Expanded Insurance Enrollments Did Not Impair Access to Care for People Previously Insured

A new AHRQ study in the May issue of Health Affairs indicates that increases in the proportion of adults with insurance following passage of the Affordable Care Act did not affect access to care for adults who already had insurance. Researchers examined insurance coverage rates in local areas and found no consistent evidence of declines in several measures of access, including preventive care. The finding also held true for adults who lived in areas with shortages of health professionals and for Medicaid beneficiaries. Using data from AHRQ’s Medical Expenditure Panel Survey and the U.S. Census Bureau’s American Community Survey, researchers studied the relationship between trends in local insurance rates and changes in access to care for adults who were continuously insured. The study covered 2008 to 2014, when insurance coverage changed for many reasons, including Medicaid expansions and coverage offered through federal Marketplaces. Access the abstract.

Growing Insurance Coverage Did Not Reduce Access To Care For The Continuously Insured

Salam Abdus1,* and
Steven C. Hill2

+Author Affiliations

¹Salam Abdus (salam.abdus@ahrq.hhs.gov) is a staff fellow at the Agency for Healthcare Research and Quality, in Rockville, Maryland.
²Steven C. Hill is a senior economist at the Agency for Healthcare Research and Quality.

↵*Corresponding author

Abstract

Recent expansions in health insurance coverage have raised concerns about health care providers’ capacity to supply additional services and how that may have affected access to care for people who were already insured. When we examined data for the period 2008–14 from the Medical Expenditure Panel Survey, we found no consistent evidence that increases in the proportions of adults with insurance at the local-area level affected access to care for adults residing in the same areas who already had, and continued to have, insurance. This lack of an apparent relationship held true across eight measures of access, which included receipt of preventive care. It also held true among two adult subpopulations that may have been at greater risk for compromised access: people residing in health care professional shortage areas and Medicaid beneficiaries.