28 Jun Study finds ACA- Eligible Uninsured Adults have fewer Chronic Health Conditions

MedicalResearch.com  Interview with Genevieve Kenney Ph.D
Senior Fellow and Co-Director, Health Policy Center
The Urban Institute
2100 M Street NW Washington DC 20037

MedicalResearch.com: What are the main findings of the study?

Dr. Kenney: Our study is the first published analysis that draws on physical examinations, laboratory tests, and patient reports to assess the health needs and health risks of uninsured adults who could be eligible for Medicaid coverage under the Affordable Care Act relative to the adults who are already enrolled in Medicaid.

Our main findings are that the uninsured adults who could enroll under the ACA are less likely than the adults with Medicaid coverage to be obese and to have functional limitations and chronic health problems, such as hypertension, hypercholesterolemia, or diabetes, but that the uninsured adults with these chronic conditions are less likely to be aware that they have them and less likely to have the condition under control. In comparison to the Medicaid population, the uninsured adults in our study were also less likely to have seen a health professional in the prior year and to have a routine place for care.  The rates of undiagnosed and uncontrolled chronic health care problems found in our study indicate that millions of low-income uninsured adults are currently at risk of premature mortality and other significant health issues.  These findings provide new evidence of the potential health benefits associated with the Medicaid expansion under the Affordable Care Act.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Kenney: These results may come as a surprise to policymakers and clinicians who have predicted that the adults who could gain Medicaid coverage under the Affordable Care Act will have high levels of disability and multiple chronic conditions.  While some new Medicaid enrollees will have these characteristics, our analysis suggests that many will not.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Kenney:   In preparing for expanded Medicaid enrollment, these results suggest that clinicians should be on the look out for undiagnosed and uncontrolled health problems in the patients they treat, particularly among those who have gone without health insurance coverage and care for some period of time.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Kenney:  These findings suggest that it will be important for future research to take into account the underreporting of health care problems based on patient reports, particularly among those who are not regularly receiving health care.

Citation:

Health Status, Risk Factors, and Medical Conditions Among Persons Enrolled in Medicaid vs Uninsured Low-Income Adults Potentially Eligible for Medicaid Under the Affordable Care Act

Citation:

Kostova D, Kenney GM, Long SK, Decker SL. Health Status, Risk Factors, and Medical Conditions Among Persons Enrolled in Medicaid vs Uninsured Low-Income Adults Potentially Eligible for Medicaid Under the Affordable Care Act. JAMA. 2013;309(24):2579-2586. doi:10.1001/jama.2013.7106

Last Updated on September 19, 2013 by Marie Benz MD FAAD