Uninsured CV Hospitalizations Reduced With Medicaid Expansion

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Compared with non-expansion states, the expansion states had a significant 5.8-percentage-point decrease in the proportion of uninsured hospitalizations.
Compared with non-expansion states, the expansion states had a significant 5.8-percentage-point decrease in the proportion of uninsured hospitalizations.

HealthDay News — States that expanded Medicaid had a greater reduction in the proportion of uninsured hospitalizations for major cardiovascular events, according to a study published online Aug. 24 in JAMA Network Open.

Ehimare Akhabue, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues compared the mean payer mix proportions and in-hospital mortality for expansion and non-expansion states for 2009 to 2013 (preceding the Affordable Care Act [ACA] Medicaid expansion) and 2014 (the year after expansion).

The researchers found that there were 801,819 hospitalizations in the 17 expansion states in 2014 and 719,459 in the 13 non-expansion states. In 2014, there were 281,184 non-Medicare hospitalizations for major cardiovascular events in the 17 expansion states and 243,664 in the 13 non-expansion states. 

Compared with non-expansion states, the expansion states had a significant 5.8-percentage-point decrease in the proportion of uninsured hospitalizations after Medicaid expansion. Also relative to non-expansion states, the expansion states had a significant 8.4 percentage-point increase in the Medicaid share. There was no significant change in in-hospital mortality after Medicaid expansion in expansion states (3.8 versus 3.7 percent before and after ACA) or the non-expansion states (4 versus 4 percent before and after ACA).

"States that expanded Medicaid during the ACA implementation had a significantly greater reduction in the proportion of uninsured hospitalizations for major cardiovascular events compared with the nonexpansion states," the authors write.

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