This article in The August 8, 2016 issue of JAMA looks at the effects of the ACA and Medicaid expansion on several factors relating access of care and health improvement. Interestingly this article compares two different Medicaid expansion programs and a state where there were no expansions undertaken. Specifically, the study looked at Kentucky, Arkansas, and Texas which all took very different approaches to the Affordable Care Act.
In the second year of Medicaid expansion, Kentucky’s Medicaid program and Arkansas’s private option were associated with significant increases in outpatient utilization, preventive care, and improved health care quality; reductions in emergency department use; and improved self-reported health. Aside from the type of coverage obtained, outcomes were similar for nearly all other outcomes between the 2 states using alternative approaches to expansion.
This is very different from other studies which showed increased emergency visits. It will also be interesting to look at It will be interesting to look at the long term numbers on all states. Some of the conclusions as to the net effect including the effect on ED visits, it is important to notice that the P value is relatively high so that it not conclusive the decrease in ED visits are completely related to these changes.