Wright, Ira Wilson, Omar Gallarraga, and Amal Trivedi, “Medicaid Expansion And Community Health Centers: Care Quality And Service Use Increased For Rural Patients” Health Affairs 37, no. 6 (June 2018), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.1542↩︎
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf↩︎
Michel Boudreaux, Yoon Choi, Liyang Xie, and Daniel Marthey, “Medicaid Expansion at Title X Clinics: Client Volume, Payer Mix, and Contraceptive Method Type,” Medical Care epub ahead of print (April 2019), https://www.ncbi.nlm.nih.gov/pubmed/30973473↩︎
Jesse Pines, Rahul Ladhania BTech, Bernard Black , Christopher Corbit, Jestin Carlson, and Arvind Venkat, “Changes in Reimbursement to Emergency Physicians After Medicaid Expansion Under the Patient Protection and Affordable Care Act,” Annals of Emergency Medicine 73, no. 3 (March 2019): 213-224, https://www.sciencedirect.com/science/article/pii/S019606441831374X↩︎
Heather Angier et al., “Racial/Ethnic Disparities in Health Insurance and Differences in Visit Type for a Population of Patients with Diabetes after Medicaid Expansion” Journal of Health Care for the Poor and Underserved 30, no.1, (March 2019) 116–130: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429963/↩︎
Gary Pickens et al., “Changes In Hospital Service Demand, Cost, And Patient Illness Severity Following Health Reform,” Health Services Research (May 2019), https://doi.org/10.1111/1475-6773.13165↩︎
Neal Bhutiani, Brian Harbrecht, Charles Scoggins, and Matthew Bozeman, “Evaluating The Early Impact Of Medicaid Expansion On Trends In Diagnosis And Treatment Of Benign Gallbladder Disease In Kentucky,” The American Journal of Surgery (January 2019), https://www.americanjournalofsurgery.com/article/S0002-9610(18)30894-8/fulltext↩︎
Brendan Saloner, Sachini Bandara, Emma McGinty, and Colleen Barry, “Justice-Involved Adults With Substance Use Disorders: Coverage Increased but Rates of Treatment Did Not in 2014,” Health Affairs 35 no. 6 (June 2016), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0005↩︎
Brendan Saloner, Sachini Bandara, Emma McGinty, and Colleen Barry, “Justice-Involved Adults With Substance Use Disorders: Coverage Increased but Rates of Treatment Did Not in 2014,” Health Affairs 35 no. 6 (June 2016), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0005↩︎
Ehimare Akhabue, Lindsay Pool, Clyde Yancy, Philip Greenland, and Donald Lloyd-Jones, “Association of State Medicaid Expansion With Rate of Uninsured Hospitalizations for Major Cardiovascular Events, 2009-2014,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2698077↩︎
Cheryl Zogg et al., “Impact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision,” Journal of the American College of Surgeons 228, no. 1 (January 2019): 29-43, https://www.journalacs.org/article/S1072-7515(18)32078-7/fulltext↩︎
Angelica Meinhofer and Allison Witman, “The Role Of Health Insurance On Treatment For Opioid Use Disorders: Evidence From The Affordable Care Act Medicaid Expansion,” Journal of Health Economics 60 (June 2018): 177-197, https://www.sciencedirect.com/science/article/abs/pii/S0167629617311530↩︎
Favel Mondesir et al., “Medicaid Expansion and Hospitalization for Ambulatory Care–Sensitive Conditions Among Nonelderly Adults With Diabetes,” Journal of Ambulatory Care Management epub ahead of print (May 2019), https://insights.ovid.com/pubmed?pmid=31107800↩︎
Gary Pickens et al., “Changes in Hospital Inpatient Utilization Following Health Care Reform,” Health Services Research epub ahead of print (June 2017), https://www.ncbi.nlm.nih.gov/pubmed/28664983↩︎
Megan Hoopes, Heather Angier, Rachel Gold, Steffani Bailey, Nathalie Huguet, Miguel Marino, and Jennifer DeVoe, “Utilization of Community Health Centers in Medicaid Expansion and Nonexpansion States, 2013-2014,” Journal of Ambulatory Care Management 39 no. 4 (October 2016): 290-298, https://www.ncbi.nlm.nih.gov/pubmed/26765808↩︎
Steven Wallace, Maria-Elena Young, Michael Rodriguez, Amy Bonilla, and Nadereh Pourat, Community Health Centers Play a Critical Role in Caring for the Remaining Uninsured in the Affordable Care Act Era (UCLA Center for Health Policy Research, October 2016), http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/FQHC_PB-oct2016.pdf↩︎
Jesse M. Pines, Mark Zocchi, Ali Moghtaderi, Bernard Black, Steven A. Farmer, Greg Hufstetler, Kevin Klauer and Randy Pilgrim, “Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix,” Health Affairs 35, no. 8 (August 2016), http://content.healthaffairs.org/content/35/8/1480.full↩︎
Mathew Davis, Achamyeleh Gebremariam, John Ayanian, “Changes in Insurance Coverage Among Hospitalized Nonelderly Adults After Medicaid Expansion in Michigan,” The Journal of the American Medical Association 315 no. 23 (June 2016): 2617-2618, http://jamanetwork.com/journals/jama/fullarticle/2529615↩︎
Stephen Berry et al., “Healthcare Coverage for HIV Provider Visits before and after Implementation of the Affordable Care Act,” Clinical Infectious Diseases, (May 2016), http://www.ncbi.nlm.nih.gov/pubmed/27143660↩︎
Ramiro Manzano-Nunez et al., “Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery,” World Journal of Surgery 43, no. 6 (June 2019): 1483-1489, https://link.springer.com/article/10.1007/s00268-019-04932-0↩︎
Craig Garthwaite et al., All Medicaid Expansions Are Not Created Equal: The Geography and Targeting of the Affordable Care Act (National Bureau of Economic Research, Working Paper No. 26289, September 2019), http://www.nber.org/papers/w26289↩︎
Alexander T. Janke, Shooshan Danagoulian, Arjun K. Venkatesh, and Phillip D. Levy, “Medicaid Expansion and Resource Utilization in the Emergency Department,” The American Journal of Emergency Medicine Epub ahead of print (January 2020), https://doi.org/10.1016/j.ajem.2019.12.050↩︎
Hawazin W. Elani, Ichiro Kawachi, and Benjamin D. Sommers, “Changes in Emergency Department Dental Visits after Medicaid Expansion,” Health Services Research Epub ahead of print (January 2020), https://doi.org/10.1111/1475-6773.13261↩︎
Beatrice D. Probst, Luther Walls, Michael Cirone, and Talar Markossian, “Examining the Effect of the Affordable Care Act on Two Illinois Emergency Departments,” Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health 20, no. 5 (September 2019): 710-716, https://doi.org/10.5811/westjem.2019.6.41943↩︎
Shannon McConville, Maria Raven, Sarah Sabbagh, and Renee Hsia, “Frequent Emergency Department Users: A Statewide Comparison Before And After Affordable Care Act Implementation,” Health Affairs 37, no. 6, (June 2018), https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.0784↩︎
Sayeh Nikpay, Seth Freedman, Helen Levy, and Tom Buchmueller, “Effect of the Affordable Care Act Medicaid Expansion on Emergency Department Visits: Evidence From State-Level Emergency Department Databases,” Annals of Emergency Medicine 70, no.2 (August 2017), http://www.annemergmed.com/article/S0196-0644(17)30319-0/pdf↩︎
Rahul Ladhania, Amelia Haviland, Arvind Venkat, Rahul Telang, and Jesse Pines, “The Effect of Medicaid Expansion on the Nature of New Enrollees’ Emergency Department Use,” Medical Care Research and Review epub ahead of print (May 2019), https://journals.sagepub.com/doi/abs/10.1177/1077558719848270↩︎
Jesse M. Pines, Mark Zocchi, Ali Moghtaderi, Bernard Black, Steven A. Farmer, Greg Hufstetler, Kevin Klauer and Randy Pilgrim, “Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix,” Health Affairs 35, no. 8 (August 2016), http://content.healthaffairs.org/content/35/8/1480.full↩︎
Aabha Sharma, Scott Dresden, Emilie Powell, Raymond Kang, Joe Feinglass, “Emergency Department Visits and Hospitalizations for the Uninsured in Illinois Before and After Affordable Care Act Insurance Expansion,” Journal of Community Health 42 no. 3 (June 2017): 591-597, https://link.springer.com/article/10.1007/s10900-016-0293-4↩︎
Gary Pickens et al., “Changes In Hospital Service Demand, Cost, And Patient Illness Severity Following Health Reform,” Health Services Research (May 2019), https://doi.org/10.1111/1475-6773.13165↩︎
Jesse Pines, Rahul Ladhania BTech, Bernard Black , Christopher Corbit, Jestin Carlson, and Arvind Venkat, “Changes in Reimbursement to Emergency Physicians After Medicaid Expansion Under the Patient Protection and Affordable Care Act,” Annals of Emergency Medicine 73, no. 3 (March 2019): 213-224, https://www.sciencedirect.com/science/article/pii/S019606441831374X↩︎
Johanna Maclean and Brendan Saloner, “The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act,” Journal of Policy Analysis and Management 38, no. 2 (2019): 366-393, https://www.ncbi.nlm.nih.gov/pubmed/30882195↩︎
Ramin Mojtabai, Christine Mauro, Melanie Wall, Colleen Barry, and Mark Olfson, “The Affordable Care Act and Opioid Agonist Therapy for Opioid Use Disorder,” Psychiatry Online (April 2019), https://doi.org/10.1176/appi.ps.201900025↩︎
Angelica Meinhofer and Allison Witman, “The Role Of Health Insurance On Treatment For Opioid Use Disorders: Evidence From The Affordable Care Act Medicaid Expansion,” Journal of Health Economics 60 (June 2018): 177-197, https://www.sciencedirect.com/science/article/abs/pii/S0167629617311530↩︎
Brendan Saloner, Sachini Bandara, Emma McGinty, and Colleen Barry, “Justice-Involved Adults With Substance Use Disorders: Coverage Increased but Rates of Treatment Did Not in 2014,” Health Affairs 35 no. 6 (June 2016), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0005↩︎
