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Medicaid Expansion Associated with Increases in Coverage and Quality of Care

July 03, 2018

Medicaid expansion under the Affordable Care Act (ACA) contributed to improvements in the quality of care and coverage, according to a recent Health Affairs analysis of 77 published studies.

The authors found evidence of improvements to health care delivery, as well as better financial performance for some hospitals, thanks in part to reductions in uncompensated care. Other key areas of improvement include:

Medicaid Expansion Enrollment in Pennsylvania's Rural and Urban Counties

Access to care

  • Improvements in insurance coverage for adults without a college degree
  • Decreased uninsured rates for people with cancer
  • Increased use of primary care and preventive visits
  • Increased use of mental health services
  • Decreases in hospital length of stay among newly insured enrollees

Quality of care

  • Improved glucose monitoring for patients with diabetes
  • Better hypertension control
  • Improved cancer screening (prostate)
  • Improved women’s health screening

Cost of care

  • Increase in prescription drug reimbursements by Medicaid

None of the studies in the systematic review reported a decrease in health or quality of care following Medicaid expansion.

Pennsylvania expanded Medicaid during 2015; since then, more than 700,000 residents have benefitted from the program. In total, more than 1.1 million Pennsylvanians have gained access to health care coverage through Medicaid expansion and the ACA insurance marketplaces. These coverage gains have helped individuals across the commonwealth access primary, specialty, and mental health care services.

HAP and Pennsylvania’s hospitals and health systems support continued improvements in access to affordable, high-quality health care coverage.

Additional data and insights about the effects of the ACA in Pennsylvania can be found at HAP’s website. For more information, contact Phillip M. Burrell, director, research and data analytics.

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