Bottom Line: The Affordable Care Act's (ACA's) Medicaid expansion was associated with significant increases in insurance coverage among patients with serious surgical conditions such as appendicitis or aortic aneurysm, and a greater likelihood of these patients receiving timely, optimal care.
Why The Research Is Interesting: Lack of insurance coverage has been associated with delays in seeking care, more complicated diseases at the time of diagnosis, and a decreased likelihood of receiving optimal surgical care. The ACA's Medicaid expansion has increased coverage among millions of low-income Americans, but its effect on care for common surgical conditions has not been known.
Who and When: 293,529 patients between the ages of 18 and 64 years with appendicitis, inflammation of the gallbladder, diverticulitis, peripheral artery disease or aortic aneurysm admitted to a hospital in 27 states that expanded Medicaid or 15 states that didn't to compare outcomes before (2010-2013) and after Medicaid expansion (2014-2015)
What (Study Measures): State adoption of Medicaid expansion (exposure); presentation of patients with early, uncomplicated disease and optimal surgical management of their conditions (outcomes)
How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and they cannot control all the natural differences that could explain study findings.
Authors: Andrew P. Loehrer, M.D., M.P.H., University of Texas MD Anderson Cancer Center, Houston, and coauthors.
Results: ACA's Medicaid expansion was associated with increased insurance coverage of patients and improvement in receiving timely and optimal care for five common surgical conditions.
Study Limitations: Data are vulnerable to coding errors and study findings may not be generalizable for other medical conditions.
For more details and to read the full study, please visit the For The Media website.
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2017.5568