HHS Brief Shows Medicaid Expansion States Actually Increased Access to Care

States that expanded Medicaid saw significant dips in their uninsured rates as their residents gained additional access to primary care and prescription medication, according to a new data brief from the U.S. Department of Health and Human Services. The data is culled from about two dozen studies, both from the federal government and private research journals and organizations such as Health Affairs and the New England Journal of Medicine.

Thirty-one states and the District of Columbia have expanded Medicaid, and Texas is not one of those. Those that have triggered an average 49.5 percent decline in their uninsured rates while the hold-outs recorded 33.8 percent declines. Patients in expansion states are less likely to report struggling to afford medical bills and the incidence of unmet medical needs among low-income adults also declined.

The data includes states that expanded the Medicaid program itself as well as those that got the Obama administration approve a waiver to access the federal expansion funds but secured insurance for that population through a different channel, such as subsidized private plans. Those are not separated, however. One of the concerns is that few doctors are taking new Medicaid patients. In Texas, which would likely insure north of 1 million new patients via expansion, many are nervous that the supply of doctors won’t be able to keep up with demand. Which is why the business community has teamed with the medical folks to push a so-called Texas Way, which would figure out a way to get the population coverage without Medicaid.

But, nonetheless, the brief digs into access to care in expansion and non-expansion states. The former are “associated with a significant reduction in low-income adults who lack a personal physician compared to non-expansion states.” Nonelderly adults in expansion states were 6.6 percent more likely to have seen or talked to a doctor in the past year than their ilk in non-expansion states. Diagnosis of diseases are increasing, too: Expansion states have seen a 23 percent spike in diabetes diagnoses since 2013 compared to a .4 percent increases in the non-expansion states.

A review of the literature examining the impacts of Medicaid expansion on specific services has generally found that the newly enrolled Medicaid population is better able to access preventive services, needed prescription medications, be screened and diagnosed for chronic conditions, and access dental care,” the briefing reads.