Increased service use following Medicaid expansion is mostly temporary: evidence from California's low income health program.
The Affordable Care Act (ACA) has already resulted in expanded eligibility for Medicaid in 27 states, including California, as of 2014. One major concern about the Medicaid expansion is that a high level of need among the newly eligible may lead to runaway costs, which could overwhelm state budgets when federal subsidies no longer cover 100 percent of the expansion population's costs in 2017. Although cost increases as a result of the newly eligible are likely, an even more important question is whether these increases will be temporary or permanent. Evidence from California's Low Income Health Program (LIHP) suggests that cost and utilization increases among newly eligible Medicaid beneficiaries will be mostly temporary. This policy brief presents data showing a significant decline in the use of hospital inpatient care and in emergency room visits after one year of enrollment in LIHP, and a stable, not increasing, rate of outpatient service use. Because LIHP provided health care coverage from 2011 to 2013 in advance of the full Medicaid expansion, our findings suggest that early and significant investments in infrastructure and in improving the process of care delivery can effectively address the pent-up demand for health care services of previously uninsured populations.
UCLA Center for Health Policy Research, Los Angeles, CA.
Nigel
N
Lo
UCLA Center for Health Policy Research and UCLA Fielding School of Public Health, Los Angeles, CA.
Dylan H
DH
Roby
UCLA Center for Health Policy Research, Los Angeles, CA.
Jessica
J
Padilla
UCLA Center for Health Policy Research, Los Angeles, CA.
Xiao
X
Chen
UCLA Center for Health Policy Research, Los Angeles, CA.
Erin N
EN
Salce
UCLA Center for Health Policy Research and UCLA Fielding School of Public Health, Los Angeles, CA.
Nadereh
N
Pourat
UCLA Center for Health Policy Research and UCLA Fielding School of Public Health, Los Angeles, CA.
Gerald F
GF
Kominski
D000553:Ambulatory Care / Q000706:statistics & numerical data* / Q000639:trends; D002140:California; D003695:Delivery of Health Care / Q000639:trends; D004608:Eligibility Determination / Q000639:trends*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000639:trends; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D019458:Insurance Coverage; D008484:Medicaid / Q000639:trends*; D058991:Patient Protection and Affordable Care Act; D011203:Poverty; D013997:Time Factors; D014481:United States