DID THE AFFORDABLE CARE ACT ACHIEVE ITS GOAL? THE EFFECT OF THE ACA AND MEDICAID EXPANSION ON SELF-ASSESSED HEALTH, ACCESS TO CARE, AND PREVENTATIVE CARE UTILIZATION (2006 - 2017)

Abstract

This paper examines the impact of extending insurance coverage through Medicaid expansion under the Affordable Care Act on self-assessed health measures, health care access, and preventative care utilization of low income, non-elderly U.S. adults. Using data from the Behavioral Risk Factor Surveillance System (BRFSS) covering years 2006 to 2017, this paper estimates this effect by utilizing a difference-in-differences approach to compare changes in these outcomes among adult residents in expansion and non-expansion states. This study also analyzes the impact of the implementation of the full ACA on the same health-related outcomes for non-elderly US adults. Results shed Medicaid expansion in favorable light as this provision had a statistically significant effect in improving self-reported mental and physical health status, health care access and affordability, as well as preventative care utilization for low-income adults. However, the effect of the full ACA returned mixed results and highlight possible problems of limited coverage plans and high costs despite the decrease in the uninsured rate.