This issue brief from the U.S. Department of Health and Human Services Assistant Secretary for Planning and Evaluation provides updated data on the impact of the expansion of Medicaid through the Affordable Care Act (ACA). Under the ACA, Medicaid provides enhanced federal matching funds to states to cover the cost of expanding coverage to nonelderly adults (ages 19 to 64) with income less than 138 percent of the federal poverty level (FPL). A 100 percent federal match rate applied to newly eligible individuals in the expansion population for 2014-2016 and is being phased down incrementally to 90 percent by 2020. The target population for this expansion includes parents and childless adults who were previously ineligible for Medicaid coverage. To date, a total of 31 states and the District of Columbia have expanded Medicaid.

Between 2014 an 2016, the percentage of uninsured adults in expansion states was reduced in half, decreasing from 18.5 percent to 9.3 percent. Medicaid expansion has increased access to primary care, expanded use of prescription medications, and increased rates of diagnosis of chronic conditions for new enrollees. For example, between 2013 and 2015, Medicaid expansion states saw a 7.2 percentage point increase in the number of low-income adults (non-elderly, ≤138 percent FPL) reporting a usual source of care. Uninsured individuals who gained Medicaid coverage had increases in prescription drug fill rates (79 percent increase) and reductions in out-of-pocket spending per prescription (58 percent reduction). In Ohio, which implemented Medicaid expansion, 27 percent of the Medicaid expansion enrollees were diagnosed with at least one chronic health condition but these individuals subsequently had lower levels of high blood pressure or high cholesterol since enrolling in Medicaid.

78 percent of Medicaid expansion enrollees who have used their plan indicated that they would not have been able to access and/or afford their care prior to Medicaid expansion and enrollment. 88 percent of adults are very or somewhat satisfied with their Medicaid health plans and 92 percent are very or somewhat satisfied with their Medicaid health plan doctors.

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