MedicalResearch.com Interview with:
Benjamin D. Sommers, M.D., Ph.D
Assistant Professor of Health Policy & Economics Department of Health Policy & Management
Harvard T.H. Chan School of Public Health
Assistant Professor of Medicine Division of General Medicine & Primary Care
Brigham & Women’s Hospital / Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: More than half of states have expanded Medicaid under the Affordable Care Act, and several states have taken alternative approaches, such as using federal Medicaid funds to purchase private insurance for low-income adults. Our study looks at the effects of these two different approaches – vs. not expanding at all – in three southern states (Kentucky Arkansas, and Texas). What we find is that expanding coverage, whether by Medicaid (Kentucky) or private insurance (Arkansas), leads to significant improvements in access to care, preventive care, quality of care, and self-reported health for low-income adults compared to not expanding (Texas). The benefits of the coverage expansion also took a while to become evident – the first year of expansion (2014) showed some of these changes, but they become much more apparent in the second year (2015).
MedicalResearch.com: What should readers take away from your report?
Response: Expanding coverage to low income adults makes a big difference in people’s lives – they can better afford their care, they get more outpatient and preventive care, rely less on the Emergency Department, and say that the quality of their health care and how they feel has improved. These are all important accomplishments of the ACA’s expansion of coverage via Medicaid and/or private insurance.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: One of the interesting findings is that the changes in utilization and health were much more dramatic in the second year of the expansion compared to the first. This indicates that it’s really important for researchers studying policies like the Affordable Care Act to continue tracking it over several years, and not to draw firm conclusions too early on.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
upcoming JAMA publication:
Benjamin D. Sommers, Robert J. Blendon, E. John Orav, Arnold M. Epstein. Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance. JAMA Internal Medicine, August 2016 DOI: 10.1001/jamainternmed.2016:4419
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