How Does the Affordable Care Act Medicaid Expansion Affect Cigarette Consumption? ‐ The Mechanism and Heterogeneity

2021 ◽  
Author(s):  
Lingxiao Wang ◽  
Yuqing Zheng ◽  
Steven C. Buck
Keyword(s):  
Affordable Care Act ◽  
Cigarette Consumption ◽  
Medicaid Expansion ◽  
The Affordable Care Act

Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care

2021 ◽  
pp. 1-9
Author(s):  
Jacob K. Greenberg ◽  
Derek S. Brown ◽  
Margaret A. Olsen ◽  
Wilson Z. Ray
Keyword(s):  
United States ◽  
Spine Surgery ◽  
Surgical Procedures ◽  
Affordable Care Act ◽  
Surgical Care ◽  
The United States ◽  
Medicaid Expansion ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
The Impact

OBJECTIVE The Affordable Care Act expanded Medicaid eligibility in many states, improving access to some forms of elective healthcare in the United States. Whether this effort increased access to elective spine surgical care is unknown. This study’s objective was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. METHODS This study evaluated elective spine surgical procedures performed from 2011 to 2016 and included in the all-payer State Inpatient Databases of 10 states that expanded Medicaid access in 2014, as well as 4 states that did not expand Medicaid access. Adult patients aged 18–64 years who underwent elective spine surgery were included. The authors used a quasi-experimental difference-in-difference design to evaluate the impact of Medicaid expansion on hospital procedure volume and payer mix, independent of time-dependent trends. Subgroup analysis was conducted that stratified results according to cervical fusion, thoracolumbar fusion, and noninstrumented surgery. RESULTS The authors identified 218,648 surgical procedures performed in 10 Medicaid expansion states and 118,693 procedures performed in 4 nonexpansion states. Medicaid expansion was associated with a 17% (95% CI 2%–35%, p = 0.03) increase in mean hospital spine surgical volume and a 23% (95% CI −0.3% to 52%, p = 0.054) increase in Medicaid volume. Privately insured surgical volumes did not change significantly (incidence rate ratio 1.13, 95% CI −5% to 34%, p = 0.18). The increase in Medicaid volume led to a shift in payer mix, with the proportion of Medicaid patients increasing by 6.0 percentage points (95% CI 4.1–7.0, p < 0.001) and the proportion of private payers decreasing by 6.7 percentage points (95% CI 4.5–8.8, p < 0.001). Although the magnitude of effects varied, these trends were similar across procedure subgroups. CONCLUSIONS Medicaid expansion under the Affordable Care Act was associated with an economically and statistically significant increase in spine surgery volume and the proportion of surgical patients with Medicaid insurance, indicating improved access to care.

scholarly journals The Affordable Care Act Medicaid Expansion and Smoking Cessation Among Low-Income Smokers

2019 ◽  
Vol 57 (6) ◽  
pp. e203-e210 ◽  
Author(s):  
J. Travis Donahoe ◽  
Edward C. Norton ◽  
Michael R. Elliott ◽  
Andrea R. Titus ◽  
Lucie Kalousová ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Affordable Care Act ◽  
Low Income ◽  
Medicaid Expansion ◽  
The Affordable Care Act

scholarly journals Medicaid on the Eve of Expansion: A Survey of State Medicaid Officials on the Affordable Care Act

2014 ◽  
Vol 40 (2-3) ◽  
pp. 253-279 ◽  
Author(s):  
Benjamin D. Sommers ◽  
Sarah Gordon ◽  
Stephen Somers ◽  
Carolyn Ingram ◽  
Arnold M. Epstein
Keyword(s):  
Affordable Care Act ◽  
Enrollment Management ◽  
Medicaid Expansion ◽  
Federal Poverty Level ◽  
Access To Services ◽  
Poverty Level ◽  
Implementation Challenges ◽  
Coverage Expansion ◽  
The Affordable Care Act ◽  
Care Costs

As of January 2014, 26 states had chosen to expand Medicaid under the Affordable Care Act (ACA) to cover individuals with incomes up to 138% of the federal poverty level. In these states, Medicaid agencies are facing one of the largest implementation challenges in the program’s history. We undertook a survey of high-ranking Medicaid officials in these states to assess their priorities, expectations, and programmatic decisions related to the coming expansion.The Medicaid expansion poses major challenges in the domains of enrollment, management of health care costs, and providing adequate access to services for beneficiaries. Previous research has documented that millions of individuals eligible for Medicaid are currently not enrolled and remain uninsured, suggesting that state outreach strategies may underpin the success or failure of the ACA’s coverage expansion.

scholarly journals Association of the Affordable Care Act Medicaid Expansion With Access to and Quality of Care for Surgical Conditions

JAMA Surgery ◽  
2018 ◽  
Vol 153 (3) ◽  
pp. e175568 ◽  
Author(s):  
Andrew P. Loehrer ◽  
David C. Chang ◽  
John W. Scott ◽  
Matthew M. Hutter ◽  
Virendra I. Patel ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Affordable Care Act ◽  
Medicaid Expansion ◽  
The Affordable Care Act ◽  
Surgical Conditions
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