Mark Clapp et al., “Association of Medicaid Expansion With Coverage and Access to Care for Pregnant Women,” Obstetrics & Gynecology 134, no. 5 (November 2019): 1066-1074, https://doi.org/10.1097/aog.0000000000003501↩︎
Rishi Wadhera et al., “Association of the Affordable Care Act’s Medicaid Expansion With Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure,” Circulation: Cardiovascular Quality and Outcomes 11, no. 7 (June 2018), https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.118.004729↩︎
Emanuel Eguia et al., “The Impact of the Affordable Care Act Medicaid Expansion on Vascular Surgery,” Annals of Vascular Surgery Epub ahead of print (January 2020), https://doi.org/10.1016/j.avsg.2020.01.006↩︎
Donald Likosky, Devraj Sukul, Milan Seth, Chang He, Hitlander Gurm, and Richard Prager, “The Association Between Medicaid Expansion and Cardiovascular Interventions: The Michigan Experience,” Journal of the American College of Cardiology 71, no. 9 (March 2018): 1050-1051, https://www.sciencedirect.com/science/article/pii/S0735109718300056?via%3Dihub↩︎
Ehimare Akhabue, Lindsay Pool, Clyde Yancy, Philip Greenland, and Donald Lloyd-Jones, “Association of State Medicaid Expansion With Rate of Uninsured Hospitalizations for Major Cardiovascular Events, 2009-2014,” JAMA Network Open 1, no. 4 (August 2018), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2698077↩︎
Favel Mondesir et al., “Medicaid Expansion and Hospitalization for Ambulatory Care–Sensitive Conditions Among Nonelderly Adults With Diabetes,” Journal of Ambulatory Care Management epub ahead of print (May 2019), https://insights.ovid.com/pubmed?pmid=31107800↩︎
Cheryl Zogg et al., “Impact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision,” Journal of the American College of Surgeons 228, no. 1 (January 2019): 29-43, https://www.journalacs.org/article/S1072-7515(18)32078-7/fulltext↩︎
Andrew Admon, Michael Sjoding, Sarah Lyon, John Ayanian, Theodore Iwashyna, and Colin Cooke, “Medicaid Expansion and Mechanical Ventilation in Asthma, Chronic Obstructive Pulmonary Disease, and Heart Failure,” Annals of the American Thoracic Society epub ahead of print (February 2019), https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201811-777OC↩︎
John Scott et al., “Lifting the Burden: State Medicaid Expansion Reduces Financial Risk for the Injured,” Journal of Trauma and Acute Care Surgery Epub ahead of print (September 2019), https://doi.org/10.1097/ta.0000000000002493↩︎
Charles A. Daly et al., “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma,” The Journal of Hand Surgery 44, no. 9 (September 2019): 720-727, https://doi.org/10.1016/j.jhsa.2019.05.020↩︎
Neal Bhutiani, Brian Harbrecht, Charles Scoggins, and Matthew Bozeman, “Evaluating The Early Impact Of Medicaid Expansion On Trends In Diagnosis And Treatment Of Benign Gallbladder Disease In Kentucky,” The American Journal of Surgery (January 2019), https://www.americanjournalofsurgery.com/article/S0002-9610(18)30894-8/fulltext↩︎
J.W. Awori Hayanga et al., “Lung Transplantation and Affordable Care Act Medicaid Expansion in the Era of Lung Allocation Score” Transplant International epub ahead of print (February 2019), https://onlinelibrary.wiley.com/doi/pdf/10.1111/tri.13420↩︎
Meera Harhay et al., “Association between Medicaid Expansion under the Affordable Care Act and Preemptive Listings for Kidney Transplantation,” Clinical Journal of the American Society of Nephrology 13 (July 2018), https://cjasn.asnjournals.org/content/13/7/1069↩︎
Meera N. Harhay, Ryan M. McKenna, and Michael O. Harhay, “Association Between Medicaid Expansion Under the Affordable Care Act and Medicaid-Covered Pre-emptive Kidney Transplantation,” Journal of General Internal Medicine 34, no. 11 (November 2019): 2322-2325, https://doi.org/10.1007/s11606-019-05279-x↩︎
Dmitry Tumin et al., “Medicaid Participation among Liver Transplant Candidates after the Affordable Care Act Medicaid Expansion” Journal of the American College of Surgeons 225, no. 2 (August 2017): 173-180.e2, https://www.journalacs.org/article/S1072-7515(17)30454-4/fulltext↩︎
Ramiro Manzano-Nunez et al., “Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery,” World Journal of Surgery 43, no. 6 (June 2019): 1483-1489, https://link.springer.com/article/10.1007/s00268-019-04932-0↩︎
Jordan Rhodes, Thomas Buchmueller, Helen Levy, and Sayeh Nikpay, “Heterogeneous Effects Of The Aca Medicaid Expansion On Hospital Financial Outcomes,” Contemporary Economic Policy epub ahead of print (April 2019), https://onlinelibrary.wiley.com/doi/full/10.1111/coep.12428↩︎
Tyler McClintock, Ye Wang, Mahek Shah, Benjamin Chung, and Steven Chang, “How Have Hospital Pricing Practices for Surgical Episodes of Care Responded to Affordable Care Act-Related Medicaid Expansion?” Urology 125 (March 2019): 79-85, https://doi.org/10.1016/j.urology.2018.10.034↩︎
Charles A. Daly et al., “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma,” The Journal of Hand Surgery 44, no. 9 (September 2019): 720-727, https://doi.org/10.1016/j.jhsa.2019.05.020↩︎
Steven Wallace, Maria-Elena Young, Michael Rodriguez, Amy Bonilla, and Nadereh Pourat, Community Health Centers Play a Critical Role in Caring for the Remaining Uninsured in the Affordable Care Act Era (UCLA Center for Health Policy Research, October 2016), http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/FQHC_PB-oct2016.pdf↩︎
Laurie Felland, Peter Cunningham, Annie Doubleday, and Cannon Warren, Effects of the Affordable Care Act on Safety Net Hospitals (Washington, DC: Mathematica Policy Research, prepared for the Assistant Secretary for Planning and Evaluation, November 2016), https://aspe.hhs.gov/sites/default/files/pdf/255491/SafetyNetHospital.pdf↩︎
Richard Lindrooth, Marcelo Perraillon, Rose Hardy, and Gregory Tung, “Understanding the Relationship Between Medicaid Expansions and Hospital Closures,” Health Affairs epub ahead of print (January 2018), https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0976↩︎
Jordan Rhodes, Thomas Buchmueller, Helen Levy, and Sayeh Nikpay, “Heterogeneous Effects Of The Aca Medicaid Expansion On Hospital Financial Outcomes,” Contemporary Economic Policy epub ahead of print (April 2019), https://onlinelibrary.wiley.com/doi/full/10.1111/coep.12428↩︎
Mark Duggan, Atul Gupta, and Emilie Jackson, The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector (National Bureau of Economic Research, working paper no. 25488, January 2019), https://www.nber.org/papers/w25488.pdf↩︎
Hefei Wen, Kenton J. Johnston, Lindsay Allen, and Teresa M. Waters, “Medicaid Expansion Associated With Reductions In Preventable Hospitalizations,” Health Affairs 38, no. 11 (November 2019): 1845-1849, https://doi.org/10.1377/hlthaff.2019.00483↩︎
Ramiro Manzano-Nunez et al., “Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery,” World Journal of Surgery 43, no. 6 (June 2019): 1483-1489, https://link.springer.com/article/10.1007/s00268-019-04932-0↩︎
Elizabeth A. Brown et al., “The Impact of the ACA Medicaid Expansion on Access to Care and Hospitalization Charges for Lupus Patients,” Arthritis Care & Research Epub ahead of print (September 2019), https://doi.org/10.1002/acr.24080↩︎
Emanuel Eguia et al., “The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Access to Minimally Invasive Surgical Care,” The American Journal of Surgery Epub ahead of print (July 2019), https://doi.org/10.1016/j.amjsurg.2019.07.003↩︎
Gary Young, Stephen Flaherty, E. Zepeda, Simone Singh, and Sara Rosenbaum, “Impact of ACA Medicaid Expansion on Hospitals’ Financial Status” Journal of Healthcare Management 64, no. 2 (March 2019): 91–102, https://insights.ovid.com/crossref?an=00115514-201904000-00007↩︎
John Ayanian, Gabriel Ehrlich, Donald Grimes, and Helen Levy, “Economic Effects of Medicaid Expansion in Michigan,” The New England Journal of Medicine epub ahead of print (January 2017), http://www.nejm.org/doi/full/10.1056/NEJMp1613981↩︎
Renuka Tipirneni et al., “Association of Medicaid Expansion With Enrollee Employment and Student Status in Michigan,” JAMA Network Open 3, no. 1 (January 2020), https://doi.org/10.1001/jamanetworkopen.2019.20316↩︎
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553↩︎
Jean Hall, Adele Shartzer, Noelle Kurth, and Kathleen Thomas, “Medicaid Expansion as an Employment Incentive Program for People With Disabilities,” American Journal of Public Health epub ahead of print (July 2018), https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2018.304536↩︎
Kevin Callison and Paul Sicilian, “Economic Freedom and the Affordable Care Act: Medicaid Expansions and Labor Mobility by Race and Ethnicity,” Public Finance Review 46, no. 2 (March 2018), https://journals.sagepub.com/doi/abs/10.1177/1091142116668254↩︎
The Ohio Department of Medicaid, 2018 Ohio Medicaid Group VIII Assessment: A Follow‐Up to the 2016 Ohio Medicaid Group VIII Assessment, (The Ohio Department of Medicaid, August 2018), https://medicaid.ohio.gov/Portals/0/Resources/Reports/Annual/Group-VIII-Final-Report.pdf
An older version of this Ohio report (see citation below) found that as of 2016, 74.8% of expansion enrollees who were unemployed but looking for work reported that Medicaid enrollment made it easier to seek employment and 52.1% of expansion enrollees who were employed reported that Medicaid enrollment made it easier to continue working.
