Marginal Increase in PCP Access After ACA Medicaid Expansion

The Affordable Care Act (ACA) Medicaid expansions correlated with a slight increase in access to primary care providers (PCPs), but no change in emergency department use, according to a study published online in the Journal of General Internal Medicine.

Hiroshi Gotanda, M.D., from the VA Greater Los Angeles Healthcare System, and colleagues examined the correlation between ACA Medicaid expansions and changes in utilization of PCP and emergency department visits during the first three years of implementation (2014 to 2016). Data were included from a nationally representative sample of U.S.-born individuals aged 26 to 64 years with family incomes lower than 138 percent of the federal poverty level from the Medical Expenditure Panel Survey.

Data were included for 17,803 participants. The researchers observed a marginal increase in the proportion of individuals with any PCP visit during a year (difference-in-differences estimate, +3.6 percentage points; 95 percent confidence interval, −0.4 to +7.6 percentage points; P = 0.08) following Medicaid expansions; no change was seen in the annual number of PCP visit per person. There was no evidence of a change in emergency department utilization after Medicaid expansions.

"These findings provide important information regarding the impact of the ACA Medicaid expansions on health care utilization and warrant further studies to better understand how we can make sure Medicaid beneficiaries receive care from appropriate health care providers," the authors write.

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