Affordable care act: comparison of healthcare indicators among different insurance beneficiaries with new coverage eligibility

BACKGROUND Health coverage in the United States will be increased to nearly universal levels under the Affordable Care Act (ACA). In order to better understand the impact of the type of health insurance and health outcomes, there is a need to examine health disparities and inequalities between the insured and the uninsured based on their eligibility for coverage. METHODS The current study used the data from the Medical Expenditure Panel Survey 2012 (MEPS). Selected health characteristics and access to care items were compared in regard to the insurance status: private, public, the uninsured, but likely eligible for Medicaid expansion (EME), and the uninsured, but likely required to purchase health plans through the health insurance exchanges (RPIE). RESULTS Analyses showed that 17.2% of US adults ages 27-64 were eligible as EME and 12.9% as RPIE in 2012. Compared to the insured groups, the uninsured who were eligible for coverage reported fewer health problems than those insured privately and publicly. However, they also reported less use of health care, including preventive health service, screenings, and unmet health care needs. CONCLUSIONS The ACA aims to increase coverage options and access to treatment and preventive health care services for the majority of the uninsured US population. However, it may not play as significant of a role in improving health among the uninsured, in particular, those eligible for the Medicaid expansion.