ArticleJournal of general internal medicine2019
Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study.
Article in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 25 citations in OpenAlex.
- Trends, disparities and projections of pericardial diseases related mortality in the United States: A 1999-2035 analysis using artificial deep neural network.American heart journal plus : cardiology research and practice · 2026Article
- Diversifying the Interventional Cardiology Workforce: Why It Matters and How to Achieve It.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Review
- Reducing inequalities in cardiovascular disease: focus on marginalized populations considering ethnicity and race.The Lancet regional health. Europe · 2025Review
- Optimizing Care for Cardiovascular-Kidney-Metabolic Syndrome: Leveraging Implementation Science in the Path Toward Pharmacoequity.Current cardiology reports · 2025Review
- Medicaid Expansion Among Nonelderly Adults and Cardiovascular Disease: Efficiency Vs. Equity.The Milbank quarterly · 2025Article
- Review
- Discrepancies in Cardiovascular Disease Risk Perception Among African American Emerging Adults.Nursing (Auckland, N.Z.) · 2025Article
- Access to Care and Cardiovascular Health in US Counties With Low Versus Higher Broadband Internet Availability.The American journal of cardiology · 2023Article
- Medicaid expansion and health care access for individuals with obesity in the United States.Obesity (Silver Spring, Md.) · 2022Article
- Health Care Access and Management of Cardiovascular Risk Factors Among Working-Age Adults With Low Income by State Medicaid Expansion Status.JAMA cardiology · 2022Article
- The Impact of Medicaid Expansion on Black-White Disparities in Cardiovascular Disease Mortality.Journal of health care for the poor and underserved · 2022Article
- Review
- Trends in Unmet Need for Physician and Preventive Services in the United States, 1998-2017.JAMA internal medicine · 2020Article
- The Houston HeartReach Registry: Recruitment Methods and Current Registry Demographics.Texas Heart Institute journalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAtherosclerotic cardiovascular disease (CVD) is the leading cause of death in the USA. Many with CVD or cardiovascular risk factors (CVRFs) lacked insurance coverage and access to care before enactment of the Affordable Care Act (ACA).
objectiveTo assess the effect of the ACA on insurance coverage, access to care, and racial/ethnic disparities among non-elderly adults with CVD or CVRFs.
designQuasi-experimental policy intervention.
participantsNationally representative, non-institutionalized sample of 1,014,450 adults aged 18 to 64 years with CVD or at least 2 established CVRFs in the pre-ACA (2012-2013) and post-ACA (2015-2016) periods.
interventionImplementation of ACA provisions on 1 January 2014. MAIN MEASURES: Insurance coverage, having a check-up, having a personal physician, and not having to forgo a needed physician visit because of cost. KEY
resultsFollowing ACA implementation, insurance coverage increased by 6.9 percentage points (95% CI, 6.6 to 7.2), not having to forgo a physician visit increased by 3.6 percentage points (CI, 3.3 to 3.9), having a check-up increased by 2.1 percentage points (CI, 1.8 to 2.6), and having a personal physician increased by 1 percentage point (0.6 to 1.3); changes were approximately doubled for those with lower incomes (< $35,000/year). Changes in coverage varied substantially by state and all outcomes improved more in Medicaid expansion states. Although racial/ethnic minorities had greater improvements in some outcomes, approximately 13% black and 29% Hispanic adults continued to lack coverage and access to care post-ACA.
conclusionThe ACA increased coverage and access for adults with CVD or multiple CVRFs; substantial gaps remain, particularly for minorities and those in Medicaid non-expansion states.
Indexed as
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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.