The Ohio Department of Medicaid, Ohio Medicaid Group VIII Assessment: A Report to the Ohio General Assembly (The Ohio Department of Medicaid, January 2017), https://medicaid.ohio.gov/Portals/0/Resources/Reports/Annual/Group-VIII-Assessment.pdf↩︎
Renuka Tipirneni et al., “Changes in Health and Ability to Work Among Medicaid Expansion Enrollees: a Mixed Methods Study” Journal of General Internal Medicine 34, no. 2 (February 2019): 272-280, https://link.springer.com/article/10.1007/s11606-018-4736-8↩︎
Susan Dorr Goold et al., “Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study,” Journal of General Internal Medicine 33, no. 8 (June 2018): 1307-1316, https://link.springer.com/article/10.1007/s11606-018-4487-6↩︎
Renuka Tipirneni et al., “Association of Expanded Medicaid Coverage With Health and Job-Related Outcomes Among Enrollees With Behavioral Health Disorders,” Psychiatric Services Epub ahead of print (September 2019), https://doi.org/10.1176/appi.ps.201900179↩︎
Heeju Sohn and Stefan Timmermans, “Social Effects of Health Care Reform: Medicaid Expansion under the Affordable Care Act and Changes in Volunteering,” Socius: Socialogical Research for a Dynamic World 3 (March 2017): 1-12, http://journals.sagepub.com/doi/full/10.1177/2378023117700903↩︎
Lizhong Peng, Xiaohui Guo, and Chad D. Meyerhoefer, “The Effects of Medicaid Expansion on Labor Market Outcomes: Evidence from Border Counties,” Health Economics Epub ahead of print (December 2019), https://doi.org/10.1002/hec.3976↩︎
Olga Scrivner et al., “Job Postings in the Substance Use Disorder Treatment Related Sector During the First Five Years of Medicaid Expansion,” PLoS One 15, no. 1 (January 2020), https://doi.org/10.1371/journal.pone.0228394↩︎
Lucie Schmidt, Lara Shore-Sheppard, and Tara Watson, The Impact of the ACA Medicaid Expansion on Disability Program Applications (National Bureau of Economic Research, Working Paper No. 26192, August 2019), http://www.nber.org/papers/w26192↩︎
Thomas C. Buchmueller, Helen G. Levy, and Robert G. Valletta, Medicaid Expansion and the Unemployed (National Bureau of Economic Research, Working Paper No. 26553, December 2019), http://www.nber.org/papers/w26553↩︎
Kevin Callison and Paul Sicilian, “Economic Freedom and the Affordable Care Act: Medicaid Expansions and Labor Mobility by Race and Ethnicity,” Public Finance Review 46, no. 2 (March 2018), https://journals.sagepub.com/doi/abs/10.1177/1091142116668254↩︎
Pauline Leung and Alexandre Mas, Employment Effects of the ACA Medicaid Expansions (Working Paper No. 22540, National Bureau of Economic Research, August 2016), http://www.nber.org/papers/w22540↩︎
Angshuman Gooptu, Asako Moriya, Kosali Simon, and Benjamin Sommers, “Medicaid Expansion Did Not Result in Significant Employment Changes or Job Reductions in 2014,” Health Affairs 35, no. 1 (January 2016): 111-118, 1-12, http://content.healthaffairs.org/content/35/1/111.short↩︎
Robert Kaestner, Bowen Garrett, Anuj Gangopadhyaya, and Caitlyn Fleming, Effects of ACA Medicaid Expansions on Health Insurance Coverage and Labor Supply (Working Paper No. 21836, National Bureau of Economic Research, December 2015), http://www.nber.org/papers/w21836↩︎
Priyanka Anand, Jody Schimmel Hyde, Maggie Colby, and Paul O’Leary, “The Impact of Affordable Care Act Medicaid Expansions on Applications to Federal Disability Programs,” Forum for Health Economics and Policy (February 2019), https://www.ncbi.nlm.nih.gov/pubmed/30796844↩︎
Emily Brown, Michelle Garrison, Hao Bao, Pingping Qu, Carole Jenny, and Ali Rowhani-Rahbar, “Assessment of Rates of Child Maltreatment in States With Medicaid Expansion vs States Without Medicaid Expansion,” JAMA Network Open 2, no. 6 (June 2019), https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2735758↩︎
Michel Boudreaux, James M. Noon, Brett Fried, and Joanne Pascale, “Medicaid Expansion and the Medicaid Undercount in the American Community Survey,” Health Services Research 54, no. 6 (December 2019): 1263-1272, https://doi.org/10.1111/1475-6773.13213↩︎
Daniel Hopkins and Kalind Parish, “The Medicaid Expansion and Attitudes toward the Affordable Care Act: Testing for a Policy Feedback on Mass Opinion,” Public Opinion Quarterly 83, no. 1 (April 2019): 123-134, https://academic.oup.com/poq/article-abstract/83/1/123/5430239↩︎
Poll: Americans Most at Risk for Coronavirus Complications Are No More Likely than Others to Report Taking Precautions or Making Preparations in Response to Pandemic
Low-Income, Hourly and Contract Workers are Most Likely to Worry About Lost Income and Putting Themselves at Risk by Going to Work
In the midst of a sweeping national health and economic crisis sparked by the novel coronavirus pandemic, a new KFF coronavirus poll finds two thirds of the public (67%) say they are taking precautions as a result, and large shares worry about its impact on their family’s health and finances.
This includes four in 10 who changed travel plans (42%) or canceled plans to attend large gatherings (40%), and about a third who stocked up on food or supplies (35%). In addition, a quarter (26%) report staying home from work, school or other regular activities, while one in eight (12%) say they bought or wore a protective mask.
Though older people and those who live in a household where someone has a serious health condition are at greater risk of developing complications if they are infected with coronavirus, they are no more likely to report taking these steps.
KFF will continue to track the public’s views and experiences with the coronavirus as the situation evolves in the coming weeks and months.
“For many workers, the coronavirus pandemic is both a health and economic threat,” KFF President and CEO Drew Altman said. “Many workers – including health care workers – worry they’ll put themselves at risk because they can’t afford not to go to work. Low-wage, hourly and gig workers also have legitimate concerns about losing income as many businesses scale back or shut down.”
Fielded from March 11-15 as many schools closed and authorities moved to discourage or prohibit large public gatherings to slow the virus’ spread, the KFF coronavirus poll provides a snapshot of the public’s experience, knowledge and views during the rapidly unfolding crisis.
The poll finds about half of workers (53%) say they are worried they will lose income due to a workplace closure or reduced hours, and four in 10 (41%) worry that they will put themselves at risk of exposure to coronavirus because they cannot afford to stay home and miss work. Among those who say they or someone in their household works to provide health care services, 40% say they worry about putting themselves at risk.
Work-related worries significantly vary based on people’s work situations. For example, nearly three quarters (73%) of workers in households with annual incomes under $40,000, two-thirds of part-time workers (68%), and six in 10 of those who are paid hourly (60%) or by the job (61%) worry about lost income.
The pattern is similar for worries about risking infection because they can’t afford to miss work. Workers in low-income households and those who work part-time and are paid hourly or by the job are more likely than others to report being worried about putting themselves at risk.
The House on Saturday passed legislation endorsed by President Trump that would expand paid sick leave and family leave for workers affected by the ongoing crisis.
The poll finds about a third (32%) of workers report that they do not get paid sick leave from their employers, and half (51%) do not get paid time off for family or medical leave. Those who work part-time, workers who are paid hourly or by the job, and those with lower incomes are much less likely to report having paid leave of any type.
Overall 10% of workers say they already have lost income from a job or business because of the crisis. This includes roughly at least one in five who are self-employed (23%) or get paid by the job (21%).
About six in 10 (62%) of the public overall worry that they or a family member will get sick from the coronavirus. Parents (68%) and those with low household incomes (68%) are among the groups most likely to worry about a family member getting sick.
Amid a steep drop in the stock market in recent weeks, about half (51%) of the public also says they worry about the crisis’ impact on their retirement and college savings. More than a third (36%), including two-thirds (66%) of adults under age 65 without health insurance, worry about being able to afford tests and treatment for coronavirus if they need it.
Overall, about a third of adults (32%) say that worry and stress related to coronavirus has had a negative impact on their mental health, including 14% who say it has had a “major” impact.
Democrats and Republicans are Reacting to the Crisis Differently
Across many questions, the poll finds significant partisan differences, with Democrats generally more worried about the health and economic consequences and more likely to take specific actions in response.
For example, nearly three-quarters of Democrats (73%) but only half of Republican (50%) worry that they or a family member will get sick. Democrats also are twice as likely as Republicans (54% vs. 27%) to worry about losing income due to workplace closures or reduced hours.
