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Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014
Author(s) -
Winkelman Tyler N. A.,
Segel Joel E.,
Davis Matthew M.
Publication year - 2019
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13085
Subject(s) - medicaid , medical expenditure panel survey , ethnic group , medical prescription , medicine , prescription drug , demography , health care , national health interview survey , health insurance , family medicine , environmental health , gerontology , population , nursing , sociology , anthropology , economics , economic growth
Objectives To examine the person‐level impact of Medicaid enrollment on costs, utilization, access, and health across previously uninsured racial/ethnic groups. Data Source Medical Expenditure Panel Survey, 2008‐2014. Study Design We pooled multiple 2‐year waves of data to examine the direct impact of Medicaid enrollment among uninsured Americans. We compared changes in outcomes among nonpregnant, uninsured individuals who gained Medicaid (N = 963) to those who remained uninsured (N = 9784) using a difference‐in‐differences analysis. Principal Findings Medicaid enrollment was associated with significant increases in total health care costs and total prescription drug costs and a significant decrease in out‐of‐pocket costs. Among those who gained Medicaid, prescription drug use increased significantly relative to those who remained uninsured. Medicaid enrollment was also associated with a significant increase in reporting a usual source of care, a decrease in foregone care, and significant improvements in severe psychological distress. Changes in total prescription drug costs and total prescription drug fills differed significantly across each racial/ethnic group. Conclusions Among a national sample of uninsured individuals, Medicaid enrollment was associated with substantial favorable changes in out‐of‐pocket costs, prescription drug use, and access to care. Our findings suggest Medicaid is an important tool to reduce insurance‐related disparities among Americans.