Harvard University researchers examined health-related trends over time in three states: Kentucky, which expanded Medicaid under the ACA: Arkansas, which used the federal marketplace established by the law to provide more low-income adults private insurance; and Texas, which did neither.
They report the rate of uninsured residents dropped dramatically between 2013 and 2016 in the two states that expanded coverage. At the end of last year, it stood at 7.4 percent in Kentucky, and 11.7 percent in Arkansas, while remaining at a stubbornly high rate of 28.2 percent in Texas.
And for the people who enrolled, having insurance really mattered.
"For uninsured people gaining coverage," the researchers write in the journal Health Affairs, "this change was associated with a 41 percentage point increase in having a usual source of care; a $337 reduction in annual out-of-pocket spending; significant increases in preventive health visits and glucose testing; and a 23 percentage point increase in 'excellent' self-reported health."
"Among adults with chronic conditions," they add, "we found improvements in affordability of care, regular care for those conditions, medication adherence, and self-reported health."
As Congress considers major changes in the plan, popularly known as Obamacare, lead author Benjamin Sommers offers a cautionary note: "It's critical for policymakers to understand what's at risk."