Table 3:
Healthcare access and cardiovascular risk factor management among low-income working-age US adults by Medicaid expansion status, 2021 vs 2019
| Measure | Medicaid Expansion Status | Weighted % (95% CI) | Unadjusted relative risk (reference: 2019) | Adjusted relative risk *(reference: 2019) | p-value of interaction term† | |
|---|---|---|---|---|---|---|
| 2019 | 2021 | |||||
| Healthcare access | ||||||
| Had some form of health insurance | Non-expansion | 58.7 (56.7,60.6) |
64.0 (61.5,66.4) |
1.09 (1.07,1.11) |
1.08 (1.06,1.10) |
0.34 |
| Expansion | 76.5 (75.6,77.4) |
83.2 (82.1,84.3) |
1.12 (1.05,1.17) |
1.11 (1.05,1.17) |
||
| Able to identify a personal health care provider | Non-expansion | 56.4 (54.4,58.4) |
64.5 (62.1,67.0) |
1.11 (1.08,1.13) |
1.09 (1.07,1.12) |
0.10 |
| Expansion | 65.7 (64.7,66.7) |
72.2 (70.9,73.6) |
1.13 (1.06,1.20) |
1.15 (1.09,1.21) |
||
| Able to afford care visits (i.e., did not skip a visit due to cost in the last 12 months) | Non-expansion | 64.5 (62.6,66.3) |
69.3 (67.1,71.6) |
1.05 (1.03,1.08) |
1.05 (1.03,1.07) |
0.16 |
| Expansion | 78.0 (77.1,78.8) |
81.8 (80.8,82.9) |
1.10 (1.04,1.14) |
1.09 (1.04,1.14) |
||
| Had a check-up within the last 12 months | Non-expansion | 67.4 (65.6,69.3) |
64.1 (61.7,66.6) |
0.97 (0.94,0.99) |
0.95 (0.92,0.98) |
0.38 |
| Expansion | 71.6 (70.6,72.5) |
67.7 (66.3,69.1) |
0.97 (0.92,1.01) |
0.97 (0.93,1.02) |
||
| Cardiovascular Risk Management | ||||||
| Cholesterol check‡ | Non-expansion | 59.7 (57.6,61.7) |
55.4 (52.8,57.9) |
0.93 (0.90,0.96) |
0.92 (0.90,0.95) |
0.45 |
| Expansion | 59.3 (58.2,60.4) |
53.9 (52.4,55.5) |
0.97 (0.91,1.00) |
0.95 (0.90,1.00) |
||
| Test for diabetes|| | Non-expansion | 47.4 (45.1,49.8) |
45.7 (42.3,49.2) |
0.94 (0.88,0.99) |
0.93 (0.88,0.99) |
0.02 |
| Expansion | 51.3 (49.4,53.3) |
45.7 (43.4,47.9) |
1.06 (0.96,1.15) |
1.06 (0.97,1.16) |
||
| Taking prescribed medication for high blood pressure# | Non-expansion | 67.5 (64.8,70.2) |
69.1 (65.4,72.8) |
1.04 (1.01,1.09) |
1.04 (1.00,1.09) |
0.77 |
| Expansion | 63.3 (61.5,65.2) |
64.4 (61.9,66.8) |
1.06 (1.00,1.11) |
1.06 (0.99,1.12) |
||
| Taking insulin for diabetes** | Non-expansion | 35.2 (28.7,41.8) |
40.0 (33.2,46.7) |
1.02 (0.86,1.21) |
1.02 (0.86,1.21) |
0.88 |
| Expansion | 37.8 (34.1,41.5) |
39.9 (35.0,44.7) |
1.00 (0.78,1.26) |
1.00 (0.77,1.29) |
||
| At least one visit for known diabetes*** | Non-expansion | 85.7 (80.3,91.0) |
88.3 (84.1,92.4) |
1.01 (0.96,1.05) |
1.00 (0.95,1.04) |
0.25 |
| Expansion | 89.3 (87.0,91.5) |
88.3 (85.5,91.2) |
1.02 (0.95,1.13) |
1.04 (0.97,1.12) |
||
Nationally-representative estimates (%) are shown after the application of BRFSS weights, unless otherwise specified.
Survey-weighted Poisson regression model that adjusts for age, sex, asthma, chronic obstructive pulmonary disease, depressive disorder, non-skin cancer, kidney disease, myocardial infarction, stroke, coronary artery disease, hypertension, hyperlipidemia, and diabetes. The year 2019 is the reference group
Assesses whether there was a differential change in the outcome of interest among low-income adults residing in Medicaid expansion versus non-expansion states in 2021 versus 2019
Participants were asked if they had a cholesterol check in the past year
Participants without diabetes were asked if they had a test for diabetes in the past three years
Among participants with high blood pressure
. Among participants with diabetes
. Participants with diabetes were asked if they had a visit in the past year