Similarly, Democrats are much more likely than Republicans to say they changed travel plans (53% vs. 29%) or cancelled plans to attend large gatherings (49% vs. 28%).
Public Mostly Knows Key Facts About Coronavirus, But Some Misconceptions Remain
The poll finds overwhelming majorities know that frequent handwashing, staying home if you are sick, and avoiding large gatherings are recommended by public health experts as a way to help slow the spread of coronavirus. The vast majority also know that adults ages 60 or older and those with pre-existing medical conditions are at a higher risk of developing serious complications.
While most adults (73%) know that someone who thinks they are experiencing symptoms of coronavirus should stay home and call a doctor or medical provider, one in four (25%) think that someone experiencing symptoms should seek immediate care at an emergency room or urgent care facility.
Other findings include:
Four in 10 Americans (40%) say their lives have already been disrupted a lot or some by the outbreak, though the disruptions appear to be growing. Half of those surveyed Friday through Sunday say their lives have been disrupted. Two thirds of parents (66%) dealing with school or day care closures say their lives have been disrupted, including about a third (36%) who say their lives have been disrupted “a lot.”
Some Americans are struggling to get needed supplies, including four in 10 (42%) who say they were unable to get cleaning supplies or hand sanitizer. One in five (19%) say they were unable to get groceries (rising to 30% among those who took the survey between March 13-15). A small share (4%) were unable to get prescription medications.
Despite widespread reports of the limited availability of coronavirus testing, two thirds of the public (66%) believe they would be able to get a test if they needed one. Republicans (73%) and independents (67%) are more confident than Democrats (54%) about the availability of a test.
The Centers for Disease Control and Prevention remains the most trusted source for reliable information about coronavirus, with 85% of the public trusting them at least a fair amount. Large majorities also trust local government (70%) and state government (71%) officials, while fewer trust the news media (47%) or President Trump (46%).
Designed and analyzed by public opinion researchers at KFF, the poll was conducted March 11-15, 2020 among a nationally representative random digit dial telephone sample of 1,216. Interviews were conducted in English and Spanish by landline (246) and cell phone (970). The margin of sampling error is plus or minus 3 percentage points for the full sample. For results based on subgroups, the margin of sampling error may be higher.
As a source of coverage for 1 in 5 Americans, Medicaid can play a key role in connecting individuals to testing and treatment for COVID-19. Through Medicaid, states can provide enrollees access to comprehensive benefits with limited out-of-pocket cost and receive federal funding with no pre-set limit to support coverage. States have options available under existing rules to expand access to coverage and facilitate enrollment in coverage for eligible individuals. Further, states can seek federal approval for additional flexibility to expedite access to coverage and care, as has occurred in response to previous disasters and emergencies. Moreover, the federal government could take a range of administrative and legislative actions to enhance state capacity to connect individuals to care through Medicaid.
This brief describes a range of steps states and the federal government could take to use Medicaid to expand coverage and access to care in the context of responding to COVID-19 as a public health crisis. The Appendix lists specific examples of Medicaid authorities available to states in emergencies. The strategies included here are not an exhaustive list of options, and, as with any such efforts, they could involve tradeoffs and may run counter to efforts by the Trump administration and some states to restrict eligibility, limit government spending, promote program integrity, and curb immigrant use of public programs. The Medicaid and CHIP Disaster Preparedness Toolkit for state agencies also specifies strategies states can implement to respond to emergencies and disasters. Moreover, on March 12, 2020, the Centers for Medicare and Medicaid Services (CMS) posted Frequently Asked Questions (FAQs) to aid state Medicaid and Children’s Health Insurance Program agencies in their response to the COVID-19 outbreak.
Medicaid’s existing coverage and financing structure enables states to provide access to comprehensive care.
Broad source of coverage for the low-income population. As the nation’s public health insurance program for people with low income, Medicaid can be a primary vehicle through which states can connect individuals to testing and treatment for COVID-19, particularly those with significant health needs who are at high risk for experiencing complications from the virus. While most adults on Medicaid are working, the vast majority of enrollees lack access to other affordable health insurance. Medicaid plays a particularly significant role for populations with complex health needs, covering 47% of children with special health care needs, 45% of nonelderly adults with disabilities, and more than six in ten nursing home residents. Unlike other types of insurance, there are no set open enrollment periods for Medicaid, meaning that people can enroll at any time they become eligible, for example, if they experience a decrease in income due to a decline in the economy. Moreover, under law, the program provides retroactive coverage for covered services incurred up to three months prior to an enrollee’s application date if the individual would have been eligible at the time they received the service.
Comprehensive benefits. Through Medicaid, states can provide enrollees access to a broad array of services to address testing and treatment needs. States determine their Medicaid benefit package within a set of federal minimum standards and state options. All states offer at least some optional benefits, including prescription drugs. States can choose to add optional services to expand the scope of covered services to address emerging health needs. For example, in recent years, states have added an array of behavioral health and substance use disorder treatment services to address the opioid crisis. In its FAQs, CMS notes that states could expand coverage for telehealth and other services to provide care for individuals who are quarantined or self-isolated. For children, the federal minimum Medicaid benefit package offers access to all necessary services (regardless of whether these services are optional for adults) through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, which includes regular screenings, vision, dental, and hearing services and any other medically necessary care. For adults, minimum benefits include physician, inpatient and outpatient hospital, as well as laboratory services. In its FAQs, CMS clarifies that testing for COVID-19 is covered as mandatory laboratory service as long as it is provided in an office or similar facility other than a hospital outpatient department or clinic and furnished by a lab meeting specified standards. It further notes that tests that do not meet these criteria may still be covered under the optional diagnostic benefit.
No or limited out-of-pocket costs. Medicaid provides enrollees access to services with no or limited out of pocket costs. Federal rules do not require states to charge any premiums or cost sharing for Medicaid, and limit the amounts that state can charge given enrollees’ limited ability to pay out of pocket costs. As of January 2019, only two states charged copayments for children in Medicaid, but most states charged cost sharing for parents and other adults. Some states have indicated that they are waiving cost sharing associated with COVID-19 testing and/or treatment.1 States could also broadly eliminate cost sharing for categories of services or eligibility groups. In public statements, federal officials have indicated insurance companies who provide coverage through Medicaid have agreed to cover all COVID-19 testing without cost sharing and to ensure treatment is full covered. However, to date, there is no official guidance on how these policies will be implemented or documenting insurers’ agreement to this statement.
Financing structure. Medicaid provides states a guarantee of federal matching payments for covered benefits provided to enrollees with no pre-set limit. The statute sets a formula to determine the share paid by the federal government (that varies based on states’ relative per capita income). Special enhanced match rates also are provided for the ACA Medicaid expansion, administration, and other services. This matching structure provides states with resources that automatically adjust for demographic and economic shifts, health care costs, public health emergencies, natural disasters and changing state priorities. As such, federal resources will automatically increase if demands for the program grow in response to COVID-19, for example, if enrollment increases due to income decreases amid an economic decline and/or if additional eligible individuals enroll in the program to access services. Medicaid also provides “disproportionate share hospital” (DSH) payments to hospitals serving many Medicaid and uninsured patients.
States can expand Medicaid eligibility to broaden access to care.
Medicaid expansion. To date, 37 states, including DC, have adopted the ACA Medicaid expansion to adults with incomes up to 138% FPL. In the remaining 14 non-expansion states, eligibility levels for parents remain very low, often below half of poverty, and, with the exception of Wisconsin, other adults are not eligible regardless of their incomes. In these non-expansion states, 2.3 million poor uninsured adults fall into a “coverage gap”, with incomes above Medicaid eligibility limits but below the 100% FPL level at which Marketplace premium tax credits become available. Non-expansion states could significantly expand access to care for low-income adults by implementing the expansion and would receive enhanced federal matching dollars (currently at 90%) for this coverage. A substantial body of research shows that the ACA Medicaid expansion has expanded coverage, increased access to care and utilization, and improved various economic measures.
Optional eligibility expansions. Beyond the ACA Medicaid expansion to low-income adults, states have options available under federal rules to increase Medicaid eligibility above the federal minimum income limit of 138% FPL, at regular state match. For example, nearly all states (49) cover children with incomes up to at least 200% FPL through Medicaid and CHIP as of January 2019, including 19 states that cover children at or above 300% FPL. Similarly, the majority of states (47) extend eligibility to pregnant women beyond the federal minimum, including nearly half (22) who extend eligibility to above 200% FPL.
Optional coverage for legal immigrant children and pregnant women. Lawfully residing immigrants may qualify for Medicaid and CHIP but are subject to eligibility restrictions that require many to wait five years before they can enroll. States have an option to eliminate the five-year wait for lawfully residing immigrant children and pregnant women. Over half of states had adopted this option for children or pregnant women in Medicaid and/or CHIP. States also have the option to provide prenatal care to women regardless of immigration status by extending CHIP coverage to the unborn child, which 16 states had taken up as of January 2019.
Waivers of eligibility provisions. Currently, a number of states have received approval for and implemented waivers that allow them to operate their programs in way federal rules do not otherwise allow, for example, by charging premiums, imposing coverage lockouts periods, and/or not providing retroactive coverage. Given that such policies may restrict enrollment and access to care, states could suspend these waivers to facilitate access to services to address increased needs arising from COVID-19.
States can conduct outreach and adopt policy options to help get and keep eligible people enrolled in coverage.
Outreach and enrollment assistance. Nationwide, nearly a quarter (24%) of the 27.9 million nonelderly individuals who were uninsured as of 2018 were eligible for Medicaid or CHIP coverage but not enrolled. Previous state experience has illustrated that states can promote enrollment of eligible individuals through a combination of broad mass media outreach campaigns to raise awareness of coverage options as well as targeted local efforts, often in collaboration with community based organizations and/or safety-net providers, to provide direct enrollment assistance.
