Medicaid expansion reduced uninsured surgical hospitalizations and associated catastrophic financial burden Journal Article


Authors: Albright, B. B.; Chino, F.; Chino, J. P.; Havrilesky, L. J.; Aviki, E. M.; Moss, H. A.
Article Title: Medicaid expansion reduced uninsured surgical hospitalizations and associated catastrophic financial burden
Abstract: An important function of health insurance is protecting enrollees from excessively burdensome charges for unanticipated medical events. Unexpected surgery can be financially catastrophic for uninsured people. By targeting the low-income uninsured population, Medicaid expansion had the potential to reduce the financial risks associated with these events. We used two data sources (state-level data for forty-four states and patient-level data for four states) to estimate the association of Medicaid expansion with uninsured surgical hospitalizations among nonelderly adults. Uninsured surgery cases were typically admitted through the emergency department-often for common emergency procedures-and 99 percent of them were estimated to be associated with financially catastrophic visit charges. We found that Medicaid expansion was associated with reductions in both the share (6.20 percent) and the population rate (7.85 per 10,000) of uninsured surgical discharges in expansion versus nonexpansion states. Our estimates suggest that in 2019 alone, adoption of Medicaid expansion in nonexpansion states could have prevented more than 50,000 incidences of catastrophic financial burden resulting from uninsured surgery.
Keywords: adult; united states; health care policy; health insurance; medicaid; hospitalization; insurance; insurance, health; insurance coverage; patient protection and affordable care act; humans; human; medically uninsured
Journal Title: Health Affairs
Volume: 40
Issue: 8
ISSN: 0278-2715
Publisher: Project HOPE  
Date Published: 2021-08-01
Start Page: 1294
End Page: 1303
Language: English
DOI: 10.1377/hlthaff.2020.02496
PUBMED: 34339246
PROVIDER: scopus
PMCID: PMC10077516
DOI/URL:
Notes: Article -- Export Date: 1 October 2021 -- Source: Scopus
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  1. Emeline Mariam Aviki
    81 Aviki
  2. Fumiko Chino
    223 Chino