The Effects of the Affordable Care Act Medicaid Expansion in Reducing Health Disparities Among the Disabled Population
Open Access
- Author:
- Lunney, Katherine Grace
- Area of Honors:
- Health Policy and Administration
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Catherine Zavatsky Baumgardner, Thesis Supervisor
Selena E Ortiz, Thesis Honors Advisor - Keywords:
- disability
Affordable Care Act
health disparity
Medicaid Expansion - Abstract:
- Since its inception in 2010, the Affordable Care Act (ACA) has aimed to increase access to affordable health insurance, and the law intended to do so through an expansion of the Medicaid program to previously unqualifying individuals, including members of the disabled population (KKF, 2019). The purpose of this research is to examine whether the ACA’s Medicaid expansion was able to positively impact reductions in health disparities among individuals with disabilities ages 25-64 by improving access to health insurance and therefore increasing service utilization for 5 key services. Additional analyses were conducted to examine if there were regional differences in the effectiveness of the Medicaid expansion and if regional differences existed, whether they were related to state- and regional-level delays in the implementation of the Medicaid expansion. The present study utilized secondary data from the Medical Expenditure Panel Survey (MEPS) from 2012-2016. Medicaid insurance status and utilization rates for 5 services were compared across 4 regions using aggregate United States data as a baseline, including dental check-ups, routine primary care check-ups, flu vaccinations, blood pressure screenings, and cholesterol screenings. A mixed-effects linear regression model was applied to examine the statistical significance of the findings at the p< 0.05 level. All analyses were conducted using Stata Version 15.0 Software. The results from this analysis suggest that the Medicaid expansion was able to positively impact and improve access to health insurance (10.0%) and increase rates of service utilization from 3.5% to 4.7% for all 5 services nationwide. The results also suggest that significant associations at the p<0.05 level existed between regions and utilization rates. Of note, the Northeast region saw the greatest increases in service utilization for all 5 services (3.4% to 8.1%) while the South consistently lagged behind national averages (-0.7% to -2.8%). These findings coincide with regional differences in the date of the program’s implementation and support the notion that the timely adoption of the Medicaid expansion, as seen most prominently in the Northeast, led to increased access to insurance and service utilization among the disabled population.