Expanding Medicaid had no noticeable effect on low-income adults’ smoking, heavy drinking or binge drinking in 2014, but it might have been good for their teeth, and their ability to work.
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Kosali Simon, a health economist at the University of Indiana, and two of her colleagues have published a paper on the health effects of the Patient Protection and Affordable Care Act (PPACA) Medicaid expansion provision behind a paywall at the National Bureau of Economic Research.
The researchers conducted the analysis using data from the federal government’s Behavioral Risk Factor Surveillance System (BRFSS) program for 2012 through 2014. The researchers focused on BRFSS survey numbers for low-income, non-disabled, childless adults living in the 36 states that would not have offered them Medicaid before 2014.
The researchers then compared the numbers for the low-income, childless adults living in the 14 states that expanded Medicaid in 2014 with the numbers for similar adults living in the 22 states that did not expand Medicaid.
Before 2014, the low-income, childless adults in 2014 all had similar levels of care access, bad habits and health problems. About half of them had some kind of public or private health insurance, about 80 percent had good access to care, and about 40 percent smoked. They said they suffered an average of about 8.8 days of poor physical health in the past month, and about 10.4 days of health bad enough to keep them from working.
After 2014, the low-income adults in both groups were about equally likely to have bad habits.
The expansion-state adults’ access to preventive care improved. The percentage who said they had had a routine checkup in the past year increased to 65 percent, from 59 percent, and the percentage who said they had seen a dentist in the past year increased to 45 percent, from 42 percent.
In the non-expansion states, the percentage of low-income adults who had had a checkup increased to 61 percent, from 59 percent, but the percentage who had seen a dentist dropped to 38 percent, from 42 percent.
The expansion-state adults were more likely to have had breast exams, Pap tests and flu shots.
In the expansion states, the average number work days lost to poor health in the past month fell 12 percent, to 9.3 days. In the non-expansion states, the number of work days lost to poor health held steady at 10.6 days.
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