Medicaid Policy Changes under the Affordable Care Act: Effects on Low-Income Individuals and Providers
The Affordable Care Act (ACA) included several changes to Medicaid policy with the potential to have far-reaching effects on both low-income populations and health care providers. The most significant change was the option for states to expand Medicaid coverage, with generous federal funding, to most individuals with incomes up to 138 percent of poverty. The expansion is expected to significantly increase coverage and improve access to care for low-income adults, but the expansion also has important implications for hospitals which may experience improved financial health as more patients gain coverage. In addition to the eligibility expansion, the ACA included a provision aimed at improving access to primary care for Medicaid enrollees by increasing payment rates to primary care providers to match rates paid by Medicare. The papers in this session assess the early impacts of these Medicaid policy changes on low-income individuals and hospital finances using three different data sources. The first paper uses data from the National Health Interview Survey to examine the effects of the Medicaid expansion on a broad range of coverage, access, affordability and health measures for low-income adults. The second paper focuses on the effect of the primary care rate increase on physician participation in Medicaid and on provision of primary care services to Medicaid enrollees using data from IMS Health. Finally, the third paper explores the effects of the Medicaid expansion on hospital operating margins and uncompensated care costs using data from the American Hospital Association Annual Survey Database.