Abstract：
In 2014, the Affordable Care Act (ACA) expanded the role of Medicaid by encouraging states to increase eligibility for lower-income adults. As of 2024, 10 states had not adopted the expanded eligibility provisions of the ACA, possibly due to concerns about the state\'s share of spending. Using the Medical Expenditure Panel Survey (MEPS), we documented how health care utilization, expenditures, and the overall health status of newly eligible enrollees compare with enrollees who would have been eligible under their states\' rules before the ACA. Our estimates suggest that, during 2014-16, newly eligible Medicaid enrollees had worse health and greater utilization and expenditures than previously eligible enrollees. However, during 2017-19, newly and previously eligible enrollees had comparable per capita health expenditures across six types of health spending. We find some evidence that changes in Medicaid enrollment composition muted observed differences between eligibility groups.
摘要：
2014年，《平价医疗法案》（ACA）通过鼓励各州增加低收入成年人的资格，扩大了医疗补助的作用。截至2024年，有10个州尚未采用ACA的扩大资格规定，可能是由于担心国家的支出份额。使用医疗支出小组调查(MEPS)，我们记录了如何利用医疗保健，支出,新符合条件的参与者的总体健康状况与根据ACA之前的州规则符合资格的参与者进行比较。我们的估计表明，在2014-16年度,新符合条件的Medicaid参与者的健康状况比以前符合条件的参与者差,利用率和支出更高.然而,在2017-19年度,新纳入和以前符合纳入条件的参与者在6种卫生支出中的人均卫生支出具有可比性.我们发现了一些证据，表明Medicaid注册构成的变化减弱了资格组之间的差异。
