| Population | Intervention | Comparison | Outcome & results | |
|---|---|---|---|---|
Population in 'expansion states' aged 19 to 64 years with family incomes below 138% of the federal poverty level
Population in 'expansion states' |
Medicaid Expansion of the Affordable Care Act
Medicaid Expansion of the Affordable Care Act |
U.S. citizens in 'non-expansion states' aged 19 to 64 years with family incomes below 138% of the federal poverty level
Population in 'non-expansion states' |
• Increased health insurance by 7.4% and Medicaid ny 10.5%
• Increased hospital and office vists • Increased dxes of diabetes (5.2%) and hypercholesterol (5.7%) Infant mortality rate decline was greater in Medicaid expansion states |
|
| Massachusetts Health Care Reform Ann Int Med 2014 PMID: 24798521 |
Adults aged 20 to 64 years in Massachusetts and control group counties | Massachusetts health care reform of 2006: near-universal insurance coverage | Similar counties in nonreform states | • All-cause mortality drop (absolute decrease of 8.2 deaths per 100,000 adults P = 0.003). Benefit greater in poorer counties. • NNT = ~ 830 adults to prevent 1 death/year |
| Oregon Medicaid N Engl J Med 2013 PMID23635051 |
Low-income, uninsured, able-bodied adults who are not eligible for other public insurance (e.g. Medicare) | Randomized via lottery to 2008 Medicaid expansion | No Medicaid | Over two years follow-up: • No improvement in measured health, but • Depression reduced • Diabetes detection and rx improved Regarding costs: • Increased use of health care services if Medicaid given • Less financial strain |
| RAND HIE JAMA, 1983 PMID: 6834620 and http://www.rand.org/pubs/research_briefs/RB9174.html |
Dayton families with incomes < $25,000 (1973 dollars) and not eligible for other public insurance (e.g. Medicare) | Random assignment to insurance | No insurance | • Improved care of HTN, vision, dental, serious symptoms. • Less worry about health • Fewer restricted activity days (including time spent seeking medical care) Regarding costs: • More spent on health care if no cost sharing by the patient. • Less spent on care if cost-sharing and patients had to pay. |