| |
| author |
Anna Smith
| | title |
Yes We Can! Or Can We? :
Medicaid Expansion Post-ACA and its Impact on Health Outcomes in all 50 States
| | abstract |
This thesis analyzes the impact of Medicaid expansion under the Affordable Care Act on health
outcomes in all fifty states. The United States healthcare system is complex and often fails to
achieve strong health outcomes despite spending the most on healthcare throughout the Western
world. The country is often compared to single-payer systems found in other countries, and there
has been a push for universal coverage across the board. The United States attempted to address
this problem in the mid-19th century for populations in need of welfare through the establishment
of Medicaid, a government-subsidized healthcare coverage plan aimed at assisting those who
cannot afford private coverage. Medicaid has been developed over time, widening eligibility
requirements to include larger population groups. One particularly notable and familiar
expansion occurred in 2010 under the Affordable Care Act (coined "Obamacare" under the
Obama Administration), in which Medicaid was expanded to provide coverage to larger low-income
populations and to reduce various barriers to access. However, the Supreme Court ruled
in 2012 that forcing the expansion of Medicaid under this federal legislation violated state
sovereignty, and this resulted in each state having the option to opt-in to the ACA's Medicaid
program. Many states expanded from the outset, a few took their time deciding, and a dozen
states still have not expanded Medicaid to this day. This sparks the question of how effective is
Medicaid in improving the health of those who are in need of public assistance, and can one see
such impact when comparing states that expanded against those who did not? This paper
investigates the structure of Medicaid programming and implementation, and offers explanations
into how states make such decisions, and analyzes data in order to identify the impact of
Medicaid expansion under the ACA on health outcomes in every state. It is evident from the data
that Medicaid expansion's impact on health outcomes is quite varied across groups, even when
looking specifically between income groupings or other variables. We conclude that Medicaid
does not necessarily achieve its goal of improving health in eligible populations, and that further
research is needed to investigate the possibility of fundamentally restructuring Medicaid
programming as it exists today.
| | school |
The College of Liberal Arts, Drew University
| | degree |
B.A. (2021)
|
| advisor |
Jason Jordan
|
| full text | ASmith.pdf |
| |
