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. 2015 Oct;34(10):1688-94.
doi: 10.1377/hlthaff.2015.0290.

California's Early ACA Expansion Increased Coverage And Reduced Out-Of-Pocket Spending For The State's Low-Income Population

Ezra Golberstein  1 , Gilbert Gonzales  2 , Benjamin D Sommers  3
Affiliations

California's Early ACA Expansion Increased Coverage And Reduced Out-Of-Pocket Spending For The State's Low-Income Population

Ezra Golberstein et al. Health Aff (Millwood). 2015 Oct.

Abstract

The Affordable Care Act (ACA) expanded eligibility for Medicaid to millions of low-income adults. While many expanding states implemented their expansion in 2014, five states and the District of Columbia expanded eligibility as early as 2010 by taking advantage of provisions in the ACA and Medicaid waivers. We used restricted data from the National Health Interview Survey to examine the impact of California's Low Income Health Program, an early expansion program that began in 2011. Our study demonstrates that the county-by-county rollout of expanded public insurance coverage in California significantly increased coverage, by 7 percentage points, and significantly reduced the likelihood of any family out-of-pocket medical spending in the previous year, by 10 percentage points, among low-income adults.

Keywords: Access To Care; Health Reform; Health Spending; Insurance Coverage < Insurance; Medicaid.

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References

    1. Kaiser Commission on Medicaid and the Uninsured. A Closer Look at the Impact of State Decisions Not to Expand Medicaid on Coverage for Uninsured Adults. Kaiser Family Foundation; 2014.
    1. Kaiser Family Foundation. States Getting a Jump Start on Health Reform's Medicaid Expansion. 2012 Available from: http://kff.org/health-reform/issue-brief/states-getting-a-jump-start-on-...
    1. Meng Y-Y, Cabezas L, Roby DH, Pourat N, Kominski GF. Successful Strategies for Increasing Enrollment in California's Low Income Health Program (LIHP) 2012 Available from: http://healthpolicy.ucla.edu/publications/Documents/PDF/lihppolicynotese....

    1. To access the Appendix, click on the Appendix link in the box to the right of the article online.

    1. Gruber J, Simon K. Crowd-out 10 years later: have recent public insurance expansions crowded out private health insurance? Journal of health economics. 2008;27(2):201–17. - PubMed

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