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Study: More Kentuckians Sought Care After Medicaid Expansion

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After the state expanded Medicaid under the Affordable Care Act in 2014, low-income Kentuckians made fewer trips to the emergency room, had less trouble paying medical bills, received a checkup and sought help for chronic conditions. That’s according to a new study released Monday from the Harvard Chan School of Public Health.

Researchers surveyed almost 3,000 low-income Kentuckians in 2013, 2014 and 2015. Participants were asked about their coverage and about their health habits, including if they skipped doses of medication, had a personal doctor or had any emergency room visits in the past year.

In 2013, prior to the Medicaid expansion, 46.3 percent of Kentuckians surveyed said they had a checkup in the past year. Of those surveyed in 2015, after the expansion, that number increased to almost 59.8 percent. There was also a big jump in the number of people who said they had a primary physician after the expansion – from 56.6 percent to 71.7 percent.

Susan Zepeda, president of the Foundation for a Healthy Kentucky, said this is good news.

“When health issues are identified early, the treatment is not only likely to be less expansive, but the outcomes are likely to be better,” Zepeda said.

Other key findings from the studies:

  • More people with chronic conditions, like diabetes, sought help. Up from 69.4 percent in 2013 to 78.6 percent in 2015.
  • Annual out-of-pocket spending decreased from $423 in 2013 to $318 in 2015.
  • In 2013, 42.7 percent of people had trouble paying medical bills. That number dropped to 27.4 percent in 2015.
  • In 2013, 9.3 percent of Kentuckians surveyed said they went to the emergency room when they were sick. That number decreased to 7.9 percent in 2015.
  • In 2013, 37 percent put off getting medication due to cost. In 2015, only 26 percent did.

Of those Kentuckians surveyed, 84 percent were white, 11 percent were black, 2 percent were Latino and 3 percent were listed as “other.” Forty-three percent had a high school diploma and 37 percent earned between $5,940 and $11,880 a year (50 to 100 percent of the federal poverty limit).

“All the things we hoped would happen because of the coverage people got is starting to show up, even in the first couple years of coverage,” said Jason Bailey of the Kentucky Center for Economic Policy.

Credit Alexandra Kanik |

The results of the new study come as the Bevin administration is still sorting through commentson its proposed Medicaid expansion waiver. If approved as-is, it would put in place monthly premiums for individuals earning more than $11,880, copays for people earning less than the federal poverty limit and eliminate default vision and dental coverage for able-bodied adults. Bevin is proposing a ‘rewards’ account that would let people earn points toward those benefits.

“Adding increased costs for a population that is generally struggling financially – we’re talking about people whose incomes are generally below $10,000 — will very likely make it harder to get the care they need,” said Ben Sommers, a lead author of the study. “A lot of what’s being proposed —  I would worry would keep people from getting the care that they need.”

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