Coverage Expansions and Utilization of Physician Care

Evidence From the 2014 Affordable Care Act and 1966 Medicare/Medicaid Expansions

Bibliographic Data

ID11020702
AuthorsAdam Gaffney (0000-0001-7326-0661, All of the authors are with the Cambridge Health Alliance, Department of Medicine, Harvard Medical School, Cambridge, MA. Steffie Woolhandler and David Himmelstein are also with the City University of New York at Hunter College, New York.), Danny Mccormick (All of the authors are with the Cambridge Health Alliance, Department of Medicine, Harvard Medical School, Cambridge, MA. Steffie Woolhandler and David Himmelstein are also with the City University of New York at Hunter College, New York.), David Bor (All of the authors are with the Cambridge Health Alliance, Department of Medicine, Harvard Medical School, Cambridge, MA. Steffie Woolhandler and David Himmelstein are also with the City University of New York at Hunter College, New York.), David H Bor (Cambridge Health Alliance), Steffie Woolhandler (0000-0002-8965-1058, All of the authors are with the Cambridge Health Alliance, Department of Medicine, Harvard Medical School, Cambridge, MA. Steffie Woolhandler and David Himmelstein are also with the City University of New York at Hunter College, New York.), David U Himmelstein (0000-0002-2394-4915, Cambridge Health Alliance), David Himmelstein (All of the authors are with the Cambridge Health Alliance, Department of Medicine, Harvard Medical School, Cambridge, MA. Steffie Woolhandler and David Himmelstein are also with the City University of New York at Hunter College, New York.)
Year2019
Volume109
Issue12
Pages1694-1701
Publication date2019-12-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2019.305330
PMID31622135
OpenAlexW2980552510
LanguageEN
References cited19

Objectives. To evaluate the effects of the 2 major coverage expansions in US history—Medicare/Medicaid in 1966 and the Affordable Care Act (ACA) in 2014—on the utilization of physician care. Methods. Using the National Health Interview Survey (1963–1969; 2011–2016), we analyzed trends in utilization of physician services society-wide and by targeted subgroups. Results. Following Medicare/Medicaid’s implementation, society-wide utilization remained unchanged. While visits by low-income persons increased 6.2% (P Conclusions. Past coverage expansions in the United States have redistributed physician care, but have not increased society-wide utilization in the short term, possibly because of the limited supply of physicians. Public Health Implications. These findings suggest that future expansions may not cause unaffordable surges in utilization

Environmental health · Family medicine · Health care · Health insurance · Medicaid · Patient Protection and Affordable Care Act · Political science · Population · Poverty · Poverty level · Public health · Demography · Healthcare cost, quality, practices · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes · Gerontology

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