Yixue Shao1, Charles Stoecker1. 1. 25812 Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Abstract
OBJECTIVES: Louisiana extended Medicaid coverage on July 1, 2016, to previously ineligible populations. We aimed to estimate the effect of Louisiana's Medicaid expansion on self-reported affordability of health care. METHODS: We used 2011-2019 data from the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS measured affordability of health care by asking respondents 2 questions: (1) whether they could not see a doctor due to cost in the previous 12 months and (2) whether they could not get a prescribed medication due to cost in the previous 12 months. We estimated difference-in-differences and difference-in-difference-in-differences analytical models using multivariable linear regression that compared trends in Louisiana with trends in states that did not expand Medicaid during the study period. RESULTS: Compared with adults aged <65 with annual household income >138% of the federal poverty level (FPL) in nonexpansion states, Medicaid expansion in Louisiana decreased the percentage of adults aged <65 with annual household income ≤138% FPL who reported being unable to see a doctor due to cost by 5.1 percentage points (95% CI, -6.5 to -3.6; P < .001) and unable to afford prescribed medication by 7.9 percentage points (95% CI, -9.2 to -6.6; P < .001). We found similar estimates when we limited the comparison group to Southern nonexpansion states. CONCLUSIONS: Louisiana's Medicaid expansion lowered cost barriers to health care. Further research may find improvements in health care affordability in states that have not yet expanded Medicaid.
OBJECTIVES: Louisiana extended Medicaid coverage on July 1, 2016, to previously ineligible populations. We aimed to estimate the effect of Louisiana's Medicaid expansion on self-reported affordability of health care. METHODS: We used 2011-2019 data from the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS measured affordability of health care by asking respondents 2 questions: (1) whether they could not see a doctor due to cost in the previous 12 months and (2) whether they could not get a prescribed medication due to cost in the previous 12 months. We estimated difference-in-differences and difference-in-difference-in-differences analytical models using multivariable linear regression that compared trends in Louisiana with trends in states that did not expand Medicaid during the study period. RESULTS: Compared with adults aged <65 with annual household income >138% of the federal poverty level (FPL) in nonexpansion states, Medicaid expansion in Louisiana decreased the percentage of adults aged <65 with annual household income ≤138% FPL who reported being unable to see a doctor due to cost by 5.1 percentage points (95% CI, -6.5 to -3.6; P < .001) and unable to afford prescribed medication by 7.9 percentage points (95% CI, -9.2 to -6.6; P < .001). We found similar estimates when we limited the comparison group to Southern nonexpansion states. CONCLUSIONS: Louisiana's Medicaid expansion lowered cost barriers to health care. Further research may find improvements in health care affordability in states that have not yet expanded Medicaid.
Entities:
Keywords:
Medicaid expansion; affordability; health care; health policy; policy evaluation
Authors: Stephen W Phillippi; Kaylin Beiter; Casey L Thomas; Olivia K Sugarman; Ashley Wennerstrom; Kenneth B Wells; Edward Trapido Journal: Am J Public Health Date: 2019-09 Impact factor: 9.308
Authors: Heather Angier; David Ezekiel-Herrera; Miguel Marino; Megan Hoopes; Elizabeth A Jacobs; Jennifer E DeVoe; Nathalie Huguet Journal: J Health Care Poor Underserved Date: 2019