TUESDAY, Dec. 20, 2016 (HealthDay News) — Expanding Medicaid — the U.S. federal-state health insurance program for the poor — gives people access to a broader array of hospital choices than they had when they were uninsured, a new study suggests.
Often, people are choosing hospitals closer to home, researchers reported.
The study uses data from two investor-owned hospital systems to see whether the 2014 Medicaid expansion provided under the Affordable Care Act (ACA) — often called Obamacare — affected emergency department use.
To date, 31 states have expanded Medicaid coverage to people in households making less than 138 percent of the federal poverty level, researchers said. In 2016, that’s less than $16,394 for a single person and $33,534 for a family of four.
The new analysis focused on whether the insurance expansion altered where people go for care. It didn’t look at how much care they received, whether that care was appropriate or the quality of care.
“By expanding Medicaid, it broadened access potentially to affordable care at a broader range of facilities,” said study author John Graves. He’s an assistant professor of health policy at Vanderbilt University School of Medicine in Nashville, Tenn.
“They seem to be kind of voting with their feet,” he said. For example, people are switching from public to private hospitals.
Graves said that his own office is located across the street from a low-income housing complex. That residence is right across the park from the nearest for-profit hospital. Nashville’s public hospital, however, is situated a couple of miles across town.
Uninsured patients use the public hospital “without having to worry as much about having unpaid medical bills,” he explained. But, had Tennessee expanded Medicaid under the ACA, more low-income people might be using the closer facility, he suggested.
Dr. Maria Raven is an associate professor of emergency medicine at the University of California, San Francisco, School of Medicine. She wasn’t involved in the new study.
Raven reasoned that Medicaid expansion “is a good thing for the patient if these hospitals actually offer higher quality or equivalent quality care,” compared with facilities that are farther away.
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