The Effects Of Medicaid Expansion Under The ACA: A Systematic Review.

@article{Mazurenko2018TheEO,
  title={The Effects Of Medicaid Expansion Under The ACA: A Systematic Review.},
  author={Olena Mazurenko and Casey P Balio and Rajender Agarwal and Aaron E. Carroll and Nir Menachemi},
  journal={Health affairs},
  year={2018},
  volume={37 6},
  pages={
          944-950
        }
}
Expanding eligibility for Medicaid was a central goal of the Affordable Care Act (ACA), which continues to be debated and discussed at the state and federal levels as further reforms are considered. In an effort to provide a synthesis of the available research, we systematically reviewed the peer-reviewed scientific literature on the effects of Medicaid expansion on the original goals of the ACA. After analyzing seventy-seven published studies, we found that expansion was associated with… 
The Affordable Care Act's Medicaid Expansion and Impact along the Cancer-Care Continuum: A Systematic Review.
TLDR
Medicaid expansion has led to improved access to insurance coverage among cancer patients and survivors, particularly among low-income and minority populations, and a lack of studies evaluating changes in treatment and access to end-of-life care following implementation of expansion is highlighted.
All Medicaid Expansions are Not Created Equal: The Geography and Targeting of the Affordable Care Act
TLDR
The Medicaid expansion increased Medicaid visits and decreased uninsured visits, and the net effect is positive for all visits, suggesting that those who gain coverage through Medicaid consume more hospital services than they would if they remained uninsured.
Many States Were Able To Expand Medicaid Without Increasing Administrative Spending.
TLDR
No overall effect of expansion on administrative spending is found, however, the size of the expansion may have produced differing effects, and states with small and large expansions experienced some decreases in administrative spending.
How Have ACA Insurance Expansions Affected Health Outcomes? Findings From The Literature.
TLDR
A review of forty-three studies that employed a quasi-experimental research design found encouraging evidence of improvements in health status, chronic disease, maternal and neonatal health, and mortality, with some findings corroborated by multiple studies.
The Impact of Medicaid Expansion on Continuous Enrollment: a Two-State Analysis
TLDR
Increasing Medicaid eligibility levels under the Affordable Care Act appears to be an effective strategy to reduce churning in the Medicaid program, with important implications for other states that are considering Medicaid expansion.
The Effect of Health Insurance on Mortality: What Can We Learn from the Affordable Care Act Coverage Expansions?
TLDR
These estimates are not statistically significant at conventional levels, and are imprecise enough to be consistent with both no effect and a large effect of ACA expansion on overall mortality for non-elderly adults over the first three post-ACA years.
Medicaid's Post-ACA Paradoxes.
  • C. Grogan
  • Medicine
    Journal of health politics, policy and law
  • 2020
TLDR
This article highlights several paradoxes within Medicaid that have led to this growing bifurcation, and concludes by shedding light on important targets for future reform.
The Rise of Health Disparities in the United States: An Investigation into Medicaid Expansionary Policies
TLDR
It is found that non-expansion Medicaid states are not capable of meeting UNESCO defined standards, due to the barriers to mental health care and the likelihood of long-term disparities in health outcomes for low-income and disabled individuals.
The Effect of Medicaid Expansion on Wait Time in the Emergency Department
  • Guihua Wang
  • Medicine, Business
    SSRN Electronic Journal
  • 2019
TLDR
A first-difference causal forest (FDCF) approach for heterogeneous treatment-effect analysis is developed by incorporating the first-Difference approach into the causal forest approach and it is found that the effect of Medicaid expansion varies widely across different hospitals.
Effects of State-level Medicaid Expansion on Veterans Health Administration Dual Enrollment and Utilization
TLDR
The need to overcome care-coordination challenges among VA patients as states implement ACA Medicaid expansion and policymakers consider additional expansions of public health insurance programs such as Medicare-for-All is highlighted.
...
...

References

SHOWING 1-10 OF 16 REFERENCES
Mortality and access to care among adults after state Medicaid expansions.
TLDR
State Medicaid expansions to cover low-income adults were significantly associated with reduced mortality as well as improved coverage, access to care, and self-reported health.
The Oregon experiment--effects of Medicaid on clinical outcomes.
TLDR
This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.
Changes in Mortality After Massachusetts Health Care Reform
TLDR
This study found that when Massachusetts counties were compared with similar counties in other states, all-cause and health careenable mortality decreased after Massachusetts passed the law, consistent with other evidence that expanding insurance coverage can improve health.
Early Medicaid Expansion Associated With Reduced Payday Borrowing In California.
TLDR
Medicaid reduced the demand for high-interest loans and improved the financial health of American families, according to a universe of payday loans from five large payday lenders with locations around the United States.
Association Between the 2014 Medicaid Expansion and US Hospital Finances.
TLDR
The hospitals located in the 19 states that implemented the Medicaid expansion had significantly increased Medicaid revenue, decreased uncompensated care costs, and improvements in profit margins compared with hospitals located on in the 25 states that did not expand Medicaid.
What the Oregon health study can tell us about expanding Medicaid.
TLDR
The Oregon Health Study is described, a randomized controlled trial that will be able to shed some light on the likely effects of such expansions of Medicaid to low-income adults in 2014.
The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations
TLDR
Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states, and the law has been associated with increased health care access, affordability, and use of preventive and outpatient services among low-income populations, though impacts on inpatient utilization and health outcomes have been less conclusive.
United States Health Care Reform: Progress to Date and Next Steps.
  • B. Obama
  • Medicine, Political Science
    JAMA
  • 2016
TLDR
Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs.
The Supreme Court's surprising decision on the Medicaid expansion: how will the federal government and states proceed?
TLDR
The Court's approach raises two fundamental issues: does the Court's holding also affect the existing Medicaid program or numerous other Affordable Care Act Medicaid amendments establishing minimum Medicaid program requirements and does the health and human services secretary have the flexibility to modify the pace or scope of the expansion as a negotiating strategy with the states.
...
...