Study: Preventive Care Improved Under Affordable Care Act

Under Medicaid expansion, low-income individuals were 11% less likely to list costs as a barrier to healthcare.

More Americans are seeking preventive care, and taking steps to prevent disease due to Medicaid expansion under the Affordable Care Act (ACA), according to a study published by the Journal of Policy Analysis and Management.

Numerous studies have surfaced recently about the benefits of the ACA after lawmakers began discussions on how to best repeal the health law. This new study is the first to determine how Medicaid expansion improved preventive care and health-related behaviors.

The study included data from the Behavioral Risk Factor Surveillance System, which was a telephone survey conducted by the US Centers for Disease Control and Prevention. Thus far, 31 states plus the District of Columbia expanded their Medicaid programs.

The investigators found that low-income adults without children largely benefited from the ACA. Because of the law, this population was 17% more likely to have health insurance than they were before the law’s implementation.

These patients were 7% more likely to have a primary care physician, and 11% less likely to say costs prevented them from utilizing healthcare services, such as purchasing prescription drugs, according to the study. Improved self-reported health, and less time spent in poor health was also experienced by low-income adults without children.

The researchers found that patients were more likely to receive preventive care, such as receiving a flu vaccination, undergoing HIV testing, or receiving dental services. These findings are significant because preventive services are covered without cost sharing under the ACA for all health plans, not just Medicaid, suggesting that this provision is the reason patients received these services.

Additionally, some who oppose Medicaid expansion may argue that the program would cause moral hazard or people engaging in risky behavior because they no longer have to pay more out-of-pocket, according to the study. However, the investigators did not find an increase in risky behaviors.

Medicaid expansion in the future is uncertain since GOP lawmakers have largely expressed opposition to the program, and have suggested numerous ways to overhaul it, including cutting funding.

These findings suggest that cutting Medicaid would likely result in a drastically higher uninsured rate, as well as increased costs from individuals not receiving preventive health services.

"Our findings indicate that the Medicaid expansions under the ACA succeeded in some of their goals, but other goals remain hard to achieve,” concluded researcher Kosali Simon, PhD. "More people are seeing doctors and taking steps to safeguard their health. But there's been no detectable reduction in obesity, smoking or heavy drinking, at least through our study period."