Effects of the Patient Protection and Affordable Care Act on coverage and access to care in metropolitan vs. non-metropolitan areas through 2016
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Rural policy brief
- Author(s):
- Wehby, George L., author Lyu, Wei, author Shane, Dan M., author
- Contributor(s):
- RUPRI Center for Rural Health Policy Analysis, issuing body. Rural Health Research & Policy Centers, issuing body. Rural Policy Research Institute (U.S.), issuing body.
- Publication:
- Iowa City, IA : Rural Policy Research Institute, August 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Insurance Coverage -- statistics & numerical data Insurance, Health -- statistics & numerical data Rural Population Urban Population Medicaid -- statistics & numerical data United States United States.
- Genre(s):
- Technical Report
- Abstract:
- Purpose. Access to health insurance coverage has changed significantly following changes in public and private insurance due to the Patient Protection and Affordable Care Act (PPACA) which was implemented in 2014. Overall, uninsured rates have continuously fallen across the US through 2018, and access to care by various measures has improved. Less is known, however, about potential differences in the effects of the PPACA on coverage and access between metropolitan and non-metropolitan areas using quasi-experimental designs that enable causal inference and that examine the combined effects of the PPACA insurance provisions versus the effect of the Medicaid expansions. This analysis uses recent national data to shed light on possible differences in PPACA effects between metropolitan and non-metropolitan areas. Key Findings. (1) From 2013 to 2016, the implementation of the PPACA led to an overall increase in insurance coverage rates of nearly 13 and 11 percentage points in non-metropolitan and metropolitan areas, respectively. (2) Nearly 10 percentage points of the overall coverage gain in non-metropolitan areas was due to Medicaid expansion, while other PPACA insurance provisions combined (including primarily the individual mandate) increased coverage by about 3 percentage points.(3) Among individuals below the new eligibility threshold of 138 percent of the Federal Poverty Level (FPL), Medicaid expansion increased the proportion with Medicaid coverage by nearly 15 percentage points from 2013 to 2016 in non-metropolitan areas, and by 11 percentage points in metropolitan areas. (4) Among individuals below 138 percent FPL living in non-metropolitan areas in 2016, Medicaid expansion reduced the likelihood of reporting cost as a barrier to care by nearly 8 percentage points and increased the likelihood of having a routine visit in the past year by 6 percentage points (relative to 2013). In metropolitan areas, effects of Medicaid expansion on having had a routine visit were small and insignificant in 2016.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (6 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101771067 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101771067