Observational studyAnnals of family medicine
An early look at rates of uninsured safety net clinic visits after the Affordable Care Act.
Observational study in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 44 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Innovative Methods for Parents And Clinics to Create Tools (IMPACCT) for Kids' Care
Community-Based HIT Tools for Cancer Screening and Health Insurance Promotion (CATCH-UP)
Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Factors affecting women's access to primary care in the United States since the Affordable Care Act: A mixed-methods systematic review.PloS one · 2024Pooled it
- Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings.Health services research · 2016Pooled it
- Patient predictors of substance use disorder treatment initiation in primary care.Journal of substance abuse treatment · 2018Trial
- Receipt of Preventive Services After Oregon's Randomized Medicaid Experiment.American journal of preventive medicine · 2016Trial
- Cervical Cancer Screening and Prevention among Latinas in the United States among a Network of Community Health Centers.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Prevalence of Colorectal Cancer Screening Among Latino Adults Following the Medicaid Eligibility Amendment Expansion.JAMA network open · 2026Article
- Improvement in physical and mental health attributable to the affordable care act.Frontiers in health services · 2025Article
- Financial impacts of the Medicaid expansion on community health centers.Health services research · 2022Article
- Obamacare: A bibliometric perspective.Frontiers in public health · 2022Article
- Effectiveness of an insurance enrollment support tool on insurance rates and cancer prevention in community health centers: a quasi-experimental study.BMC health services research · 2021Observational
- The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California and Texas.BMC health services research · 2021Article
- Medical service utilization and out-of-pocket spending among near-poor National Health Insurance members in South Korea.BMC health services research · 2021Article
- Using Electronic Health Records in Longitudinal Studies: Estimating Patient Attrition.Medical care · 2020Article
- Payment for Contraceptive Services in Safety Net Clinics: Roles of Affordable Care Act, Title X, and State Programs.Medical care · 2020Article
- The Affordable Care Act Medicaid Expansion Positively Impacted Community Health Centers and Their Patients.Journal of general internal medicine · 2020Article
- Health Care Expenditures Among Adults With Diabetes After Oregon's Medicaid Expansion.Diabetes care · 2020Article
- Improving the HIV Prevention Landscape to Reduce Disparities for Black MSM in the South.AIDS and behavior · 2019Article
- Adapting to a Shifting Health Care Landscape: Illinois Breast and Cervical Cancer Program Lead Agencies' Perspectives.Health promotion practice · 2019Article
- Following Uninsured Patients Through Medicaid Expansion: Ambulatory Care Use and Diagnosed Conditions.Annals of family medicine · 2019Article
- Study protocol: a mixed-methods study of women's healthcare in the safety net after Affordable Care Act implementation - EVERYWOMAN.Health research policy and systems · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
purposeThe Affordable Care Act of 2010 supports marked expansions in Medicaid coverage in the United States. As of January 1, 2014, a total of 25 states and the District of Columbia expanded their Medicaid programs. We tested the hypothesis that rates of uninsured safety net clinic visits would significantly decrease in states that implemented Medicaid expansion, compared with states that did not.
methodsWe undertook a longitudinal observational study of coverage status for adult visits in community health centers, from 12 months before Medicaid expansion (January 1, 2013 to December 31, 2013) through 6 months after expansion (January 1, 2014 to June 30, 2014). We analyzed data from 156 clinics in the OCHIN practice-based research network, with a shared electronic health record, located in 9 states (5 expanded Medicaid coverage and 4 did not).
resultsAnalyses were based on 333,655 nonpregnant adult patients and their 1,276,298 in-person billed encounters. Overall, clinics in the expansion states had a 40% decrease in the rate of uninsured visits in the postexpansion period and a 36% increase in the rate of Medicaid-covered visits. In contrast, clinics in the nonexpansion states had a significant 16% decline in the rate of uninsured visits but no change in the rate of Medicaid-covered visits.
conclusionsThere was a substantial decrease in uninsured community health center visits and a significant increase in Medicaid-covered visits in study clinics in states that expanded Medicaid in 2014, whereas study clinics in states opting out of the expansion continued to have a high rate of uninsured visits. These findings suggest that Affordable Care Act-related Medicaid expansions have successfully decreased the number of uninsured safety net patients in the United States.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.