Presumptive eligibility and eligibility verification. Presumptive eligibility allows states to expedite connections to coverage by authorizing certain qualified entities, like community health centers or schools, to enroll individuals who appear likely eligible for coverage while the state processes the full application. Prior to the ACA, states could utilize this option for children and pregnant women. The ACA allowed states to adopt this option for other eligibility groups. The ACA also required states to allow hospitals to conduct presumptive eligibility determinations regardless of whether the state had otherwise adopted the policy. While most states have adopted this option for pregnant women and children, only a few currently utilize it for parents and other adults. In addition, under existing rules, states can allow for self-attestation for all eligibility criteria, excluding citizenship and immigration status, including on a case-by-case for individuals subject to a disaster when documentation is not available.
12-month continuous eligibility for children. States who elect to use this option can allow a child to remain enrolled for a full year unless the child ages out of coverage, moves out of state, voluntarily withdraws, or does not make premium payments. As such, 12-month continuous eligibility eliminates coverage gaps due to fluctuations in income over the course of the year, promoting stable and continuous access to care. As of January 2019, 32 states provide 12-month continuous eligibility to children in either Medicaid or CHIP. States do not have an option under federal rules to extend 12-month continuous eligibility to groups other than children, but two states (New York and Montana) have obtained waivers to provide 12-month continuous eligibility to adults.
Suspend or delay renewals. Under federal rules, states renew coverage every twelve months. States have existing authority to extend redetermination timelines for current enrollees subject to a disaster to maintain continuity of coverage. Some states have previously delayed or suspended renewals through 1115 waivers in response to emergencies. Moreover, CMS allowed states to delay or suspend renewals as a mitigation strategy when states were implementing the ACA and addressing system challenges and processing a large number of new enrollments under the Medicaid expansion.
Suspend periodic data checks between renewals. Between annual renewal periods, enrollees are required to report changes in circumstances that may affect eligibility, and states may conduct periodic electronic data matches to identify potential changes in circumstances. If a state identifies a change that may affect eligibility, it may request information or documentation from the individual to continue coverage. If the individual does not respond to a request within the required timeframe, the state will disenroll the individual from coverage. Recent reports suggest that these periodic data checks may be leading to coverage losses among eligible individuals because they do not receive or are not able to respond to information requests within required timeframes, which are limited to 10 days in many states conducting these checks. As such, suspending these data checks could help keep enrollees connected to coverage.
States can seek federal approval for additional flexibility to connect people to coverage and care.
Section 1135 waivers. If the President has declared an emergency or disaster and the Secretary of Health and Human Services (HHS) has declared a public health emergency, the Secretary can use Section 1135 authority to waive or modify certain Medicare, Medicaid, and CHIP requirements to ensure that sufficient health care items and services are available to meet the needs of Medicaid enrollees in affected areas. Examples of items that can be waived through Section 1135 authority include: conditions of participation or other certification requirements for providers; program participation and preapproval requirements for providers; requirements that physicians and other health care professionals be licensed in the state in which they are providing services (as long as they have equivalent licensing in another state for Medicare, Medicaid, and CHIP reimbursement only); and the Emergency Medical Treatment and Labor Act. The Secretary used Section 1135 to provide hurricane relief to a number of areas affected by storms during 2017. On March 13, President Trump issued a proclamation that the COVID-19 outbreak in the United States constitutes a national emergency, beginning March 1, 2020. With this declaration, the administration announced steps to take to address COVID-19 through 1135 waivers.
Section 1115 waivers. Section 1115 waiver authority allows the Secretary of HHS to test new approaches in Medicaid not otherwise allowed under current law, provided the demonstrations meet the objectives of the program. During past emergencies, states obtained Section 1115 waivers to expedite access to coverage and health care services for affected individuals. These included waivers to: expand coverage to individuals not otherwise eligible (including adults who were not eligible for Medicaid prior the ACA), streamline application and eligibility verification processes, temporarily suspend or delay renewals for existing enrollees, waive cost sharing and/or expand benefits for targeted population groups, and address needs for individuals within specific geographic areas of a state. For example:
Approximately 350,000 New Yorkers were covered by Disaster Relief Medicaid in a four-month time period following the September 11th attacks in 2001. DRM allowed for a simplified expedited application process, expanded income eligibility guidelines and adjusted immigrant eligibility rules to make more New Yorkers eligible for coverage in the immediate aftermath of the disaster. It also temporarily suspended annual renewals for many existing enrollees.
Following Hurricane Katrina, the Department of HHS released a waiver initiative to assist states in providing temporary coverage to certain groups of evacuees. Under these waivers, states could get expedited approval to provide up to five months of Medicaid or CHIP coverage to certain evacuees and receive authorization for an “uncompensated care pool” to reimburse providers for the costs of furnishing services to uninsured evacuees and services not otherwise covered under Medicaid or CHIP (including mental health counseling). Similar to Disaster Relief Medicaid in New York, these waivers also streamlined eligibility verification criteria for the temporary coverage period.
In 2016, Michigan received a waiver to expand Medicaid and CHIP eligibility for children and pregnant women affected by the Flint water crises and to waive cost sharing and premiums and expand targeted case management benefits and community support services for these enrollees.
Following Hurricane Harvey in 2017, Texas received approval to allow individuals in the affected service area to receive services beyond their renewal period, suspended certain eligibility verification requirements, and eliminated cost sharing for the waiver period.
The federal government could take action to enhance state capacity to provide access to care through Medicaid.
Administrative Options
Provide guidance and/or a template to facilitate state adoption of policy options. CMS posted a national fact sheet outlining coverage and benefits related to COVID-19 and posted the FAQs to aid states in determining steps they can take to enhance their response. CMS also could issue guidance and/or state plan amendment and waiver templates to facilitate states’ implementation of options to enhance access to coverage and care. For example, in 2016, CMS put out an informational bulletin with information related to optional Medicaid benefits states could adopt to help address the Zika virus. In addition, CMS recently issued a waiver template to encourage states to take up options tied to the new Healthy Adult Opportunity demonstrations.
Suspend pending regulations that would limit financing. CMS is currently reviewing comments related to the Medicaid Fiscal Accountability Rule. The rule would make changes to what funding states can use for the state share of Medicaid funding and to supplemental payments to providers. The changes could have significant implications for providers and state budgets. While the rule could reduce federal spending on Medicaid, it also creates significant uncertainty for states as they work to address COVID-19.
Suspend administrative actions focused on increasing eligibility verification requirements. As part of program integrity efforts, the Trump Administration has recently increased its focus on oversight of eligibility determinations. It has indicated plans to conduct new audits of state beneficiary eligibility determinations, promoted the use of periodic data matches between renewals, and indicated plans to issue regulatory changes to increase requirements around verification, monitoring of changes in beneficiary circumstances, and eligibility redeterminations. While current and planned administrative efforts might limit instances of ineligible people being enrolled in the program, they could also result in greater enrollment barriers and coverage losses for people who are eligible and add additional administrative burden for state agencies at a time when expediting enrollment in coverage for eligible individuals would help connect them to testing and treatment.
Suspend immigration policies that may be deterring immigrant families from enrolling in coverage and seeking care. Over the past several years, the Trump Administration has implemented a range of immigration policies focusing on restricting immigration, enhancing immigration enforcement, and restricting access to public programs, including Medicaid, for immigrant families. These include recent changes to public charge policies that newly take into account use of Medicaid by non-pregnant adults as part of the public charge test federal officials use to determine whether to grant certain individuals entry into the U.S. or adjustment to legal permanent resident (LPR) status (i.e., receive a green card). A growing set of evidence suggests that families have increased fears of enrolling themselves and their children, who are primarily U.S. citizens, in Medicaid and CHIP due to these policy changes and that some may be avoiding seeking care. The administration could take steps to alleviate these fears by suspending the changes to public charge policies. They also could take steps to assure families that they will not use any information shared to enroll in coverage for immigration enforcement purposes and that enrolling in coverage and/or seeking care will not have negative effects on their immigration status. U.S. Citizenship and Immigration Services issued an alert in March 2019, encouraging all individuals with symptoms that resemble COVID-19 to seek necessary medical treatment or preventive services and noted that such treatment or services will not negatively affect future public charge tests.2
Legislative Options
Enhance federal financing. During economic downturns, more people qualify and enroll in Medicaid, increasing program spending at the same time that state tax revenues may be stagnating or falling. To mitigate these budget pressures, Congress has twice passed temporary increases in the federal match rate to help support states during economic downturns, most recently in 2009 as part of the American Recovery and Reinvestment Act (ARRA). To receive ARRA funds, states could not roll back Medicaid eligibility. These temporary increases in the Medicaid match rate provided states fiscal capacity to address health issues for vulnerable populations through an existing, efficient mechanism. Congress could use such a mechanism to provide additional fiscal capacity for states. In addition, as providers will likely serve individuals who are uninsured or underinsured, Congress could increase funding for Medicaid disproportionate share hospital (DSH) to help reimburse hospitals for increased uncompensated care costs.
Increase access to coverage for lawfully present immigrants. As noted, lawfully residing immigrants may qualify for Medicaid and CHIP but are subject to eligibility restrictions that subject many to a five-year waiting period before they may enroll in coverage. These eligibility restrictions have been in place since 1996 under the Personal Responsibility and Work Opportunity Act. The CHIP Reauthorization Act of 2009 provided states the option to cover lawfully residing immigrant pregnant women and children without a five-year waiting period, but not other groups. Congress could enact legislation to extend this option to parents and other adults.
