Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 46911,
    "title": "Impacts of the Affordable Care Act Medicaid Expansion in California",
    "subtitle": null,
    "abstract": "We examined the impact of the Affordable Care Act (ACA) on healthcare coverage, access, health status, and affordability, as well as disparities in these outcomes by race/ethnicity among low-income Californians. We used nationally representative survey data from the Behavioral Risk Factor Surveillance Survey 2011-2019 and a difference-in-differences approach that compared California with nonexpansion states. We examined the impact of Medicaid expansion on health insurance coverage, having a usual source of care, self-reported health status, frequent (≥14) unhealthy days in the past month (physical, mental, and both), and foregone care due to cost. The sample population included low-income Californians (<100% of the federal poverty guidelines) aged 19-64 and low-income childless adults. Low-income adults, childless adults, and white childless adults in California saw post-ACA gains in six of seven outcomes, including a 7.7 percentage point increase in having a usual source of care for all low-income adults (CI: 0.051 to 0.104). Childless adult people of color (POC) reported significant improvements in three measures, with a 6.6 percentage point increase in having a usual source of care (CI: 0.013 to 0.120). All of the groups we examined had coverage gains, ranging from 3.9 percentage points for all low-income adults (CI: 0.013 0.066) to 8.4 percentage points for white childless adults (CI: 0.025 to 0.143). Additionally, all groups reported improved mental health, including an 8.2 percentage point decrease in frequent mental distress for childless adults (CI: -0.120 to -0.044). These findings indicate that the ACA coverage expansion benefitted the targeted population of low-income Californians. Additionally, the disparity between white and non-white Californians decreased for the unadjusted mean rate of having a usual source of care. However, unadjusted means showed that white low-income adults remained more likely to have health insurance coverage and a usual source of care compared with POC in both California and nonexpansion states.",
    "language": "en",
    "license": null,
    "keywords": [],
    "section": "Articles",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/17d520j7",
    "frozenauthors": [
        {
            "first_name": "Natalie",
            "middle_name": "",
            "last_name": "Schwehr",
            "name_suffix": "",
            "institution": "University of Minnesota",
            "department": "None"
        },
        {
            "first_name": "Giovann",
            "middle_name": "",
            "last_name": "Alarcón",
            "name_suffix": "",
            "institution": "University of Minnesota",
            "department": "None"
        },
        {
            "first_name": "Lacey",
            "middle_name": "",
            "last_name": "Hartman",
            "name_suffix": "",
            "institution": "University of Minnesota",
            "department": "None"
        }
    ],
    "date_submitted": "2021-08-31T16:15:36Z",
    "date_accepted": "2021-08-31T16:15:36Z",
    "date_published": "2021-01-01T00:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/cjpp/article/46911/galley/35464/download/"
        }
    ]
}