Medicaid Expansion Doesn't Overburden Healthcare

The expansion of Medicaid eligibility that the federal government is requesting states to adapt with the enactment of the Affordable Care Act has not reduced care access nor has it overburdened emergency departments, according to a new study.

A new study recently published by the Journal of the American Medical Association (JAMA) Internal Medicine, details the results of an investigation into common concerns about the effects of the Medicaid eligibility expansion plan that accompanies the launch of the Affordable Care Act (ACA) in the United States.

The expansion plan, which is proposed under provisions of the newly enacted  ACA was designed by policy-makers to extend eligibility to millions of Americans who were previously ineligible to receive Medicaid coverage and had little access to public health care due to cost restrictions.

A 2012 U.S. Federal Supreme Court ruling established that states have the right to refuse expanding Medicaid coverage in compliance with the ACA provisions. Since the launch of the ACA, many have done just that, citing concerns that an immediate expansion of the suggested magnitude will overwhelm their healthcare providers, causing a reduction in overall care access due to backlogging and an increased rate of emergency department use that could dangerously overburden hospitals.

However, according to the recent analysis of ten states that expanded Medicaid between 2000 and 2009, enrollee report of care access actually fell from 8.5 percent to 7.3 percent despite a climbing number of people using healthcare providers. Emergency department (ED) use also decreased among Medicaid enrollees in states that expanded their coverage. Interestingly, this ED use reduction fell at the same rate, on average, as states that did not expand their Medicaid.

Researcher theorize that this was because while states that did not expand their Medicaid were able to work on reducing ED burden without worry of a rise in use, Medicaid expanded states also did not see a rise simply because increased access to doctors among Medicaid enrollees proactively results in a reduction in emergency cases.

The study was published in JAMA Internal Medicine on April 7.