Impact Of Medicaid Expansion On Insurance Coverage And Cost Barriers To Care : A Difference-In-Differences Analysis Using Brfss Data
Nyirenda, N.; Chisanga, B.; Muturi, H.; Siachalinga, L.
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BackgroundThe Affordable Care Act (ACA) expanded Medicaid eligibility to improve healthcare access. This study evaluates whether Medicaid expansion led to increased insurance coverage and reduced cost-related barriers to healthcare. MethodsWe used Behavioral Risk Factor Surveillance System (BRFSS) data from 2012, 2013, 2015, 2016, and 2018. A Difference-in-Differences (DiD) approach was applied, comparing adults in expansion versus non-expansion states before and after 2014. Logistic regression was employed to calculate odds ratios (OR) along with their corresponding 95% confidence intervals (CI). ResultsMedicaid expansion was associated with 25% greater odds of insurance coverage (OR = 1.25; 95% CI: 1.22, 1.28) and 10% lower odds of cost-related barriers to care (OR = 0.90; 95% CI: 0.89 to 0.91, indicating a statistically significant association (p < 0.001). ConclusionMedicaid expansion under the ACA significantly improved healthcare access by increasing insurance coverage and reducing cost-related barriers.
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