Observational studyAnnals of internal medicine2016
Early Coverage, Access, Utilization, and Health Effects Associated With the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study.
Observational study in Annals of internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 172 papers, 3 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
172 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- What Interventions Work to Reduce Cost Barriers to Primary Healthcare in High-Income Countries? A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- 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
- Do Patient-Centered Medical Homes Improve Health Behaviors, Outcomes, and Experiences of Low-Income Patients? A Systematic Review and Meta-Analysis.Health services research · 2018Pooled it
- Effects of State Medicaid Expansions Affecting Parental Eligibility on Children's Healthcare Access and Health During the COVID-19 Pandemic.Maternal and child health journal · 2026Article
- Medicaid Expansion and 1-Year Mortality Among Young Adults Initiating Dialysis.JAMA pediatrics · 2026Article
- The impact of Medicaid expansion on coverage among those lacking housing basics, 2010-2019.Health affairs scholar · 2026Article
- Duration of health insurance coverage gaps and subsequent cost-related barriers to care among adults aged 18-64 years with multimorbidity.Frontiers in public health · 2026Article
- Medicaid's role in critical care after Medicaid expansion: evidence from Virginia.Health affairs scholar · 2025Article
- What Is the Effect of Medicaid Expansions on Preexposure Prophylaxis for HIV Prevention Use among Women?AIDS and behavior · 2025Article
- Frequent seizure and epilepsy-related emergency department visits in the United States: A retrospective cohort study.Epilepsia · 2025Article
- Employment, Income, the ACA, and Health Insurance Coverage of Working-Age Adults During the First Year of the COVID-19 Pandemic: A Reassessment.Health services research · 2025Article
- Design-Based Uncertainty for Quasi-Experiments.Journal of the American Statistical Association · 2025Article
- The relationship between state-level factors and LGBTQ+ policies in diverse healthcare settings in the United States: a cross-sectional multilevel analysis.BMC health services research · 2025Article
- The complexity of pharmaceutical expenditures across U.S. states.Scientific reports · 2025Article
- The Protective Role of Medicaid Expansion for Low-Income People During the COVID-19 Pandemic.Health services research · 2025Article
- Review
- Health Insurance Coverage Changes Under the Affordable Care Act Among High Housing Cost Households, 2010-18.Health economics · 2025Article
- The Relationship Between a Hospital's Magnet Status and LGBTQ+ Inclusivity in Policies and Practices in US Hospitals.Research in nursing & health · 2025Article
- Association between type of health insurance and dental visits among Ecuadorian older population: evidence from a cross-sectional study.BMC public health · 2025Article
- Effects of Medicaid managed care on early detection of cancer: Evidence from mandatory Medicaid managed care program in Pennsylvania.Health services research · 2024Article
112 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundIn 2014, only 26 states and the District of Columbia chose to implement the Patient Protection and Affordable Care Act (ACA) Medicaid expansions for low-income adults.
objectiveTo evaluate whether the state Medicaid expansions were associated with changes in insurance coverage, access to and utilization of health care, and self-reported health.
designComparison of outcomes before and after the expansions in states that did and did not expand Medicaid.
settingUnited States.
participantsCitizens aged 19 to 64 years with family incomes below 138% of the federal poverty level in the 2010 to 2014 National Health Interview Surveys. MEASUREMENTS: Health insurance coverage (private, Medicaid, or none); improvements in coverage over the previous year; visits to physicians in general practice and specialists; hospitalizations and emergency department visits; skipped or delayed medical care; usual source of care; diagnoses of diabetes, high cholesterol, and hypertension; self-reported health; and depression.
resultsIn the second half of 2014, adults in expansion states experienced increased health insurance (7.4 percentage points [95% CI, 3.4 to 11.3 percentage points]) and Medicaid (10.5 percentage points [CI, 6.5 to 14.5 percentage points]) coverage and better coverage than 1 year before (7.1 percentage points [CI, 2.7 to 11.5 percentage points]) compared with adults in nonexpansion states. Medicaid expansions were associated with increased visits to physicians in general practice (6.6 percentage points [CI, 1.3 to 12.0 percentage points]), overnight hospital stays (2.4 percentage points [CI, 0.7 to 4.2 percentage points]), and rates of diagnosis of diabetes (5.2 percentage points [CI, 2.4 to 8.1 percentage points]) and high cholesterol (5.7 percentage points [CI, 2.0 to 9.4 percentage points]). Changes in other outcomes were not statistically significant. LIMITATION: Observational study may be susceptible to unmeasured confounders; reliance on self-reported data; limited post-ACA time frame provided information on short-term changes only.
conclusionThe ACA Medicaid expansions were associated with higher rates of insurance coverage, improved quality of coverage, increased utilization of some types of health care, and higher rates of diagnosis of chronic health conditions for low-income adults. PRIMARY FUNDING SOURCE: None.
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