Families First Coronavirus Response Act. Legislation enacted on March 19, 2020 will provide coverage for COVID-19 testing with no cost sharing under Medicaid and CHIP (as well as other insurers) and provide 100% federal funding through Medicaid for testing provided to uninsured individuals for the duration of the emergency period associated with COVID-19. The law will also provide states and territories a temporary 6.2 percentage point increase in the federal matching rate for the emergency period. To receive this increase, states will need to meet certain requirements including: not implementing more restrictive eligibility standards or higher premiums than those in place as of January 1, 2020; providing continuous eligibility for enrollees through the end of the month of the emergency period unless an individual asks to be disenrolled or ceases to be a state resident; and not charging any cost sharing for any testing services or treatments for COVID-19, including vaccines, specialized equipment or therapies. The law will also increase federal allotments to the territories.
Appendix
Table 1: Medicaid Authorities Available in Emergencies
Allowed by Existing Regulations
Allow self-attestation to verify eligibility for all criteria except citizenship and immigration status on a case-by-case basis; verify assets if financial institution unable to verify due to disaster; verify incurred medical expenses for spend down eligibility
Extend renewal timeframes
Exempt enrollees from premiums
Temporarily suspend periodic data checks on case-by-case basis
Temporarily delay acting on certain changes in circumstances affecting eligibility
Reinstate services or eligibility if discontinued because whereabouts unknown due to evacuation, after whereabouts become known and if still eligible
Consider people evacuated from state as temporarily absent to maintain enrollment
Treat Federally facilitated Marketplace assessments as eligibility determinations or fully delegate eligibility determination authority to Federally facilitated Marketplace
Expand application processing times
Suspend adverse actions for those in disaster area where state has completed determination but has not yet sent notice or state believes notice likely not received
Temporarily increase HCBS waiver service payment rates if no change to rate methodology and no impact on cost neutrality
Amended/Updated Verification Plan – No CMS Approval Required
Accept self-attestation and conduct post-enrollment verification for eligibility criteria other than citizenship and immigration status (beyond case-by-case basis)
Adopt or increase reasonable compatibility thresholds for income inconsistencies
Allow reasonable explanation of inconsistencies in lieu of paper documentation
Temporarily suspend periodic data checks (beyond case-by-case basis)
State Plan Amendment – Can be Retroactive to 1st Day of Quarter
Cover non-residents or state-defined subset of non-residents such as those living temporarily in state due to disaster in home state
Apply host state’s asset limit, or if less restrictive, asset limit from state where individual evacuated (if statewide rule)
Enrollment & Renewal:
Adopt or extend presumptive eligibility for certain populations
Extend hospital presumptive eligibility to non-MAGI groups
Establish state as presumptive eligibility qualified entity to enroll individuals based on preliminary application information
Provide 12-month continuous eligibility for children
Develop simplified paper application for affected areas
Extend reasonable opportunity period to provide documentation for immigration status
Benefits:
Temporarily modify copayment requirements to support access to services (if rule applies statewide)
Offer additional benefits (if comparable for all categorically needy groups and statewide with free choice of provider, or via alternative benefit plan with free choice of provider)
Change amount, duration, or scope of covered benefits
Amend payment methodology to account for increased cost of personal protective equipment for home care workers
Health Plan Contract/Oversight
Temporarily suspend out of network requirements for managed care enrollees
Require health plans to expedite processing of new prior authorization requests and allow flexibility in documentation (e.g., physician signature)
Section 1115 Waiver – state is deemed to meet budget neutrality if federally declared disaster, waiver can be retroactive to date of Secretary-declared public health emergency, exemptions from public notice in emergencies
Coverage:
Increase eligibility limits for specific categories in specific geographic regions
Enrollment & Renewal:
Provide 12-month continuous eligibility for adults or for a subset of children
Allow self-attestation for citizenship and immigration status if unable to verify by data sources and individual unable to document due to disaster
Benefits:
Provide benefits to targeted group of enrollees impacted by disaster
Temporarily modify copayment requirements to support access to services (less than statewide)
Authorize off-island coverage for those in territories eligible for FEMA transitional shelter assistance who are temporarily relocated to a state
Long-Term Services and Supports:
Temporarily suspend requirement to be institutionalized at least 30 days and have income below 300% SSI to be eligible for special income group
Temporarily suspend asset transfer rules for those placed in nursing homes
Apply host state’s asset limit, or if less restrictive, asset limit from state where individual evacuated (if less than statewide)
Do not reduce institutional provider payments by post-eligibility treatment of income
Section 1135 Waiver – if President declares national emergency and HHS Secretary declares public health emergency
Benefits:
Temporarily suspend fee-for-service prior authorization requirements and/or require providers to extend prior authorization through the termination of emergency declaration
Covered Providers:
Temporarily waive requirements for out-of-state providers to be licensed in state where they are providing services if provider is licensed by another state Medicaid agency or Medicare
Temporarily waive provider screening requirements, such as application fees, criminal background checks, and site visits, to ensure sufficient number of providers
Temporarily cease revalidation of providers in state or who are otherwise directly impacted by disaster
Temporarily suspend pending enforcement or termination actions or payment denial sanction to specific provider
Allow facilities to provide services in alternative settings such as temporary shelters when provider facility is inaccessible
Provide nursing home care to evacuees in host state for less than 30 days if individual is Medicaid-eligible in home state
Temporarily suspend pre-admission screening and annual resident review assessments for 30 days
Extend minimum data set authorizations for nursing home and skilled nursing facility residents
Temporarily suspend requirement that home health agency aides be supervised for 2 weeks by registered nurse
Temporarily suspend requirement that hospice aides be supervised by registered nurse every 14 days
Modify or suspend certain state survey agency activities
Appeals:
Allow direct access to fair hearing without first exhausting managed care appeal
Extend timeframes for individuals to request managed care appeals or state fair hearings
Section 1915 (c) Home and Community-based Services Waiver Appendix K – can be submitted before or during emergency, can be retroactive to date of event
Eligibility:
Increase number of unduplicated waiver enrollees
Temporarily increase individual cost limit to assure health and welfare
Modify eligibility targeting criteria to serve more enrollees and forestall institutionalization in emergency
Extend level of care authorizations for 12 months
Benefits:
Add covered services not expressly authorized in statute if necessary to assist waiver enrollees to avoid institutionalization
Modify scope of covered services and temporarily exceed individual service limits to ensure health and welfare
Institute or expand self-direction
Temporarily suspend prior authorization and extend medical necessity authorizations
Modify person-centered planning process, including qualifications of individuals required to develop plan
Providers:
Temporarily increase payment rates with a temporary change in rate methodology and/or impact on cost neutrality
Amend payment methodology to account for increased cost of personal protective equipment for home care workers
Allow payment for services provided by family caregivers or legally responsible relatives
Temporarily modify provider types, qualifications, and licensure or other setting requirements
Include retainer payments to personal care assistants when waiver enrollee is hospitalized or absent from home up to 30 days
Expand covered settings to include out-of-state
Temporarily allow payment for waiver services up to 30 days to support enrollees in acute care hospital or short-term institutional stay when services are required for communication and behavioral stabilization and not provided by institution
In the midst of the largest health crisis to hit the United States and the world in the current era, a new KFF poll finds that many U.S. residents have faced disruptions in their lives from the coronavirus pandemic, and large shares are worried about their own risk as well as the economic consequences. This is an incredibly fast-moving crisis, with guidance and policy decisions changing daily. The new survey finds major differences from the KFF February Health Tracking Poll, and even in the span of the 5-day period in which the new survey was fielded, there were changes in the public’s levels of concern and reported behaviors. KFF will continue tracking the public’s attitudes and experiences in the coming weeks and months as the crisis evolves.
Key findings:
Four in ten say their life has been disrupted “a lot” or “some” as a result of the coronavirus outbreak, and many worry that they or someone in their family will get sick (62%), that their retirement or college savings will be negatively impacted (51%), or that they won’t be able to afford testing or treatment for coronavirus if they need it (36%).
Among workers, about half (53%) are worried they will lose income due to a workplace closure or reduced hours, and four in ten (41%) worry they will put themselves at risk of coronavirus exposure because they can’t afford to stay home from work. These worries are particularly prevalent among workers in lower-income households (earning less than $40,000 a year), part-time workers, and hourly wage-earners, many of whom say their employer does not offer them paid sick leave or paid time off to care for a sick family member.
Parents of children under age 18 are disproportionately worried about someone in their family getting sick, and disproportionately likely to say their lives have been disrupted by the outbreak. Among parents facing school or daycare closures, two-thirds (66%) say their life has been disrupted. Lower-income parents and those who work non-salaried jobs are the most likely to say it would be difficult to find alternative childcare in the event of a school closure.
The survey was in the field as social distancing measures were being put in place across the country, and many adults report taking measures like changing or canceling travel (42%), canceling plans to attend large gatherings (40%), stocking up on food, supplies and medications (35%), staying home instead of going to work or other regular activities (26%), and buying or wearing a protective mask (12%). Although older adults and those with serious health conditions are at greater risk from serious complications if infected with coronavirus, these groups are not more likely than the general public to report taking these types of precautions.
Large shares of the public are aware of basic facts about the symptoms of coronavirus infection, as well as methods of transmission and recommended ways to slow the spread of the disease. While most also recognize that someone who thinks they are experiencing symptoms of coronavirus infection should stay and home and call a medical provider, one-quarter think they should seek care immediately at an emergency room or urgent care facility, rising to about four in ten (38%) among those with lower incomes.
Large shares trust the U.S. Centers for Disease Control and Prevention and the World Health Organization to provide reliable information about coronavirus. About half (46%) trust President Trump, with sharp divides along partisan lines. Partisans are also divided on other attitudes and behaviors, with larger shares of Democrats than Republicans expressing worry, saying their lives have been disrupted, and to report taking various precautionary measures.
