The Effects of Medicaid Expansion Under the Affordable Care Act on Health Insurance Coverage, Health Care Access, and Health Care Use for People with Disabilities

More than 27% of individuals in the United States experience a disability. We conducted a scoping review of the literature to examine what is known about the impact of the 2010 Affordable Care Act Medicaid expansion on individuals with disabilities’ health care insurance coverage, health care access, and health care use. We followed the approach of Arskey and O’Malley in conducting our review. Electronic journal databases, hand searching of key health and disability journals, and reference checking were used to identify potential articles for the review. Individuals with disabilities or with conditions that could be disabling were included. The intervention used was the 2010 Affordable Care Act Medicaid expansion. Study eligibility criteria were peer-reviewed studies published in 2014 or later that conducted multivariate analyses of the effect of the Medicaid expansion on people with disabilities’ health insurance coverage, health care access, and health care use. The most consistent finding across studies was that the Medicaid expansion had a positive effect on health insurance coverage. It was generally found to have increased Medicaid coverage and decreased the uninsured rate. Its effect on private or employer-sponsored insurance coverage was a mix of no and negative effects. Findings related to health care access and use of care were more mixed. On a scale of 0 to 8 (highest quality), the quality of individual studies ranged from 2 to 6, with an average across studies of 4.2, the low end of adequate quality. Future studies should develop a more consistent approach to measuring disability and develop a core set of health care access and use measures to facilitate comparisons across studies so as to systematically evaluate the evidence related to the Medicaid expansion

Actuarial science · Business · Economic growth · Economics · Environmental health · Health care · Health insurance · Medicaid · Patient Protection and Affordable Care Act · Global Health Care Issues · Healthcare Policy and Management · Medicine · Nursing · Retirement, Disability, and Employment

• The Effects Of Medicaid Expansion Under The ACA

  Olena Mazurenko, Casey P Balio et al.•Health Affairs•2018

  Incluir item

• Sicker and Poorer—The Consequences of Being Uninsured

  Open Access•Jack Hadley•Medical Care Research and Review•2003

  Incluir item

• Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance

  Benjamin D Sommers, Robert J Blendon et al.•JAMA Internal Medicine•2016

  Incluir item

• Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach

  Open Access•Zachary Munn, Micah D J Peters et al.•BMC Medical Research Methodology•2018

  Incluir item

• The Implications of Unmet Need for Future Health Care Use

  Open Access•Sharon K Long, Jennifer King et al.•INQUIRY The Journal of Health…•2005

  Incluir item

• Unmet Need for Personal Assistance Services

  Mitchell P LaPlante, H S Kaye et al.•The Journals of Gerontology…•2004

  Incluir item

• Provider Perceptions of Their Capacity to Offer Accessible Health Care for People With Disabilities

  Open Access•Sara S Bachman, Mark Vedrani et al.•Journal of Disability Policy…•2006

  Incluir item

• Relationships Among Race/Ethnicity, Gender, and Mental Health Status in Patient–Provider Interactions

  Open Access•Shreyasi Deb, Nancy A Miller•Journal of Disability Policy…•2018

  Incluir item

• Delayed and Unmet Need for Medical Care Among Publicly Insured Adults With Disabilities

  Carrie Henning‐smith, Carrie Henning-Smith et al.•Medical Care•2013

  Incluir item

• Scoping studies

  Hilary Arksey, Lisa O’malley•International Journal of Social…•2005

  Incluir item