title: The expansion of Medicaid coverage under the ACA: implications for health care access, use, and spending for vulnerable low-income adults.
abstract: The expansion of Medicaid coverage under the Affordable Care Act offers the potential for significant increases in health care access, use, and spending for vulnerable nonelderly adults who are uninsured. Using pooled data from the Medical Expenditure Panel Survey, this study estimates the potential effects of Medicaid, controlling for individual and local community characteristics. Our findings project significant gains in health care access and use for uninsured adults who enroll in Medicaid coverage and have chronic health conditions and mental health conditions. With that increased use, annual per capita health care spending for those newly insured individuals (excluding out-of-pocket spending) is projected to grow from $2,677 to $6,370 in 2013 dollars, while their out-of-pocket spending would drop by $921. It is expected that these increases in spending would be offset at least in part by reductions in uncompensated care and charity care.
authors.affiliation: Urban Institute, Washington, DC, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Clemans-Cope
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Long
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Coughlin
authors.forename: Alshadye
authors.initials: A
authors.lastname: Yemane
authors.forename: Dean
authors.initials: D
authors.lastname: Resnick
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000191:economics; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000191:economics; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence*; D011203:Poverty / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States; D035862:Vulnerable Populations / Q000706:statistics & numerical data
keywords: Medicaid; access to care; health care spending; health care use; uninusured; vulnerable adults