Agency for Healthcare Research and Quality, Rockville, MD, USA.
San Diego State University, San Diego, CA, USA.
Med Care Res Rev. 2022 Feb;79(1):125-132. doi: 10.1177/1077558721996851. Epub 2021 Mar 3.
The Affordable Care Act's (ACA) Medicaid expansion resulted in substantial gains in coverage. However, little research has documented eligibility or participation rates among eligible adults in the post-ACA period in part because of the complexities involved in assigning eligibility status. We used simulation modeling to examine Medicaid eligibility and participation during 2014 to 2017. More than one in five adults were Medicaid eligible in expansion states in the post-ACA period. In contrast, about one in 30 adults were Medicaid eligible in nonexpansion states. While eligibility rates differed substantially by expansion status, participation rates among Medicaid-eligible adults were similar in both sets of states (44% to 46%). These estimates indicate that differences in eligibility rather than in participation rates explained differences in enrollment between expansion and nonexpansion states during the study period. Participation in Medicaid is expected to grow during the coronavirus pandemic. Our study provides baseline estimates for future analyses of enrollment trends.
平价医疗法案（ACA）的医疗补助扩大计划带来了覆盖范围的显著扩大。然而，由于确定资格状态所涉及的复杂性，很少有研究记录 ACA 后时期符合条件的成年人的资格或参与率。我们使用模拟模型来研究 2014 年至 2017 年期间的医疗补助资格和参与情况。在 ACA 后时期，超过五分之一的成年人有资格获得扩大计划州的医疗补助。相比之下，在没有扩大计划的州，大约有三十分之一的成年人有资格获得医疗补助。虽然资格率因扩大计划状态而有很大差异，但在这两组州中，符合医疗补助条件的成年人的参与率相似（44%至 46%）。这些估计表明，在研究期间，扩大计划州和非扩大计划州之间的入学差异是由资格差异而不是参与率差异造成的。在冠状病毒大流行期间，对医疗补助的参与预计将增加。我们的研究为未来分析入学趋势提供了基准估计。
