Evidence map›Paper›PMID 35183170›Full record

ArticleBMC health services research2022

Longitudinal trends in enrollees' employment and student status after Medicaid expansion.

Renuka Tipirneni, Edith C Kieffer, John Z Ayanian, Minal R Patel, Matthias A Kirch, Jamie E Luster, Monita Karmakar, Susan D Goold

Abstract read
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Renuka TipirneniUniversity of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, 48109, USA. rtipirne@med.umich.edu.ORCID http://orcid.org/0000-0002-0610-9707
Edith C KiefferUniversity of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, 48109, USA.
John Z AyanianUniversity of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, 48109, USA.
Minal R PatelUniversity of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, 48109, USA.
Matthias A KirchUniversity of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, 48109, USA.
Jamie E LusterDepartment of Internal Medicine, University of Michigan, 2800 Plymouth Road, Bldg 16, Rm 419W, Ann Arbor, MI, 48109, USA.
Monita KarmakarDepartment of Internal Medicine, University of Michigan, 2800 Plymouth Road, Bldg 16, Rm 419W, Ann Arbor, MI, 48109, USA.
Susan D GooldUniversity of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, 48109, USA.

Funding

Research BaseP30DK092926 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARY ELLEN MICHELE HEISLER, ADESUWA B OLOMU · 2011 to 2026
$10.0M
Improving the Health of Low-SES Americans Approaching Retirement Under the Affordable Care ActK08AG056591 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI TIPIRNENI, RENUKA · 2017 to 2021
$836k
NIA NIH HHS 1K08AG056591NIA NIH HHS K08 AG056591NIDDK NIH HHS P30 DK092926
6 · The paper itself

Abstract

backgroundMedicaid community engagement requirements previously received federal approval in 12 states, despite limited data on their impact on enrollees' employment-related activities. Our objective was to assess longitudinal changes in enrollees' employment and student status after implementation of Michigan's Medicaid expansion.

methodsLongitudinal telephone survey of Michigan Medicaid expansion enrollees in 2016 (response rate [RR] = 53.7%), 2017 (RR = 83.4%), and 2018 (N = 2,608, RR = 89.4%) serially assessing self-reported employment or student status. Survey responses were benchmarked against statewide changes in assessed similar low-income adults in the U.S. Census Bureau Current Population Survey. We used mixed models with individual random effects to assess changes in the proportion of enrollees who were employed or students by year.

resultsMost respondents had incomes < 100% FPL (61.7% with 0-35% of the federal poverty level [FPL], 22.9% with 36-99% FPL, and 15.4% with 100-133% FPL), 89.3% had at least a high school diploma/equivalent, and they ranged in age (39.6% age 19-34, 34.5% age 35-50, 25.9% age 51-64). Employment or student status increased significantly among Michigan Medicaid expansion respondents, from 54.5% in 2016 to 61.4% in 2018 (P < 0.001), including among those with a chronic condition (47.8% to 53.8%, P < 0.001) or mental health/substance use disorder (48.5% to 56.0%, P < 0.001). In contrast, the statewide proportion of low-income non-elderly adults who were employed or students did not change significantly (from 42.7% in 2016 to 46.0% in 2018, P = 0.57).

conclusionsMedicaid expansion, absent a community engagement requirement, was associated with increased employment and related activities. The role of Medicaid in providing safety-net coverage to individuals during times of economic stress is likely to grow.

Indexed as

EmploymentMedicaidAdultHealth Services AccessibilityHumansInsurance CoverageMichiganMiddle AgedPatient Protection and Affordable Care ActPovertyStudentsUnited StatesYoung AdultEmploymentHealth policyHealth reformMedicaid

Identifiers

PMID35183170
PMCPMC8857876

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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.