Disparities in the Impact of Medicaid Expansion on Adults in Poverty

Introduction The Affordable Care Act’s Medicaid expansion in 2014 improved access to care. However, not all states adopted the expansion, and debates on reform or repeal continue. In addition, few studies have analyzed differential effects by demographic characteristics. Methods Using nationally representative data from the 2011-2016 Behavioral Risk Factor Surveillance System, we applied a difference-in-differences approach to compare changes in health care access, preventive care utilization, health status, and chronic illness diagnoses from pre- to post-expansion years stratified by race, age, income, and urban or rural residence. Results Medicaid expansion was associated with reductions in the uninsured rate (-5.4 percentage points, p