Table 2.
Unadjusted Differences in Outcomes before and after the ACA Medicaid Expansion for Expansion and Non-expansion states Among Non-elderly, Low-income Adults.
| All low–income adults | Low–income White adults | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Expansion states | Non-expansion states | Expansion states | Non-expansion states | |||||||||
| Before | After | Before | After | Before | After | Before | After | |||||
| Sample size† | 21 303 | 17 933 | 16 070 | 11 098 | N/A | N/A | N/A | N/A | ||||
| No insurance | 0.35 (0.48) | 0.18 (0.38) | −0.17*** | 0.46 (0.5) | 0.35 (0.48) | −0.11*** | 0.34 (0.47) | 0.17 (0.38) | −0.17*** | 0.43 (0.5) | 0.33 (0.47) | −0.10*** |
| Medicaid | 0.28 (0.45) | 0.45 (0.5) | 0.17*** | 0.16 (0.37) | 0.21 (0.41) | 0.05*** | 0.23 (0.42) | 0.4 (0.49) | 0.17*** | 0.14 (0.35) | 0.19 (0.39) | 0.05*** |
| No usual source of care | 0.21 (0.41) | 0.15 (0.36) | −0.06*** | 0.27 (0.44) | 0.21 (0.41) | −0.06*** | 0.2 (0.4) | 0.16 (0.37) | −0.04*** | 0.25 (0.43) | 0.19 (0.39) | −0.06*** |
| Delayed care due to cost | 0.21 (0.41) | 0.14 (0.35) | −0.07*** | 0.24 (0.43) | 0.19 (0.4) | −0.05*** | 0.24 (0.42) | 0.17 (0.38) | −0.07*** | 0.27 (0.45) | 0.22 (0.41) | −0.05*** |
| Unmet need for medical care | 0.18 (0.39) | 0.12 (0.32) | −0.06*** | 0.22 (0.41) | 0.18 (0.39) | −0.04*** | 0.2 (0.4) | 0.14 (0.35) | −0.06*** | 0.23 (0.42) | 0.2 (0.4) | −0.03*** |
| Unmet need for mental health care | 0.07 (0.25) | 0.04 (0.2) | −0.03*** | 0.07 (0.25) | 0.06 (0.23) | −0.01** | 0.08 (0.27) | 0.05 (0.22) | −0.03*** | 0.08 (0.27) | 0.07 (0.26) | −0.01 |
| Unmet need for specialty care | 0.12 (0.32) | 0.08 (0.27) | −0.04*** | 0.14 (0.34) | 0.11 (0.32) | −0.03*** | 0.12 (0.33) | 0.09 (0.28) | −0.03*** | 0.15 (0.36) | 0.12 (0.32) | −0.03*** |
| No visits to physician | 0.43 (0.5) | 0.37 (0.48) | −0.06*** | 0.46 (0.5) | 0.44 (0.5) | −0.02** | 0.42 (0.49) | 0.34 (0.47) | −0.08*** | 0.43 (0.5) | 0.42 (0.49) | −0.01 |
| No visits to mental health providers | 0.87 (0.33) | 0.87 (0.34) | 0.00 | 0.91 (0.29) | 0.9 (0.31) | −0.01* | 0.85 (0.36) | 0.84 (0.36) | −0.01 | 0.88 (0.32) | 0.87 (0.34) | −0.01 |
| No visits to specialists | 0.81 (0.39) | 0.79 (0.41) | −0.02** | 0.82 (0.38) | 0.83 (0.38) | 0.01 | 0.79 (0.41) | 0.76 (0.43) | −0.03*** | 0.79 (0.41) | 0.81 (0.4) | 0.02 |
| Low–income Black adults | Low–income Hispanic adults | |||||||||||
| Expansion states | Non-expansion states | Expansion states | Non-expansion states | |||||||||
| Before | After | Before | After | Before | After | Before | After | |||||
| Sample sizea | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | ||||
| No insurance | 0.35 (0.48) | 0.19 (0.39) | −0.16*** | 0.45 (0.5) | 0.33 (0.47) | −0.12*** | 0.37 (0.48) | 0.18 (0.39) | −0.19*** | 0.55 (0.5) | 0.43 (0.49) | −0.12*** |
| Medicaid | 0.37 (0.48) | 0.51 (0.5) | 0.14*** | 0.22 (0.42) | 0.28 (0.45) | 0.06*** | 0.36 (0.48) | 0.53 (0.5) | 0.17*** | 0.14 (0.34) | 0.17 (0.37) | 0.03*** |
| No usual source of care | 0.22 (0.41) | 0.14 (0.35) | −0.08*** | 0.24 (0.43) | 0.2 (0.4) | −0.04*** | 0.24 (0.43) | 0.16 (0.37) | −0.08*** | 0.38 (0.49) | 0.3 (0.46) | −0.08*** |
| Delayed care due to cost | 0.19 (0.39) | 0.12 (0.33) | −0.07*** | 0.21 (0.41) | 0.16 (0.37) | −0.05*** | 0.17 (0.38) | 0.09 (0.29) | −0.08*** | 0.19 (0.39) | 0.19 (0.39) | 0.00 |
| Unmet need for medical care | 0.18 (0.39) | 0.11 (0.31) | −0.07*** | 0.21 (0.41) | 0.17 (0.38) | −0.04*** | 0.16 (0.36) | 0.08 (0.27) | −0.08*** | 0.18 (0.38) | 0.16 (0.37) | −0.02 |
| Unmet need for mental health care | 0.05 (0.22) | 0.03 (0.18) | −0.02** | 0.06 (0.24) | 0.04 (0.2) | −0.02** | 0.06 (0.23) | 0.03 (0.18) | −0.03*** | 0.05 (0.21) | 0.04 (0.2) | −0.01 |
| Unmet need for specialty care | 0.1 (0.3) | 0.08 (0.27) | −0.02 | 0.12 (0.33) | 0.1 (0.31) | −0.02 | 0.13 (0.33) | 0.07 (0.25) | −0.06*** | 0.13 (0.33) | 0.13 (0.33) | 0.00 |
| No visits to physician | 0.42 (0.49) | 0.38 (0.49) | −0.04* | 0.48 (0.5) | 0.43 (0.49) | −0.05*** | 0.48 (0.5) | 0.41 (0.49) | −0.07*** | 0.55 (0.5) | 0.49 (0.5) | −0.06** |
| No visits to mental health providers | 0.89 (0.31) | 0.89 (0.31) | 0.00 | 0.93 (0.25) | 0.92 (0.27) | −0.01 | 0.91 (0.28) | 0.91 (0.29) | 0.00 | 0.94 (0.23) | 0.94 (0.23) | 0.00 |
| No visits to specialists | 0.82 (0.39) | 0.82 (0.39) | 0.00 | 0.85 (0.36) | 0.85 (0.35) | 0.00 | 0.85 (0.35) | 0.85 (0.36) | 0.00 | 0.86 (0.34) | 0.85 (0.35) | −0.01 |
Note. Cases were weighted by NHIS final survey weights. Standard deviations are in parentheses.
a
Sample size varies by outcome.
†
Sample size varies by outcome.
***
P < .01. **P < .05. *P < .1. Before and after were defined based on specific month to each state based on expansion date in the expansion states, and in non-expansion states before and after were defined using Jan 2014 as a cutoff.