ACA Improved Access to Coverage, Reduced Uncompensated Care

Mon Feb 8 12:59:09 PST 2016

January 15, 2016

ACA Improved Access to Coverage, Reduced Uncompensated Care

<http://californiahealthline.org/morning-breakout/aca-improved-access-to-cov
erage-reduced-uncompensated-care/> California Healthline

The Affordable Care Act has increased U.S. residents' access to health
coverage and reduced hospitals' shares of uncompensated care, according to
two research letters published Tuesday in the New England Journal of
Medicine, HealthDay/U.S. News & World Report reports.

Study: ACA Has Reduced Share of Uncompensated Care

One letter discussed a study for which researchers examined the amount of
uncompensated care hospitals experienced in states that expanded Medicaid
under the ACA, compared with states that did not expand Medicaid. The
researchers compared hospital discharge data from 11 expansion states to
similar data from 10 non-expansion states.

The researchers found that from 2013 to 2014, both inpatient and emergency
department care was more frequently paid for by Medicaid in states that
expanded the program. As a result, rates of uncompensated care fell
significantly in those states.

According to the study, expansion states saw a 30% reduction in rates of
uncompensated ED care, while non-expansion states saw such rates fall by
about 9%. In addition, expansion states' rates of uncompensated inpatient
care fell by about 33%, compared with a 7% reduction of uncompensated
inpatient care in non-expansion states.

Katherine Hempstead, director of health insurance research at the Robert
Wood Johnson Foundation and the study's lead author, said, "It seems like
[Medicaid expansion is] pretty advantageous for hospitals," adding, "Not
surprisingly, hospital associations are huge advocates of Medicaid
expansion, and [the study's findings] really show why."

Study: More Young Adults Insured Under ACA

The second letter discussed a study that examined an ACA provision allowing
U.S. residents up to age 26 to stay on their parents' health plans
(Thompson, HealthDay/U.S. News & World Report, 1/13).

For the study, Indiana University researchers examined data from CDC's
natality files and the Agency for Healthcare Research and Quality (Antwi et
al., New England Journal of Medicine, 1/14).

The researchers found that after the ACA took effect, private health plans
covered childbirths among women ages 19 to 26 more frequently than Medicaid.
According to the study, the share of childbirths among such women that were
paid for by private coverage increased by about 10%. Meanwhile, the share of
such births that were covered by Medicaid or out-of-pocket decreased.

According to HealthDay/U.S. News & World Report, the findings suggest that
more U.S. residents are remaining on their parents' health plans since the
ACA provision took effect.

Aaron Carroll, the study's lead author, said, "The young adult provision
appears to be associated with a significant decrease in public coverage and
a significant increase in private coverage, which is contrary to what many
people might think about the [ACA]" (HealthDay/U.S. News & World Report,
1/13).

Jeff Wells
Deputy Editor, CAL/AAEM News Service

Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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