Article Figures & Data
Tables
- Table 1
Demographic Characteristics of Adults Aged 19 to 64 Years, United States, National Health and Nutrition Examination Survey, 2007–2010
Characteristic Current Medicaid Beneficiaries Potentially Eligible for Medicaid Under ACAa P Value t Test χ2 Test Mean age, y (95% CI) 38.7 (37.4–40.1) 36.3 (35.2–37.4) .002 – Sex, % (95% CI) – <.001 Male 33.3 (30.1–36.6) 49.2 (46.0–52.4) Female 66.7 (63.4–69.9) 50.8 (47.6–54.0) Race/ethnicity, % (95% CI) – .02 Non-Hispanic white 49.9 (39.8–60.1) 58.8 (48.7–68.2) Non-Hispanic black 25.2 (19.0–32.7) 20.0 (15.3–25.6) Mexican American 9.8 (7.3–13.1) 11.7 (6.2–21.0) Other 15.0 (11.0–20.1) 9.6 (6.6–13.8) Education, % (95% CI) – .48 Less than high school graduate 35.9 (31.6–40.5) 35.3 (29.7–41.5) High school graduate or GED 28.1 (24.3–32.2) 31.4 (28.2–34.7) Some college and above 36.0 (31.2–41.1) 33.3 (28.5–38.4) -
ACA = Patient Protection and Affordable Care Act; GED = general equivalency diploma.
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Notes: For current Medicaid beneficiaries, unweighted n = 991 and weighted N = 13.8 million; for newly eligible for Medicaid, unweighted n = 952 and weighted N = 13.6 million. Sum of percentages in each group may not equal 100 because of rounding.
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↵a A US citizen with “no insurance” at the time of survey interview and a “poverty-to-income ratio” of 1.38 or less.
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- Table 2
Health Measures of Adults Aged 19 to 64 Years, United States, National Health and Nutrition Examination Survey, 2007–2010
Measure Current Medicaid Beneficiaries % (95% CI) Potentially Eligible for Medicaid Under ACAa % (95% CI) P Valueb Health status <.001 Excellent/very good 33.5 (28.8–38.6) 34.8 (30.6–39.3) Good 31.6 (28.6–34.7) 40.4 (36.5–44.3) Fair/poor 35.0 (30.6–39.5) 24.8 (22.3–27.5) Body mass indexc .008 Normal weight 24.6 (21.3–28.2) 31.5 (28.1–35.1) Overweight 29.9 (25.7–34.5) 29.9 (27.2–32.8) Obese 42.9 (37.8–48.3) 34.5 (30.8–38.4) Diabetesd 7.5 (5.7–9.9) 5.2 (3.6–7.4) .094 Hypertensione 9.9 (7.9–12.4) 12.3 (10.2–14.7) .15 Depressionf 22.3 (19.5–25.3) 15.5 (12.8–18.8) .003 Smokingg .002 Never smoker 44.8 (38.9–50.8) 37.1 (32.6–42.0) Former smoker 17.3 (13.6–21.7) 13.7 (11.0–16.9) Current smoker 38.0 (33.0–43.3) 49.2 (43.8–54.6) Alcohol useh <.001 Nondrinker 17.7 (14.0–22.0) 12.7 (9.9–16.0) Light drinker 56.5 (50.5–62.2) 49.2 (45.2–53.2) Moderate drinker 16.0 (12.7–20.1) 21.6 (17.5–26.5) Heavier drinker 9.8 (8.0–12.0) 16.5 (12.9–21.0) -
ACA = Patient Protection and Affordable Care Act.
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↵a A US citizen with “no insurance” and a “poverty-to-income ratio” of 1.38 or less.
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↵b With the χ2 test.
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↵c Underweight omitted (<5% of population). Body mass index was classified as normal (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), or obese (≥30 kg/m2).
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↵d A hemoglobin A1c level of 6.5% or greater.
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↵e Systolic blood pressure 140 mm Hg or greater or diastolic blood pressure 90 mm Hg or greater. Blood pressure averaged over 3 consecutive measurements after 5-minute rest.
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↵f A score of greater than 10 on 9-item Patient Health Questionnaire screen.
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↵g Never smoker defined as smoking fewer than 100 cigarettes in lifetime. Former smoker defined as smoking more than 100 cigarettes in lifetime and not currently smoking. Current smoker defined as smoking more than 100 cigarettes in lifetime and currently smoking daily or some days.
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↵h Nondrinkers had no drinks in the past year, including former drinkers and lifetime abstainers. Light drinkers had an average of 3 drinks or less per week. Moderate drinkers had an average of 4 to 14 drinks per week if male and 4 to 7 drinks per week if female. Heavier drinkers had an average of more than 14 drinks per week if male or an average of more than 7 drinks per week if female.
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Additional Files
The Article in Brief
Potential Adult Medicaid Beneficiaries Under the Patient Protection and Affordable Care Act Compared With Current Adult Medicaid Beneficiaries
Tammy Chang , and colleagues
Background Under the Patient Protection and Affordable Care Act (ACA), states will have the opportunity to expand Medicaid to millions of uninsured American adults. This study uses the most recent nationally representative data to examine the characteristics of individuals potentially eligible for Medicaid under ACA coverage expansion and compare them with current Medicaid beneficiaries.
What This Study Found The population potentially eligible for Medicaid coverage under the ACA is similarly healthy as--if not healthier than--the current Medicaid population. The exception is that tobacco smoking and alcohol use patterns are higher among potential Medicaid enrollees than for current Medicaid beneficiaries. Specifically, the analysis of data on 13.8 million current and 13.6 million eligible Medicaid beneficiaries indicates eligible adults are expected to have better health status than current beneficiaries. Additionally, the proportion of potentially eligible beneficiaries who are obese and with depression is significantly lower than current beneficiaries. There were no significant differences in the expected prevalence of diabetes or hypertension. Current tobacco smoking and moderate and heavy alcohol use are more common among the potentially eligible population than among current beneficiaries.
Implications
- These findings suggest that federal Medicaid expenditures for newly covered beneficiaries may not be as high as projected by the Congressional Budget Office in the short term, thereby reducing spending anticipated with implementation of the ACA.
- Given the higher prevalence of tobacco smoking and alcohol use, the authors point to the need for broad enrollment and engagement of this potentially eligible population to address their higher prevalence of modifiable risk factors for future chronic disease.