Summary
The objective of the study is to examine the association between the Medicaid expansions and changes in the utilization of primary care physicians (PCPs) and emergency departments (EDs) at the national level during the first 3 years (2014–2016) of ACA implementation. A difference-in-differences analysis was used to compare outcomes between 17,803 individuals in 32 states that expanded Medicaid versus individuals in 19 non-expansion states. A nationally representative sample was used of US-born individuals 26–64 years old with family incomes lower than 138% of the federal poverty level from the 2010–2016 Medical Expenditure Panel Survey. Main measures authors examined were PCP-related outcomes [(i) whether a participant had any PCP visit during a year and (ii) the annual number of PCP visits per person) and ED-related outcomes ((i) whether a participant had any ED visit during a year and (ii) the annual number of ED visits per person].
The proportion of individuals with any PCP visit during a year marginally increased following the Medicaid expansions, without any change in the annual number of PCP visits per person. Authors found no evidence that ED utilization (both the proportion of individuals with any ED visit during a year and the annual number of ED visits per person) changed meaningfully after the Medicaid expansions.
