Objectives: We examined the potential economic, policy, and political influences on the decisions of the 50 US states to expand Medicaid under the Affordable Care Act.
Methods: We related a measure of relative state progress toward Medicaid expansion updated to 2015 to each state's economic circumstances, established policy frameworks in states, partisan control of state government, and lobbyists for businesses, medical professionals, unions, and public interest organizations.
Results: The 9201 lobbyists working on health care reform in state capitols exerted a strong and significant impact on Medicaid expansion. Controlling for confounding factors (including partisanship and existing policy frameworks), we found that business and professional lobbyists exerted a negative effect on state Medicaid expansion and, unexpectedly, that public interest advocates exerted a positive effect.
Conclusions: There are 3.1 million adults who lack coverage because they live in the 20 states that refused to expand Medicaid. Although political party and lobbyists for private interests present significant barriers in these states, legislative lobbying on behalf of the uninsured appears likely to be effective.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985851 | PMC |
| http://dx.doi.org/10.2105/AJPH.2015.302943 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Provider capacity during Medicaid expansion and a public health emergency.
Am J Manag Care
December 2024
University of Missouri Truman School of Government and Public Affairs, 615 Locust St, E004 Locust Street Bldg, Columbia, MO 65211. Email:
Objectives: To assess the capacity of Medicaid providers to take on new patients during a time of unprecedented growth in program enrollment due to Medicaid expansion and the COVID-19 public health emergency.
Study Design: We conducted a survey of Medicaid providers in Missouri in 2023 about their patient load and capacity to accept new patients.
Methods: We recruited 141 Missouri Medicaid providers through probability sampling and 109 additional providers through convenience sampling for a total sample size of 250, representing 0.
Telehealth Usability Among Rural and Low-Income Populations: A Survey of Wyoming Medicaid Members.
J Patient Exp
December 2024
Division of Healthcare Financing, Wyoming Department of Health, Cheyenne, WY, USA.
Telehealth has been shown as a tool to improve health access and outcomes in rural areas. There is less literature examining the usability and utility of telehealth by rural and low-income populations. Existing literature focuses on examining telehealth usability for specific telehealth platforms and specific use cases.
View Article and Find Full Text PDFIs the Affordable Care Act Medicaid expansion in the USA associated with reductions in intimate partner violence victimisation?
Inj Prev
December 2024
Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Objective: Intimate partner violence (IPV) affects an estimated 47% of women living in the USA in their lifetime and is associated with increased risk of physical and mental health concerns. Current prevention efforts focus on individual and family-level interventions rather than macrosystem-level policies. Thus, we sought to test the effects of Medicaid expansion on the rates of IPV and violence more broadly.
View Article and Find Full Text PDFThe Impact of Medicaid Expansion on Congenital Heart Surgery Outcomes: Data From the Society of Thoracic Surgeons Database.
Anesth Analg
December 2024
From the Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA.
Article Synopsis
- The Affordable Care Act expanded Medicaid for children, leading to differences in coverage between states that adopted the expansion and those that did not.
- A study analyzed data on pediatric cardiac surgeries from 2010 to 2019 to see if Medicaid expansion improved surgical outcomes like mortality, complications, and length of hospital stay.
- Results showed no significant improvement in surgical outcomes in states that expanded Medicaid, indicating that while overall surgery mortality declined, Medicaid expansion did not lead to better results compared to non-expansion states.
Factors affecting women's access to primary care in the United States since the Affordable Care Act: A mixed-methods systematic review.
PLoS One
December 2024
Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire, United Kingdom.
Background: In the United States, the Affordable Care Act (ACA) expanded public and private health coverage, increased health insurance affordability, reduced healthcare costs, and improved healthcare quality for many. Despite ACA provisions, lack of insurance and other factors continue to affect working-age women's access to primary care services.
Methods: We conducted a mixed-method systematic review to identify factors that affect women's access to primary care services since the ACA.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!