University of Pennsylvania Researcher Focuses on Health Insurance (Changes in Health Care Workers’ Economic Outcomes Following Medicaid Expansion): Health Insurance

Insurance Daily News

2024 MAR 15 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on health insurance. According to news reporting originating from the University of Pennsylvania by NewsRx correspondents, research stated, “Importance: The extent to which changes in health sector finances impact economic outcomes among health care workers, especially lower-income workers, is not well known. To assess the association between state adoption of the Affordable Care Act’s Medicaid expansion-which led to substantial improvements in health care organization finances-and health care workers’ annual incomes and benefits, and whether these associations varied across low- and high-wage occupations.”

The news editors obtained a quote from the research from University of Pennsylvania: “Design, Setting, and Participants: Difference-in-differences analysis to assess differential changes in health care workers’ economic outcomes before and after Medicaid expansion among workers in 30 states that expanded Medicaid relative to workers in 16 states that did not, by examining US individuals aged 18 through 65 years employed in the health care industry surveyed in the 2010-2019 American Community Surveys. Exposure: Time-varying state-level adoption of Medicaid expansion. Main Outcomes and Measures: Primary outcome was annual earned income; secondary outcomes included receipt of employer-sponsored health insurance, Medicaid, and Supplemental Nutrition Assistance Program benefits. The sample included 1 322 263 health care workers from 2010-2019. Health care workers in expansion states were similar to those in nonexpansion states in age, sex, and educational attainment, but those in expansion states were less likely to identify as non-Hispanic Black. Medicaid expansion was associated with a 2.16% increase in annual incomes (95% CI, 0.66%-3.65%; P = .005). This effect was driven by significant increases in annual incomes among the top 2 highest-earning quintiles (b coefficient, 2.91%-3.72%), which includes registered nurses, physicians, and executives. Health care workers in lower-earning quintiles did not experience any significant changes. Medicaid expansion was associated with a 3.15 percentage point increase in the likelihood that a health care worker received Medicaid benefits (95% CI, 2.46 to 3.84; P < .001), with the largest increases among the 2 lowest-earning quintiles, which includes health aides, orderlies, and sanitation workers.”

According to the news editors, the research concluded: “There were significant decreases in employer-sponsored health insurance and increases in SNAP following Medicaid expansion. Conclusion and Relevance: Medicaid expansion was associated with increases in compensation for health care workers, but only among the highest earners. These findings suggest that improvements in health care sector finances may increase economic inequality among health care workers, with implications for worker health and well-being.”

For more information on this research see: Changes in Health Care Workers’ Economic Outcomes Following Medicaid Expansion. JAMA, 2024,331(8). The publisher for JAMA is American Medical Association (AMA).

A free version of this journal article is available at https://doi.org/10.1001/jama.2023.27014.

Our news journalists report that additional information may be obtained by contacting Sasmira Matta, Department of Health Care Management, Wharton School, University of Pennsylvania, Philadelphia. Additional authors for this research include Paula Chatterjee, Atheendar S. Venkataramani.