Injecting Facts Into the Heated Debates Over Medicaid Expansion
Authors: Jeffrey T. Kullgren
Journal: Annals of Internal Medicine (2016)

Editorials21 June 2016Injecting Facts Into the Heated Debates Over Medicaid ExpansionJeffrey T. Kullgren, MD, MS, MPHJeffrey T. Kullgren, MD, MS, MPHFrom VA Ann Arbor Healthcare System and University of Michigan, Ann Arbor, Michigan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-0776 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Medicaid expansion has been a contentious political issue since the 2012 U.S. Supreme Court decision that state expansions of Medicaid under the Patient Protection and Affordable Care Act (ACA) are optional rather than mandatory. In the wake of this decision, 31 states have expanded their Medicaid programs and 19 have not (1).The debates around these decisions—which continue in earnest in many states—have been dominated by partisan rhetoric about the potential effects of Medicaid expansion. Yet, few objective national data have been available on the effects of the expansions. The study by Wherry and Miller in this week's Annals (2), ...References1. The Henry J. Kaiser Family Foundation. Status of State Action on the Medicaid Expansion Decision. Menlo Park, CA: The Henry J. Kaiser Family Foundation. Accessed at http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act on 29 March 2016. Google Scholar2. Wherry LR, Miller S. Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions. A quasi-experimental study. Ann Intern Med. 2016;164:795-803. doi:10.7326/M15-2234 LinkGoogle Scholar3. Sommers BD, Gunja MZ, Finegold K, Musco T. Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. JAMA. 2015;314:366-74. [PMID: 26219054] doi:10.1001/jama.2015.8421 CrossrefMedlineGoogle Scholar4. Claxton G, Rae M, Panchal N, Whitmore H, Damico A, Kenward K, et al. Health benefits in 2015: stable trends in the employer market. Health Aff (Millwood). 2015;34:1779-88. [PMID: 26395215] doi:10.1377/hlthaff.2015.0885 CrossrefMedlineGoogle Scholar5. Kullgren JT, Galbraith AA, Hinrichsen VL, Miroshnik I, Penfold RB, Rosenthal MB, et al. Health care use and decision making among lower-income families in high-deductible health plans. Arch Intern Med. 2010;170:1918-25. [PMID: 21098352] doi:10.1001/arch CrossrefMedlineGoogle Scholar6. Sommers BD, Graves JA, Swartz K, Rosenbaum S. Medicaid and marketplace eligibility changes will occur often in all states; policy options can ease impact. Health Aff (Millwood). 2014;33:700-7. [PMID: 24622387] doi:10.1377/hlthaff.2013.1023 CrossrefMedlineGoogle Scholar7. Clemans-Cope L, Long SK, Coughlin TA, Yemane A, Resnick D. The expansion of Medicaid coverage under the ACA: implications for health care access, use, and spending for vulnerable low-income adults. Inquiry. 2013;50:135-49. [PMID: 24574131] doi:10.1177/0046958013513675 CrossrefMedlineGoogle Scholar8. Kaufman HW, Chen Z, Fonseca VA, McPhaul MJ. Surge in newly identified diabetes among Medicaid patients in 2014 within Medicaid expansion states under the Affordable Care Act. Diabetes Care. 2015;38:833-7. [PMID: 25802324] doi:10.2337/dc14-2334 CrossrefMedlineGoogle Scholar9. Baicker K, Taubman SL, Allen HL, Bernstein M, Gruber JH, Newhouse JP, et al; Oregon Health Study Group. The Oregon experiment—effects of Medicaid on clinical outcomes. N Engl J Med. 2013;368:1713-22. [PMID: 23635051] doi:10.1056/NEJMsa1212321 CrossrefMedlineGoogle Scholar10. Rudowitz R, Musumeci M. The ACA and Medicaid Expansion Waivers. Washington, DC: The Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation; 2015. Google Scholar Author, Article, and Disclosure InformationAffiliations: From VA Ann Arbor Healthcare System and University of Michigan, Ann Arbor, Michigan.Disclaimer: The views expressed in this article are those of the author and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the U.S. government.Financial Support: By the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development (HSR&D) Service. Dr. Kullgren is a VA HSR&D Career Development awardee at VA Ann Arbor Healthcare System.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0776.Corresponding Author: Jeffrey T. Kullgren, MD, MS, MPH, VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, PO Box 130170, Ann Arbor, MI 48113-0170; e-mail, [email protected]umich.edu.This article was published at www.annals.org on 19 April 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEarly Coverage, Access, Utilization, and Health Effects Associated With the Affordable Care Act Medicaid Expansions Laura R. Wherry and Sarah Miller Metrics 21 June 2016Volume 164, Issue 12Page: 848-849KeywordsDisclosureHealth careHealth care utilizationHealth insuranceHealth services administration and managementHealth services researchHealth surveysPatient Protection and Affordable Care ActPrimary care physiciansVeteran care ePublished: 19 April 2016 Issue Published: 21 June 2016 PDF downloadLoading ...