Low-income Americans open to overdue long-term care, as long as it’s paid for

Middle-aged individuals of modest means widely availed themselves of formal long-term care after Obamacare funded the expansion of Medicaid in participating states.

The jump in utilization suggests this subset of the population had been putting off needed care due to money concerns, according to a study running in JAMA Network Open.

What’s more, the researchers found most of the newly eligible began receiving home healthcare—but a sizeable proportion entered nursing homes as well.

Courtney Harold Van Houtven of Duke University and colleagues compared long-term care utilization from 2008 to 2012 with that from 2014 to 2016. The team focused on low-income adults 50 to 64 years old living in states in which Medicaid coverage expanded in 2014 and those living in states without expansion.

They found the Medicaid expansion funded by the Affordable Care Act corresponded with utilization bounces of 3.8% in home healthcare, 2.1% in nursing-home care and 4.4% for any long-term care.

In their discussion, Van Houtven et al. comment that the across-the-board lift probably reflects the cohort’s receptivity to professional long-term care as long as it’s covered by insurance.

“Of importance, this interpretation was supported by a supplemental analysis that found no evidence of a reduction in the number of middle-aged, lower-income adults receiving informal care (defined as assistance with activities of daily living from family or unpaid friends) after the ACA Medicaid expansion,” the authors write. “Thus, the Medicaid expansion appears to have been associated with a net gain in long-term care access for low-income, middle-aged adults in the U.S.”

The study is available in full for free.

Dave Pearson

Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.

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