American Heart Association: Wider Access to Health Insurance via Medicaid Expansion Improved Cardiac Care
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Expanding health insurance access may lessen the toll of heart disease in the
Research Highlights:
* States that participated in the Medicaid expansion provision of the Affordable Care Act, raising the income level to be eligible for Medicaid up to 138% of the federal poverty level, improved several measures of heart disease care for Medicaid recipients in their states.
* In an analysis of 30 studies comparing states that chose to participate in Medicaid expansion with those that didn't, Medicaid expansion was associated with improvement in insurance coverage for cardiac care, decreased out-of-hospital deaths, fewer socioeconomic and demographic disparities in care and increased preventive care and screening.
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An expansion of the Affordable Care Act that extends Medicaid eligibility to more people improved patient outcomes, prevention measures and screening access, according to a review of research published today in Circulation: Cardiovascular Quality and Outcomes, a peer-reviewed
A provision of the Affordable Care Act of 2010 extended Medicaid eligibility to all adults with incomes of up to 138% of the federal poverty level in states that elect to participate, with the federal government covering 90% of the costs. Medicaid provides health insurance coverage for people with low income, and the expansion ensures that, as of
"Our work adds to the growing body of evidence supporting the idea that expanding health insurance coverage results in better health outcomes," said lead study author
More than 1 in 4 people covered by Medicaid have a history of heart disease, and many deal with multiple chronic conditions that raise the risk of heart disease - such as Type 2 diabetes, high blood pressure, high cholesterol and high triglycerides, Jiang noted.
"Expansion of Medicaid is one of the most important health policy changes over the past 10-15 years," said senior study author
The researchers reviewed 30 studies, published between
The analysis found:
* Of the studies tracking changes in insurance coverage for cardiac treatments, 64% found improvement with Medicaid expansion.
* Of the studies tracking changes in heart-related deaths and illness, 36% found improvement with Medicaid expansion. With Medicaid expansion, there was a decrease in out-of-hospital deaths from heart disease but no association with in-hospital deaths.
* Of the studies tracking disparities in care across different socioeconomic and demographic groups, 37.5% found reduced disparities with Medicaid expansion.
* Of the studies tracking preventive care, such as screening and treatment for high blood pressure, high cholesterol and Type 2 diabetes, 48% found improved preventive care with Medicaid expansion.
"Overall, it appears that expansion of Medicaid was associated with increased health insurance coverage for individuals with heart disease and improved uptake in preventive care such as screening for health concerns that impact heart health," said Wasfy. "What is less clear is whether Medicaid expansion improved outcomes in hospital settings. Perhaps when patients are in the hospital, they tend to get recommended therapies regardless of insurance status, but then later, as outpatients without insurance, they may have many more difficulties in terms of accessing care."
Studies included in the review are limited by a short follow-up time following Medicaid expansion, which may underestimate the eventual impact of the measure given the long-term benefits of preventive care and the delay between obtaining insurance coverage and receiving cardiac surgery or other interventions.
In addition, the study could not confirm whether differences in Medicaid expansion and non-expansion states are due to the Medicaid policy itself or other differences among the states.
The study's other co-author is
The study was funded in part by a
Studies published in the
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Original text here: https://newsroom.heart.org/news/wider-access-to-health-insurance-via-medicaid-expansion-improved-cardiac-care
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