ACA Improved Access to Coverage, Reduced Uncompensated Care

The Affordable Care Act has increased U.S. residents’ access to health coverage and reduced hospitals’ shares of uncompensated care, according to two research letters published Tuesday in theNew England Journal of Medicine, HealthDay/U.S. News & World Report reports.

Study: ACA Has Reduced Share of Uncompensated Care

One letter discussed a study for which researchers examined the amount of uncompensated care hospitals experienced in states that expanded Medicaid under the ACA, compared with states that did not expand Medicaid. The researchers compared hospital discharge data from 11 expansion states to similar data from 10 non-expansion states.

The researchers found that from 2013 to 2014, both inpatient and emergency department care was more frequently paid for by Medicaid in states that expanded the program. As a result, rates of uncompensated care fell significantly in those states.

According to the study, expansion states saw a 30% reduction in rates of uncompensated ED care, while non-expansion states saw such rates fall by about 9%. In addition, expansion states’ rates of uncompensated inpatient care fell by about 33%, compared with a 7% reduction of uncompensated inpatient care in non-expansion states.

Katherine Hempstead, director of health insurance research at the Robert Wood Johnson Foundation and the study’s lead author, said, “It seems like [Medicaid expansion is] pretty advantageous for hospitals,” adding, “Not surprisingly, hospital associations are huge advocates of Medicaid expansion, and [the study’s findings] really sho[w] why.”

Study: More Young Adults Insured Under ACA

The second letter discussed a study that examined an ACA provision allowing U.S. residents up to age 26 to stay on their parents’ health plans (Thompson, HealthDay/U.S. News & World Report, 1/13).

For the study, Indiana University researchers examined data from CDC’s natality files and the Agency for Healthcare Research and Quality (Antwi et al., New England Journal of Medicine, 1/14).

The researchers found that after the ACA took effect, private health plans covered childbirths among women ages 19 to 26 more frequently than Medicaid. According to the study, the share of childbirths among such women that were paid for by private coverage increased by about 10%. Meanwhile, the share of such births that were covered by Medicaid or out-of-pocket decreased.

According to HealthDay/U.S. News & World Report, the findings suggest that more U.S. residents are remaining on their parents’ health plans since the ACA provision took effect.

Aaron Carroll, the study’s lead author, said, “The young adult provision appears to be associated with a significant decrease in public coverage and a significant increase in private coverage, which is contrary to what many people might think about the [ACA]” (HealthDay/U.S. News & World Report, 1/13).

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