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A Comprehensive Review of Research Finds That the ACA Medicaid Expansion Has Reduced the Uninsured Rate and Increased Access to Care in Expansion States

Multiple studies find that the Affordable Care Act’s Medicaid expansion has increased coverage, with enrollment exceeding expectations in some states, while producing budget savings for states and reductions in uncompensated care costs for hospitals, according to a Kaiser Family Foundation review of 61 studies and policy reports.

The literature review provides a useful reference on the effects of the ACA Medicaid expansion at a time when the future of the expansion – and the ACA more broadly — is a subject of debate in the presidential election and in Congress, and as some states that have not expanded Medicaid consider whether to do so. While most studies find that Medicaid expansion has improved access to care and use of services, studies of changes in health status have mixed results.  Some studies also pointed to challenges following expansion, including provider shortages in some areas. Moreover, additional research will be important to assess the economic effects of state Medicaid expansions as states begin paying a small share of expansion costs and as cuts in federal payments for uncompensated care costs go into effect.

The brief is based on both peer-reviewed studies, government reports, and analyses by research and policy organizations between January 2014 and May 2016, using data from 2014 or later.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.