Journal article
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, Vol.53(2), pp.1248-1271
04/2018
DOI: 10.1111/1475-6773.12711
PMCID: PMC5867173
PMID: 28517042
Abstract
Objective: Examine the ACA Medicaid expansion effects on Medicaid take-up and private coverage through 2015 and coverage disparities by age, race/ethnicity, and gender.
Data sources: 2011-2015 American Community Survey for 3,137,989 low-educated adults aged 19-64 years.
Study design: Difference-in-differences regressions accounting for national coverage trends and state fixed effects.
Principal findings: Expansion effects doubled in 2015 among low-educated adults, with a nearly 8 percentage-point increase in Medicaid take-up and 6 percentage-point decline in uninsured rate. Significant coverage gains were observed across virtually all examined groups by age, gender, and race/ethnicity. Take-up and insurance declines were strongest among younger adults and were generally close by gender and race/ethnicity. Despite the increased take-up however, coverage disparities remained sizeable, especially for young adults and Hispanics who had declining but still high uninsured rates in 2015. There was some evidence of private coverage crowd-out in certain subgroups, particularly among young adults aged 19-26 years and women, including in both individually purchased and employer-sponsored coverage.
Conclusions: The ACA Medicaid expansions have continued to increase coverage in 2015 across the entire population of low-educated adults and have reduced age disparities in coverage. However, there is still a need for interventions that target eligible young and Hispanic adults.
Keywords: Medicaid; disparities; insurance.
© Health Research and Educational Trust.
Details
- Title: Subtitle
- The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender
- Creators
- George L Wehby - University of IowaWei Lyu - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Health services research, Vol.53(2), pp.1248-1271
- DOI
- 10.1111/1475-6773.12711
- PMID
- 28517042
- PMCID
- PMC5867173
- NLM abbreviation
- Health Serv Res
- ISSN
- 0017-9124
- eISSN
- 1475-6773
- Publisher
- John Wiley and Sons Inc
- Language
- English
- Date published
- 04/2018
- Academic Unit
- Preventive and Community Dentistry; Health Management and Policy; Economics; Public Policy Center (Archive)
- Record Identifier
- 9984221752802771
Metrics
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