Health Insurance Expansions, Access, and Utilization
The current healthcare debate revolves around the likely supply and demand responses to increased coverage resulting from full implementation of the Affordable Care Act (ACA). This session will examine issues related to healthcare expansions from both the provider and patient perspectives. The first paper documents the association between state-level measures of physician participation in Medicaid and measures of access to care for children on Medicaid/CHIP. The author finds access measures are better for children on Medicaid/CHIP who live in states with higher rates of acceptance of new Medicaid patients, validating the use of physician participation rates to gauge access to care for Medicaid beneficiaries. The second and third papers analyze insurance expansions preceding the full implementation of ACA in 2014. The second paper analyzes how the extended dependent coverage provision of the Affordable Care Act affected HPV vaccination rates among young women. The provision, which required plans to insure adult children up to age 26 under their parents’ plans, has the potential to increase vaccination rates by reducing the effective cost of the vaccine. The results indicate 19-25 year old women were more likely to receive the vaccine after the September 2010 policy implementation. The third paper analyzes the effect of extending public coverage in Wisconsin on outpatient, emergency department and inpatient events for previously uninsured low-income adults. The authors’ results suggest access to care increases utilization substantially.