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AHRQ: Uninsured Hospital Stays, ED Visits Decreased in Medicaid Expansion States

Rates of uninsured hospital stays and emergency department visits have decreased in states that expanded Medicaid eligibility, new research from the Agency for Healthcare Research and Quality (AHRQ) has found.

Published in Health Services Research, the retrospective study used AHRQ Healthcare Cost and Utilization Project data from 2011 to 2015 to estimate the effects of Medicaid coverage expansion on hospital utilization rates, costs, and patient illness severity. The study also examined the relationship between the size of the uninsured population eligible for Medicaid and changes in outcome.

The research shows that uninsured hospital stays in states that expanded Medicaid decreased an average of 39 percent in all age and sex demographic groups, except for young women. Expansion states had negative changes in inpatient costs, and all-payer inpatient costs per patient discharge declined less than 6 percent. In states that did not expand Medicaid, uninsured utilization rates remained unchanged or slightly increased.

The study also found that the size of the uninsured population eligible for coverage was strongly associated with health outcomes; positive change in health outcomes was greater in states with larger populations eligible for Medicaid coverage.

Researchers concluded that significant changes in cost per discharge and patient severity were consistent with Medicaid expansion.


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