Precautions and Preparations
many report taking various measures to prepare FOR or protect against coronavirus, with few differences across age and health status but large partisan differences
About two-thirds of people report taking some type of precaution or making some type of preparation in reaction to the coronavirus outbreak. Most commonly, 42% say they decided not to travel or changed travel plans (up from 13% in the February KFF Health Tracking Poll), 40% say they canceled plans to attend large gatherings, and 35% say they stocked up on items like food, household supplies, or medications. One quarter (26%) say they stayed home instead of going to work, school, or other activities. Twelve percent say they bought or wore a protective mask, which is currently recommended only for those who are sick.
Figure 1: Many Report Various Measures In Reaction To Coronavirus Outbreak
The survey was in the field over a period of five days (March 11-15), during which social distancing measures were being put into place across the country. Some of these precautions were more commonly reported among those who took the survey later in the field period. For example, among those who took the survey between March 13-15, 49% say they canceled plans to attend large gatherings, 47% say they changed travel plans, and 33% say they stayed home instead of going to work or regular activities.
Some people report being unable to get different types of supplies as a result of the outbreak, including about four in ten (42%) who say they were unable to get cleaning supplies or hand sanitizer, 19% who were unable to get groceries (rising to 30% among those who took the survey between March 13-15), and 4% who were unable to get prescription medications.
Figure 2: Many Report Being Unable To Get Supplies Due To Coronavirus
Older people and those who live in a household where someone has a serious health condition are not more likely than other groups to report taking various precautions, even though they are among the groups most at risk of developing serious complications if infected with coronavirus1 .
Instead, there is a large partisan difference in the share who report taking precautions, with Democrats more likely than Republicans to say they changed travel plans (53% vs. 29%) or canceled plans to attend large gatherings (49% vs. 28%). Overall, eight in ten Democrats and about half of Republicans (53%) report taking at least one of these precautions.
Figure 3: Similar Shares Report Taking Precautions Regardless Of Age Or Chronic Condition Status In HouseholdFigure 4: Democrats More Likely Than Republicans To Report Taking Coronavirus Precautions
Despite widespread reports of the limited availability of testing for coronavirus, two-thirds of adults think they would be able to get a test if they needed one. Just over half of Democrats (53%) think they would be able to get a test if needed, compared to about two-thirds of independents (65%) and nearly three-fourths of Republicans (73%).
Figure 5: About Half Of Democrats Think They Would Be Able To Get Test For Coronavirus, Compared To Three In Four Republicans
Experiences and Worries
FOUR in ten say their life has been disrupted by the outbreak
Overall, 40% of the public says their life has been disrupted at least “some” by the coronavirus outbreak, including 16% who say it has been disrupted “a lot.” Among those answering the survey between March 13-15, half (50%) say their life was disrupted, including 22% who said it was disrupted “a lot.” Those most likely to say their life was disrupted include Hispanics (50%), women (46%), and parents of children under age 18 (45%).
Figure 6: Women, Parents, Hispanic Adults Most Likely To Report Life Disruption From Coronavirus
There is also a partisan difference in the share reporting life disruption from the coronavirus, with about half of Democrats (49%) compared to three in ten Republicans (30%) saying their lives have been disrupted “a lot” or “some.”
Table 1: Self-Reported Life Disruption from Coronavirus by Party Identification
How much, if at all, has your life been disrupted by the coronavirus outbreak?
Party ID
Total
Democrats
Independents
Republicans
A lot/Some (NET)
40%
49%
40%
30%
A lot
16%
18%
17%
14%
Some
24%
31%
24%
17%
Just a little/None (NET)
59%
51%
60%
70%
Just a little
29%
29%
27%
31%
None
31%
22%
32%
39%
BIGGEST PERSONAL WORRY IS ABOUT A FAMILY MEMBER GETTING SICK, with large shares also worrying about lost income or savings
Large shares of the public report being worried about various potential impacts of coronavirus in their own lives. Most commonly, 62% say they are “very” or “somewhat” worried that they or a family member will get sick from coronavirus. About half also express financial worries, including that their investment savings will be negatively impacted (51%, rising to 61% among those with annual incomes over $90,000) or that they’ll lose income due to a workplace closure or reduced hours (46%). Just over a third (36%) worry they won’t be able to afford testing or treatment for coronavirus if they need it, including 64% of Hispanics and 66% of adults ages 18-64 without health insurance. A similar share (35%) of adults overall worry they will put themselves at risk of exposure to coronavirus because they can’t afford to stay home and miss work.
Figure 7: Personal Worries About Coronavirus Include Family Member Getting Sick, Various Economic Impacts
There are large partisan difference in worries about the coronavirus. Nearly three-quarters of Democrats (73%) say they are “very” or “somewhat” worried that they or someone in their family will get sick from the virus, compared with half of Republicans. Democrats are also much more likely than Republicans to worry about loss of job-related income (54% vs. 27%), being unable to afford coronavirus testing or treatment (46% vs. 16%), and putting themselves at risk of exposure because they can’t afford to miss work (43% vs. 20%).
Figure 8: Democrats More Likely Than Republicans To Worry About Negative Consequences Of Coronavirus
Parents of children under age 18 (68%) are more likely than others to say they’re worried that someone in their family will get sick from coronavirus, as are Hispanics (83%) and those with incomes under $40,000 (68%).
Adults under age 60 are only slightly more likely than those ages 60 and older to worry about themselves or a family member getting sick (65% vs. 56%). Although those with serious health conditions are at higher risk for complications of coronavirus, those who have a chronic condition themselves of live in a household with someone who does are not significantly more likely to worry about themselves or a family member getting sick compared to those who say no one in their household has such a condition (65% vs. 61%).
Figure 9: Parents, Hispanic Adults, And Those With Lower Incomes More Likely To Worry About Family Member Getting Sick
These worries are taking a toll for some. About a third of adults overall (32%) feel that worry and stress related to coronavirus has had a negative impact on their mental health, including 14% who say it has had a “major” impact.
Figure 10: One-Third Report Feeling Negative Mental Health Effects From Worry About Coronavirus
LOW-INCOME, HOURLY, AND PART-TIME WORKERS ARE PARTICULARLY WORRIED, AND PARTICULARLY VULNERABLE TO ECONOMIC CONSEQUENCES
Work-related worries vary by people’s employment status. About half (53%) of those who are employed say they are very or somewhat worried that they will lose income due to a workplace closure or reduced hours because of coronavirus, rising to 73% of workers with household incomes less than $40,000, 68% of those who work part-time, 61% of those who are payed by the job, 60% of those who are paid by the hour, and 60% of those who are self-employed.
Four in ten workers (41%) express worry that they will put themselves at risk of exposure to coronavirus because they can’t afford to stay home and miss work, a worry that is highest among lower-income workers (60%), part-time workers (49%), and those paid by the hour (46%) or by the job (43%). Among those who say they or someone in their household works in a health care delivery setting, a group at higher risk for coronavirus exposure, 40% say they worry about putting themselves at risk because they can’t afford not to work.
Table 2: Employment-Related Worries Related to Coronavirus
Percent who are very or somewhat worried that they will…
Hours
Compensation
Household income
Employer
Total employed
Full-time
Part-time
Salary
Hourly
By the job
<$40K
$40 to <$90K
$90K+
Self-employed
Work for someone else
Lose income due to a workplace closure or reduced hours because of coronavirus
53%
50%
68%
38%
60%
61%
73%
52%
41%
60%
52%
Put themselves at risk of exposure to coronavirus because they can’t afford to and miss work
41%
39%
49%
30%
46%
43%
60%
38%
28%
37%
42%
One in ten employed adults report that they have already lost income from a job or business because of coronavirus. This share rises to about one-quarter (23%) among those who are self-employed, 21% of those who are paid by the job, and 18% of part-time workers.
Figure 11: One In Ten Workers Report Lost Income From Work Or Business, Including One-Quarter Of Self-Employed And Contract Workers
As social distancing measures have been put in place across the country, many employers have asked or required all or part of their workforce to work from home. About half of those who are employed (45%) say they can do at least part of their job from home, but the share is much lower among lower-income workers (29%), part-time workers (32%), hourly workers (25%).
Most workers overall (64%) say their employer offers them paid time off if they are sick or ill, and about four in ten (43%) say their employer offers them paid time off to care for an ill family member. This leaves about one-third (32%) who say they do not get paid sick leave and about half (51%) who say they do not get paid family leave.
Those who work part-time, workers who are paid hourly or by the job, and those with lower incomes are much less likely to report having paid leave of any type. A recent KFF analysis provides more detail on how paid leave policies vary by state, average wage level, and employer size and discusses the implications for workers.
Table 3: Remote Work and Paid Leave
Among those who are employed
Total employed
Hours
Compensation
Household income
Full-time
Part-time
Salary
Hourly
By the job
<$40K
$40 to <$90K
$90K+
Percent who say if required to remain at home because of a quarantine or school or work closure, they could do at least part of their job from home
45%
48%
32%
79%
25%
47%
29%
42%
63%
Percent whose employer offers them paid time off if they are sick or ill
64%
70%
38%
86%
61%
25%
51%
69%
70%
Percent whose employer offers them paid time off to care for a family member who is sick or ill
43%
48%
18%
66%
36%
17%
31%
42%
56%
PARENTS FACING SCHOOL CLOSURES ARE PARTICULARLY LIKELY TO SAY THEIR LIVES HAVE BEEN DISRUPTED
Among parents of children under age 18, nearly half (45%) say their lives have been disrupted at least “some” by the coronavirus outbreak. Among those who say their child’s school or daycare has closed as a result of the outbreak, two-thirds (66%) say their lives have been disrupted, including 36% who say they’ve been disrupted “a lot.” About a third of parents (36%) in the survey overall say their child’s school or daycare has closed for some amount of time, a share that increased sharply throughout the survey field period. Among parents answering the survey between March 13-15, 63% say their child’s school or daycare had closed.
