title: The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: Evidence from the National Health and Nutrition Examination Survey.
abstract: BACKGROUND
  Medicaid is the main public health insurance program for individuals with low income in the United States. Some state Medicaid programs cover preventive eye care services and vision correction, while others cover emergency eye care only. Similar to other optional benefits, states may add and drop adult vision benefits over time.
  
  
  OBJECTIVE
  This article examines whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam.
  
  
  METHODS
  We estimate the effect of Medicaid vision coverage on the likelihood of having appropriately corrected distance vision using examination data from the 2001-2008 National Health and Nutrition Examination Survey. We compare vision outcomes for Medicaid beneficiaries (n = 712) and other low income adults not enrolled in Medicaid (n = 4786) before and after changes to state vision coverage policies.
  
  
  RESULTS
  Between 29 and 33 states provided Medicaid adult vision benefits during 2001-2008, depending on the year. Our findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision of up to 10 percentage points.
  
  
  CONCLUSIONS
  Providing vision coverage to adults on Medicaid significantly increases the likelihood of appropriate correction of distance vision. Further research on the impact of vision coverage on related functional outcomes and the effects of Medicaid coverage of other services may be appropriate.
authors.affiliation: National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD 20782, USA. Electronic address: Brandy.lipton@ahrq.hhs.gov.
authors.forename: Brandy J
authors.initials: BJ
authors.lastname: Lipton
authors.affiliation: National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD 20782, USA. Electronic address: Sandra.decker@ahrq.hhs.gov.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Decker
mesh_terms: D000065:Accommodation, Ocular; D000328:Adult; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000592:standards*; D008484:Medicaid / Q000592:standards* / Q000706:statistics & numerical data; D008875:Middle Aged; D009749:Nutrition Surveys; D011203:Poverty / Q000706:statistics & numerical data; D014481:United States; D014786:Vision Disorders / Q000191:economics* / Q000628:therapy*
keywords: Insurance expansion; Low-income adults; Medicaid; Public insurance; United States; Vision care; Visual acuity