Table 2.

Adjusted mean changes in biomarkers from pre- to post-ACA between insurance groups

Measure	Continuously uninsured	Discontinuously insured	Continuously insured	Newly insured
HbA1c, %
Pre-ACA, mean	8.12	8.14	7.81	8.24
Post-ACA, mean	8.29	8.23	7.96	8.17
Change pre- to post-ACA	+0.17	+0.09	+0.15	−0.07
DID	+0.24	+0.16	+0.22	Ref
95% CI	0.17–0.30	0.11–0.22	0.16–0.27	Ref
P value	<0.001	<0.001	<0.001	Ref
LDL cholesterol, mg/dL
Pre-ACA, mean	107.22	108.62	105.03	108.52
Post-ACA, mean	103.45	104.47	101.19	101.49
Change pre- to post-ACA	−3.77	−4.15	−3.84	−7.03
DID	+3.26	+2.88	+3.19	Ref
95% CI	1.45–5.07	1.30–4.45	1.59–4.78	Ref
P value	<0.001	<0.001	<0.001	Ref
SBP, mmHg
Pre-ACA, mean	128.10	129.09	127.87	130.07
Post-ACA, mean	128.80	129.26	128.30	129.01
Change pre- to post-ACA	+0.70	+0.17	+0.43	−1.06
DID	+1.76	+1.23	+1.49	Ref
95% CI	1.34–2.19	0.89–1.58	1.14–1.84	Ref
P value	<0.001	<0.001	<0.001	Ref
DBP, mmHg
Pre-ACA, mean	78.65	79.26	78.86	80.06
Post-ACA, mean	78.19	78.71	78.37	78.56
Change pre- to post-ACA	−0.46	−0.55	−0.49	−1.50
DID	+1.04	+0.95	+1.00	Ref
95% CI	0.77–1.30	0.73–1.17	0.78–1.22	Ref
P value	<0.001	<0.001	<0.001	Ref
BMI, kg/m2
Pre-ACA, mean	31.98	32.79	33.21	32.70
Post-ACA, mean	31.84	32.58	32.84	32.58
Change pre- to post-ACA	−0.14	−0.21	−0.37	−0.12
DID	−0.02	−0.09	−0.24	Ref
95% CI	−0.08 to 0.04	−0.13 to −0.03	−0.29 to −0.19	Ref
P value	0.510	<0.001	<0.001	Ref

Biomarker-adjusted means at each period (pre- and post-ACA) and for each insurance group were estimated using a linear mixed-effects model. Random effects for patients and CHCs accounted for temporal observations of biomarkers within patients as well as for patients nested with CHCs. Boldface type denotes statistical significace (i.e., P < 0.05). Ref, reference.