Implications of the ACA Medicaid Expansion: A Look at the Data and Evidence

Implications of the ACA Medicaid Expansion: A Look at the Data and Evidence

States that expanded Medicaid under the Affordable Care Act have seen significant increases in Medicaid enrollment and large reductions in uninsured rates, especially in rural areas, a report from the Kaiser Family Foundation finds. Based on research and a comprehensive literature review, the report, Implications of the ACA Medicaid Expansion: A Look at the Data and Evidence (12 pages, PDF), found that gains in insurance coverage in expansion states were seen broadly among vulnerable populations, including children and young adults, low-income individuals, newly diagnosed cancer patients, people living with HIV, veterans, women of reproductive age, and lesbian, gay, and bisexual adults. While some studies suggested that provider shortages could be a challenge, most found that Medicaid expansion led to improved access to, utilization of, and affordability of care, without requiring significant increases in state spending. The analysis also found that while states implementing the expansion through Section 1115 demonstration waivers — which provide states an avenue to test new approaches in Medicaid that differ from federal program rules — have seen similar gains in coverage, some states’ requirements present a barrier to enrollment for some adults.