Analysing the impact of the Medicaid expansion under the affordable care act on the healthcare expenditures for individuals with chronic conditions

Abstract

Non-communicable diseases pose a significant economic burden on the healthcare system of the United States of America. In 2010, the Affordable Care Act (ACA) was enacted to alleviate this burden through Medicaid expansion which commenced on a state-by-state basis in 2014. This study aims to explore the impact of the Medicaid expansion on healthcare expenditures among individuals with chronic diseases. Using data from the Household Component of the Medical Expenditure Panel Survey spanning 2010 to 2019, we used a difference-in-difference approach to assess changes in healthcare expenditures before and after the implementation of the Medicaid expansion. We found that the Medicaid expansion in 2014 was associated with a statistically significant increase in the average amount paid by Medicaid and a significantly higher average amount paid by Medicaid for each additional chronic disease. We further analysed the impact of ACA on out-of-pocket and total healthcare expenditures including the effects across various demographic variables (i.e. family income, gender, and age). This study contributes to a better understanding of the ACA's impact on Medicaid expenditures for individuals with chronic diseases, informing policy decisions that target individuals with multimorbidity and improving healthcare accessibility and affordability nationwide.