Gaining Medicaid Coverage During ACA Implementation: Effects on Access to Care and Preventive Services.

Objective: The continued expansion of Medicaid is under debate; it is critical to evaluate the effect of obtaining Medicaid on access to preventive care.

Methods: We analyzed longitudinal data from the 2013-2014 Medical Expenditure Panel Survey and applied a difference-in-differences approach. Our treatment group included low-income, non-pregnant, non-disabled adults aged 18-64 with no insurance in 2013 who received Medicaid in 2014; the comparison group included individuals who did not have insurance in either year.

Results: Gaining Medicaid increased the likelihood of having a usual source of care, at least one office visit, annual checkup, annual cholesterol and blood pressure tests by 13 (CI: 2-24), 14 (CI: 2-27), 11 (CI: 1-21), 29 (CI: 20-39), and 13 (CI: 1-25) percentage points, respectively. Receipt of flu vaccine increased by eight (CI: -3-19) percentage points (insignificant).

Conclusions: Medicaid coverage improved use of evidence-based preventive services at a national level among uninsured, non-pregnant, low-income adults.