While most parents say it would not be difficult to find alternative childcare if their child’s school or daycare closed for 2 weeks or more, about one-third say it would be “very” or “somewhat” difficult. Those most likely to say it would be difficult include parents with household incomes less than $40,000 (46%), and working parents who do not get paid family leave (45%) or are paid by the hour or the job (42%).
Table 4: Alternative Childcare Issues Among Parents
If your child’s school or daycare was closed for two weeks or more due to coronavirus, how difficult, if at all, would it be for you to find alternative childcare?
Total parents
Household income
Paid family leave?
Compensation
<$40K
$40K or more
Yes
No
Paid hourly or by job
Difficult (NET)
33%
46%
27%
27%
45%
42%
Very difficult
19%
29%
13%
11%
28%
24%
Somewhat difficult
14%
17%
14%
16%
18%
18%
Not difficult (NET)
61%
50%
67%
67%
48%
52%
Not too difficult
15%
13%
14%
19%
12%
12%
Not at all difficult
47%
36%
53%
48%
36%
40%
Not applicable/child doesn’t require childcare
5%
4%
5%
5%
6%
6%
Knowledge and Sources of Information
Public mostly knows key facts about coronavirus, though some gaps in knowledge remain
Overall, large majorities of the public are aware of key information about prevention, transmission, risk, and treatment of coronavirus. However, sizeable shares hold some misconceptions that could potentially lead to confusion about how to identify symptoms or what to do if they or someone in their household becomes ill.
Overwhelming majorities, across partisans and demographic groups, know that frequent handwashing, staying home if you are sick, and avoiding large gatherings are recommended by public health experts as a way to help slow the spread of coronavirus. Nine in ten are aware that coronavirus can be transmitted by being in close proximity with someone who is infected and by touching surfaces that contain small amounts of bodily fluids from an infected person.
The public is also generally knowledge about the symptoms of coronavirus, as 95% know that a fever is a common symptom of the virus and 80% know that a dry cough is a common symptom. Overwhelming majorities know that adults ages 60 or older and those with pre-existing medical conditions are at a higher risk of developing serious medical complications from the coronavirus (96% and 98% respectively). About nine in ten (89%) are aware that there currently is no vaccine for coronavirus, and a similar share (86%) knows that the seasonal flu vaccine does not provide protection from the coronavirus.
However, there remain some notable knowledge gaps which may lead to confusion about when to seek care or testing or who is most at risk. For example, a majority of adults (56%) think nasal congestion is a common symptom of coronavirus. However, according to data reported by the World Health Organization, nasal congestion was present in only 5% of coronavirus cases in China.2 Similarly, four in ten adults mistakenly think children are at a higher risk of developing serious medical issues due the coronavirus, including 39% of parents. Thus far, however, children do not appear to be a higher risk.3
Table 5: Public Knowledge About Various Aspects Of Coronavirus
Large shares get many facts right…
But some knowledge gaps remain…
Recommendations to slow spread of coronavirus
Between 88%-97% know that frequent handwashing, staying home if feeling sick, and avoiding large gatherings are recommended
25% think it is recommended for health people to wear masks in public
How coronavirus is transmitted
Nine in ten know transmission occurs through close physical proximity (90%) or touching surfaces that contain small amounts of bodily fluids from someone who is infected (91%)
12% think coronavirus is transmitted through mosquito bites
Common symptoms
Large majorities recognize fever (95%) and dry cough (80%) as common symptoms, and 85% know that rash is not a symptom
56% think nasal congestion is a common symptom of coronavirus
Who is at most risk of serious complications
Nearly everyone recognizes that people with chronic health conditions (98%) and those over the age of 60 (96%) have a higher risk of developing serious medical issues if they become infected
40% think children are at higher risk
What happens to most people infected
65% recognize that most people infected with coronavirus recover without serious complications
23% think most people develop serious complications that require intensive care.
Vaccine
89% know there is no vaccine for COVID-19, and 86% know that the flu vaccine doesn’t protect against it
While most adults (73%) know that someone who thinks they are experiencing symptoms of coronavirus should stay home and call a doctor or medical provider, one in four (25%) think that someone experiencing symptoms should seek immediate care at an emergency room or urgent care facility, including 38% of lower-income adults and 39% among those ages 18-64 who are uninsured.
Figure 12: About Four In Ten Lower-Income Adults Say Those With Symptoms Should Seek Immediate Care At An ER Or Urgent Care Facility
most feel they have enough information TO PROTECT THEMSELVES, with cdc and who most trusted sources
About eight in ten adults (83%) say they feel they have enough information about how to protect themselves and their family from coronavirus while 16% say they don’t have enough information. The share who feel they don’t have enough information is somewhat higher among adults who are Black (25%) or Hispanic (22%), and those with a high school education or less (20%).
More than eight in ten adults (85%) say they trust the U.S. Center for Disease Control and Prevention (CDC) as a source for reliable information on coronavirus. More than three in four (77%) trust the World Health Organization (WHO) as a reliable source of information, while seven in ten trust their local government officials (70%) or their state government officials (71%). Fewer say they trust the news media (47%) and President Trump (46%) as a reliable source of information on coronavirus.
Figure 13: Most Trust The CDC And WHO As Sources Of Information While Half Trust The News Media And President Trump
There are some notable partisan differences on who the public trusts as reliable sources of information. While 88% of Republicans have a great deal or a fair amount of trust in President Trump to provide reliable information about coronavirus, 80% of Democrats say they have not much or no trust in the President. Notably, Democrats are more likely than Republicans to trust the news media to provide reliable information (69% vs. 29%).
Trust for both the CDC and WHO is high across partisan groups. Similar shares of Democrats (85%) and Republicans (90%) trust the CDC to provide reliable information about the virus, but Democrats are somewhat more likely than Republicans to trust the WHO (90% vs 71%).
Table 6: Trust In Sources of Coronavirus Information By Party Identification
Percent who say they trust each of the following a great deal or a fair amount to provide reliable information on coronavirus:
Total
Party ID
Democrats
Independents
Republicans
The U.S. Centers for Disease Control and Prevention, or CDC
85%
85%
85%
90%
The World Health Organization, or WHO
77%
90%
75%
71%
State government officials
71%
80%
67%
72%
Local government officials
70%
77%
65%
74%
The news media
47%
69%
41%
29%
President Trump
46%
19%
42%
88%
More generally, when it comes in their level of trust in presidential candidates to handle public health emergencies like the coronavirus outbreak, about four in ten adults overall say they trust President Donald Trump (44%), Joe Biden (44%), and Bernie Sanders (41%) “a great deal” or “a fair amount.” There is a large partisan divide, with 86% of Republicans expressing at least a fair amount of trust in President Trump compared with 20% of Democrats. Among Democrats, at least seven in ten trust both Joe Biden (76%) and Bernie Sanders (70%) to handle a public health emergency.
Table 7: Trust In Trump, Sanders, and Biden to Handle Public Health Emergencies
How much do you trust each of the following to handle public health emergencies like the current coronavirus outbreak?
Total
Party ID
Democrats
Independents
Republicans
Donald Trump
A great deal/a fair amount
44%
20%
40%
86%
Not much/Not at all
51%
79%
53%
11%
Bernie Sanders
A great deal/a fair amount
41%
70%
41%
13%
Not much/Not at all
48%
23%
47%
80%
Joe Biden
A great deal/a fair amount
44%
76%
39%
20%
Not much/Not at all
45%
18%
49%
74%
Methodology
This KFF Coronavirus Poll was designed and analyzed by public opinion researchers at the Kaiser Family Foundation (KFF). The survey was conducted March 11th -15th, 2020, among a nationally representative random digit dial telephone sample of 1,216 adults ages 18 and older, living in the United States, including Alaska and Hawaii (note: persons without a telephone could not be included in the random selection process). Computer-assisted telephone interviews conducted by landline (246) and cell phone (970, including 702 who had no landline telephone) were carried out in English and Spanish by SSRS of Glen Mills, PA. To efficiently obtain a sample of lower-income and non-White respondents, the sample also included an oversample of prepaid (pay-as-you-go) telephone numbers (25% of the cell phone sample consisted of prepaid numbers). Both the random digit dial landline and cell phone samples were provided by Marketing Systems Group (MSG). For the landline sample, respondents were selected by asking for the youngest adult male or female currently at home based on a random rotation. If no one of that gender was available, interviewers asked to speak with the youngest adult of the opposite gender. For the cell phone sample, interviews were conducted with the adult who answered the phone. KFF paid for all costs associated with the survey.
The combined landline and cell phone sample was weighted to balance the sample demographics to match estimates for the national population using data from the Census Bureau’s 2018 American Community Survey (ACS) on sex, age, education, race, Hispanic origin, and region along with data from the 2010 Census on population density. The sample was also weighted to match current patterns of telephone use using data from the July-December 2018 National Health Interview Survey. The weight takes into account the fact that respondents with both a landline and cell phone have a higher probability of selection in the combined sample and also adjusts for the household size for the landline sample, and design modifications, namely, the oversampling of prepaid cell phones and likelihood of non-response for the re-contacted sample. All statistical tests of significance account for the effect of weighting.
The margin of sampling error including the design effect for the full sample is plus or minus 3 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available by request. Note that sampling error is only one of many potential sources of error in this or any other public opinion poll. Kaiser Family Foundation public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.