Study: ACA reduced disparities in healthcare access

 The gap in healthcare access between poor and higher-income residents in the United States is closing thanks to the Affordable Care Act, a new study suggests.

The study, published in the July issue of Health Affairs, by researchers at Boston University School of Public Health, or BUSPH, found that the ACA reduced disparities in access to healthcare between wealthy and poor residents.

Researchers reviewed national survey data of U.S. adults, between ages 18 to 64, from the Centers for Disease Control and Prevention and found that in states that expanded Medicaid, the gap in insurance coverage between residents of households with annual incomes less than $25,000 and higher-income households with annual incomes greater than $75,000 fell by 46 percent between 2013 and 2015.

The coverage gap decline was less steep, only 23 percent, in states that did not participate in Medicaid expansion.

“Reducing health access disparities has been a subject of national debate since President Harry Truman proposed universal coverage in 1945,” the study authors said in a news release. “As we have shown in this analysis, the ACA substantially improved health insurance coverage and access to care for the poor and significantly reduced socioeconomic gaps in health care access in just two years.”

The study showed that although there were reductions in health insurance access gaps, many residents with annual incomes of less than $25,000 remained without coverage in 2015 — 35 percent in non-Medicaid expansion states and 21 percent in expansion states.

“In its first two years of full implementation, the ACA improved health care access for Americans in low-income households, people who were not college graduates, and the unemployed,” the authors said. “The law’s Medicaid expansion was responsible for about half of these gains. The ACA was associated with a substantial (but incomplete) narrowing of socioeconomic disparities in access, particularly in states that expanded Medicaid.”

Researchers cautioned that more research is needed and that the gains may be short-lived.

“We must stress that these gains are fragile,” Kevin Griffith, a researcher at BUSPH, said. “We would likely end up where we started if the ACA is repealed. Even without a full repeal, our political turmoil is injecting a great deal of uncertainty into the marketplaces, which could dissuade insurer participation and discourage enrollment.”


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