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. 2024 Dec;45(4):740-756.
doi: 10.1057/s41271-024-00522-0. Epub 2024 Sep 23.

Affordable Care Act Medicaid expansion, access to health care, and financial behavior of the United States adults

Redwan Bin Abdul Baten  1 , Abdullah Noman  2 , Mohammad Nakibur Rahman  2
Affiliations

Affordable Care Act Medicaid expansion, access to health care, and financial behavior of the United States adults

Redwan Bin Abdul Baten et al. J Public Health Policy. 2024 Dec.

Abstract

The access to care benefits of Affordable Care Act (ACA) Medicaid expansions are important for 45-64-year-old adults who are living below 100% of the Federal Poverty Level, a particularly vulnerable group in the United States (US). Gaining coverage from Medicaid expansions should improve access to healthcare and affect social determinants of health, including financial behavior. We analyzed data from 2009 to 2018 from the National Financial Capability Survey (NFCS) and utilize a difference-in-differences model to compare outcomes changes in states with and without expansion before and after the ACA Medicaid expansions. Overall, Medicaid expansion was associated with increased healthcare access for 45-64-year-olds, potentially resulting in better healthcare experience. Results indicate effects of the Medicaid expansion on the financial behavior of 45-64-year-olds, with evidence of credit card bills being paid in full, higher banking activities, and better financial preparedness. These findings have important implications for financial regulators and healthcare policymakers.

Keywords: Access to care; Financial behavior; Financial preparedness; Healthcare coverage; Medicaid expansion; Social determinants of health.

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Conflict of interest statement

Declarations. Conflict of interest: On behalf of all authors, the corresponding author states that there is no conflict of interest.

References

    1. KFF, K.F.F. Status of state Medicaid expansion decisions: Interactive map. 2023 12/01/2023 Available from: https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expans.... Accessed 21 Dec 2023.
    1. Wehby GL, Lyu W. The impact of the ACA Medicaid expansions on health insurance coverage through 2015 and coverage disparities by age, race/ethnicity, and gender. Health Serv Res. 2018;53(2):1248–71. - PMC - PubMed
    1. Courtemanche C, et al. Effects of the Affordable Care Act on health care access and self-assessed health after 3 years. Inquiry. 2018;55:46958018796361. - PMC - PubMed
    1. Gruber J, Sommers BD. The Affordable Care Act’s effects on patients, providers, and the economy: what we’ve learned so far. J Policy Anal Manag. 2019;38(4):1028–52.
    1. Bin Abdul Baten R, Wehby GL. Wehby, Effects of the ACA medicaid expansions on access and health by nurse practitioner scope of practice laws. Nurs Outlook. 2022. - PMC - PubMed

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