Health Analytics Logo

7 Effects of Medicaid Expansion on Healthcare Access and Outcomes

Table of Contents

Medicaid expansion under the Affordable Care Act (ACA) has been a controversial topic since the law’s inception. However, there is no denying that Medicaid expansion has significantly impacted healthcare access in the United States. In this article, we will discuss the seven effects of Medicaid expansion on healthcare access.

1. Medicaid expansion improves access to healthcare services

The Medicaid expansion improves access to healthcare services by removing or reducing the financial cost of accessing these services, allowing individuals and families to access the treatment they would not otherwise have been able to afford.

By increasing health coverage, individuals have improved access to care, including preventative care and treatment for existing ailments. The availability of this coverage reduces the financial burden on individuals, families, and providers, allowing them to focus on their health instead of costs.

Additionally, research has found that Medicaid expansion was associated with increased early-stage cancer diagnoses in the first year, improved birth outcomes, and lower overall mortality rates for specific health conditions.

2. Medicaid expansion improves health outcomes

Medicaid expansion has been linked to improved access to healthcare, increased coverage for low- and moderate-income adults, increased preventive service use, and decreased disparities in access to care. These improvements have, in turn, positively impacted health outcomes.

Studies have shown that Medicaid expansion was associated with increased usage of buprenorphine with naloxone prescriptions and a shift to early-stage cancer diagnosis, suggesting improved access to treatment for opioid-use disorder and improved access to screening services.

In addition, disparities in the percentage of uninsured patients by race/ethnicity, census tract-level poverty, and rurality were diminished or eliminated in states with Medicaid expansion, suggesting that it is an effective strategy for mitigating health disparities.

3. Medicaid expansion reduces uninsured rates

Medicaid expansion has been instrumental in reducing the number of uninsured people. Expansion states have seen significant reductions in uninsured rates and uncompensated care costs, with a 45% reduction from 2013 to 2017 compared to only a 2% reduction in non-expansion states. The increase in Medicaid coverage is partly due to the ‘crowd-out’ effect of private insurance in expansion states.

People with opioid-use disorders have also seen significant coverage gains from expansion, with Medicaid coverage helping to reduce the share of opioid-related hospitalizations in which the patient was uninsured by 79% in expansion states. The expansion has also helped to narrow disparities in health coverage and access to care, with the gap in uninsured rates between white and Black/Hispanic adults shrinking by 51%/45% in expansion states.

Overall, Medicaid expansion has significantly reduced the uninsured rate across all FPL groups, particularly among those aged 55–64 years old, well-educated, and employed.

4. Medicaid expansion can reduce poverty

Medicaid expansion has been linked to reducing poverty in the United States by increasing the number of people who have access to health insurance coverage. It expands the eligibility of income-based assistance programs to cover individuals and families below the poverty line, allowing them to receive health care that they would not otherwise be able to afford.

5. Medicaid expansion increases self-reported physical and mental health

The study conducted by Project HOPE—The People-to-People Health Foundation, Inc. in June 2018 analyzed the effects of Medicaid expansion on health outcomes, healthcare utilization, and access to healthcare. Through the use of difference-in-difference models, the study found that state Medicaid expansion had a positive effect on adults and increased healthcare utilization of preventive care.

This increase in healthcare utilization can lead to an increase in self-reported physical and mental health. The increased access to healthcare services means that individuals with Medicaid insurance can receive regular primary care checkups, blood pressure checks, and other preventive care, which can help to improve physical and mental health.

Furthermore, the study found that Medicaid expansion was associated with decreased racial and ethnic disparities in healthcare access and treatment, which could lead to better physical and mental health outcomes for individuals from traditionally underserved communities.

? Learn more: Medicaid Expansion, Behavioral Health, And More

6. Medicaid expansion increases prescription drug use

The effects of Medicaid expansion on prescription drug use can be seen in the study by Mulia et al. (2022). They found that after 2014, treatment rates for alcohol and opioid use disorders (OUD) for Medicaid-covered patients increased in expansion states and decreased in non-expansion states. This suggests that Medicaid expansion led to increased access to treatment medications for OUD, which in turn led to increased prescription drug use.

Furthermore, Khatri et al. (2021) found that Medicaid expansion was associated with a 165 percent increase in the receipt of medications for opioid use disorder among individuals referred by criminal justice agencies. These findings suggest that Medicaid expansion leads to increased access to prescription medications and therefore increased prescription drug use.

7. Medicaid expansion increases outpatient care

Medicaid expansion has positively affected patient access to health care and improved the financial stability of safety-net institutions. The changes in the payer mix after Medicaid expansion in clinics, urgent care centers, and emergency departments have been driven by the uptake of Medicaid coverage among previously uninsured individuals.

This increased access to Medicaid coverage has resulted in decreased self-pay healthcare visits and patients and increased primary care visits. This suggests that Medicaid expansion has expanded access to primary care services and reduced uncompensated care in the patient population. These findings indicate that Medicaid expansion has had a positive effect on patient access to health care services, increasing the number of outpatient visits to primary care clinics.


Medicaid expansion has major impacts on healthcare access and can improve health outcomes. These results underscore the importance of carefully weighing the pros and cons of any policy change before implementing it. Overall, the findings suggest that Medicaid expansion has had a positive impact on healthcare access and affordability for low-income families—especially those who were previously uninsured.