From the Journals
Medicaid expansion produced opposing cost effects
Did the states that expanded enrollment in 2014 spend more or less?
Uninsured patients made up a smaller share of the average physician’s practice in 2016 than in 2012, according to a survey by the American Medical Association.
For the average practice in 2016, 6.1% of patients were uninsured, compared with 6.9% in 2012. That significant drop of 0.8 percentage points was accompanied by significant increases in the number of patients covered by Medicaid and by private insurance, the AMA said in a report released Oct. 30.
“The overall picture from new physician-reported data is of more patients covered and fewer uninsured, but the findings also indicate that the improvement along those lines was concentrated in states that expanded their Medicaid programs under the ACA,” said David O. Barbe, MD, AMA president.
In the 31 states and the District of Columbia that expanded Medicaid, the average patient share dropped from 6.4% uninsured in 2012 to 5.4% in 2016, which was significant. In the states that did not expand Medicaid, the average share of uninsured patients went from 8.0% to 7.4% over that period, a drop that did not reach significance, the AMA said.
The changes involving Medicaid itself were of somewhat greater magnitude, in both directions: nonexpansion states saw a smaller increase and expansion states had a larger increase. In nonexpansion states the average share of a practice’s patients covered by Medicaid basically held steady at 15.3% (there was actually a very slight increase, but the AMA reported the figures for both 2012 and 2016 as 15.3%). In expansion states, the average Medicaid share went from 16.2% to 17.6% – a statistically significant increase of 1.4 percentage points, the AMA analysis shows.
The AMA report covers data from its 2012 and 2016 Benchmark Surveys, which each year involved approximately 3,500 physicians in patient care who were not employed by the federal government.