ArticleJournal of general internal medicine2020
Association Between the ACA Medicaid Expansions and Primary Care and Emergency Department Use During the First 3 Years.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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Who cites it
13 citing papers in PubMed.
- Unmet need for depression treatment before and after the affordable care act.Social psychiatry and psychiatric epidemiology · 2026Article
- The association between becoming uninsured and forgoing medical care among middle-aged and older adults in Mexico with chronic health conditions.Innovation in aging · 2025Article
- Healthcare Utilization and Chronic Disease Management for Non-Medicaid-Eligible Patients in a City-Wide Safety-Net Healthcare Access Program.Journal of general internal medicine · 2025Observational
- Medicaid Expansion and Preventable Emergency Department Use by Race/Ethnicity.American journal of preventive medicine · 2024Article
- Changes in emergency department use associated with Medicaid expansion under the Affordable Care Act: A comparison of waiver and traditional expansion states.Journal of the American College of Emergency Physicians open · 2023Article
- Association of the affordable care act with racial and ethnic disparities in uninsured emergency department utilization.BMC health services research · 2023Article
- Medicaid expansion associated with no change in emergency department use across racial and ethnic groups.Health services research · 2023Article
- Estimating the causal effect of the Medicaid expansion on heart transplant volume with a differences-in-differences model.JTCVS open · 2022Article
- Association of Medicaid Expansion With 5-Year Changes in Hypertension and Diabetes Outcomes at Federally Qualified Health Centers.JAMA health forum · 2021Article
- Association Between the ACA Medicaid Expansions and Changes in Cardiovascular Risk Factors Among Low-Income Individuals.Journal of general internal medicine · 2021Article
- Impact of Expanded Medicaid Eligibility on the Diabetes Continuum of Care Among Low-Income Adults: A Difference-in-Differences Analysis.American journal of preventive medicine · 2021Article
- Association of Affordable Care Act Implementation With Ambulance Utilization for Asthma Emergencies in New York City, 2008-2018.JAMA network open · 2020Article
- The Association between Emergency Department Super-Utilizer Status and Willingness to Participate in Research.Emergency medicine international · 2020Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence is limited and mixed as to how the Patient Protection and Affordable Care Act (ACA) Medicaid expansions affected the utilization of primary care physicians (PCPs) and emergency departments (EDs) at the national level.
objectiveTo examine the association between the ACA Medicaid expansions and changes in the utilization of PCP and ED visits at the national level during the first 3 years (2014-2016) of the implementation.
designA difference-in-differences analysis to compare outcomes between individuals in 32 states that expanded Medicaid versus individuals in 19 non-expansion states.
participantsA nationally representative sample of US-born individuals 26-64 years old with family incomes lower than 138% of the federal poverty level from the 2010-2016 Medical Expenditure Panel Survey.
interventionACA Medicaid expansions MAIN MEASURES: We examined PCP-related outcomes ((i) whether a participant had any PCP visit during a year and (ii) the annual number of PCP visits per person) and ED-related outcomes ((i) whether a participant had any ED visit during a year and (ii) the annual number of ED visits per person). KEY
resultsA total of 17,803 participants were included in our analysis. We found that the proportion of individuals with any PCP visit during a year marginally increased (difference-in-differences estimate, + 3.6 percentage points [pp]; 95% CI, - 0.4 pp to + 7.6 pp; P = 0.08) following the Medicaid expansions, without any change in the annual number of PCP visits per person. We found no evidence that ED utilization (both the proportion of individuals with any ED visit during a year and the annual number of ED visits per person) changed meaningfully after the Medicaid expansions.
conclusionUsing the nationally representative data of individuals who were affected by the ACA, we found that the ACA Medicaid expansions were associated with a modest improvement in access to PCPs without an increase in ED use.
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