Medicaid expansion associated with better health outcomes
Expanding Medicaid is associated with better health outcomes at federally qualified health centers (FQHCs), according to a recent study published in JAMA.
Since the implementation of the Affordable Care Act that enabled states to expand Medicaid, 39 have done so to date, helping lower the uninsured rate and providing greater healthcare access to millions. Researchers from Boston and Providence, Rhode Island, sought to distinguish the association of Medicaid expansion with uninsured rates and hypertension and diabetes outcome measures by race and ethnicity over a five-year period in a national patient population at FQHCs.
FQHCs serve roughly 30 million low-income patients every year, and the health centers have been significantly impacted by Medicaid expansion. However, the long-term effect of Medicaid expansion has not been measured until now.
Researchers compared Medicaid expansion and non-expansion states before (2012-2013) vs after (2014-2018) expansion, analyzing changes in uninsured rates and intermediate health outcomes for hypertension and diabetes by race and ethnicity. There were 578 FQHCs within expansion states in the study and 368 that were in non-expansion states.
The results showed expansion states saw an uninsured rate drop of 9.24 percentage points compared to non-expansion states. In addition, expansion was associated with a 1.61 percentage point (PP) improvement in hypertension control over this time period, as well as a 1.84 PP improvement in glucose control. Among Black and Hispanic patients, improvements were consistently reported.
Hypertension and glucose control also improved more as time went on, researchers found.
“The association between Medicaid expansion and improvement in health outcomes increased over the 5-year post-expansion period, during which time Black and Hispanic patients experienced substantial gains in blood pressure and glucose control,” wrote first author Megan B. Cole, PhD, MPH, of Department of Health Law, Policy, and Management, Boston University School of Public Health, et al.
They concluded that FQHCs will also see better financial health with Medicaid expansion as patients’ health improves over time. Black and Hispanic patients were also more likely to gain insurance coverage under Medicaid expansion compared to other demographics.
For states that have yet to expand Medicaid, the results of the study may be helpful, indicating that low-income patients and health centers have seen improvements in the long term.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."