Table 5.
Changes in Access to Health Care Following Medicaid Expansion among Childless Adults with One or More Chronic Conditions (n = 79,306)
| Outcome | Unadjusted pre-ACA prevalence | Unadjusted post-ACA prevalence | Unadjusted difference in differences | P value | Adjusted difference in differences* | P value |
|---|---|---|---|---|---|---|
| Health insurance coverage (%) | ||||||
| Medicaid expansion state | 71.3 | 86.3 | 6.6 (1.9, 11.3) |
0.007 | 6.4 (1.8, 10.9) |
0.007 |
| Non-Medicaid expansion state | 61.1 | 69.5 | ||||
| Did not seek care due to cost (%) | ||||||
| Medicaid expansion state | 37.3 | 27.7 | −2.5 (−4.6, −0.47) |
0.02 | −2.1 (−4.0, −0.15) |
0.04 |
| Non-Medicaid expansion state | 46.7 | 39.7 | ||||
| Check-up within last year (%) | ||||||
| Medicaid expansion state | 70.0 | 76.8 | 2.7 (0.29, 5.2) |
0.03 | 1.8 (−0.14, 3.7) |
0.07 |
| Non-Medicaid expansion state | 70.1 | 74.2 | ||||
| Personal doctor (%) | ||||||
| Medicaid expansion state | 78.8 | 83.8 | 2.2 (−0.88, 5.2) |
0.16 | 2.5 (−0.14, 5.2) |
0.06 |
| Non-Medicaid expansion state | 76.0 | 78.9 | ||||
*Adjusted analyses account for state and quarter-year fixed effects, age, sex, race/ethnicity, education, marital status, and annual state unemployment rate
Note: A negative coefficient (i.e., unadjusted and adjusted difference-in-differences estimates) indicates a decrease in states that expanded Medicaid relative to states that did not expand Medicaid, whereas a positive coefficient indicates a relative increase in Medicaid expansion states