Association Between State Medicaid Expansion and Emergency Access to Acute Care Hospitals in the United States

Key Points Question Are states that chose not to expand Medicaid under the Patient Protection and Affordable Care Act associated with reduced emergency access to acute care hospitals? Findings In this cross-sectional study of acute care hospital availability in all 50 US states and the District of Columbia, states that did not expand Medicaid experienced worsened emergency access to acute care hospitals compared with states that expanded Medicaid. Meaning This study found reduced emergency access to acute care hospitals in states that did not expand Medicare, which could negatively impact the quality of care for time-sensitive conditions such as acute myocardial infarction, stroke, sepsis, and trauma.