Increased Medicaid eligibility of Affordable Care Act: Evidence of improved outcomes for patients with peripheral artery disease

Peripheral artery disease (PAD) is a debilitating vascular disease that disproportionately affects people with lower socioeconomic status (SES) and racial minority individuals, specifically Black people [1]. Patients with low SES and racial minority patients with PAD often present later and with more advanced disease, often with no option but major amputation [2,3]. Although barriers to adequate access are varied, insurance access has been found to be a significant barrier [3].

Improving access to care by increasing insurance coverage has led to better outcomes, as the results of an evaluation of the 2006 Massachusetts Health Care Reform Law and its effects on vascular surgery outcomes showed [4]. In 2010, the Affordable Care Act (ACA) was signed into law and improved health care access for millions of uninsured and socioeconomically challenged Americans [5]. The ACA, which follows many tenets of the Massachusetts Health Care Reform Law, provided access in a variety of ways, including Medicaid expansion—making more people eligible to receive it—and health insurance market reforms, which made private health insurance more affordable [5]. Expansion of Medicaid made people who fall below 138% of the federal poverty level eligible to receive health care coverage via Medicaid [5]. Many changes were made to the insurance market as a result of the ACA, including preventing insurers from basing premiums on pre-existing conditions, prohibiting limits on benefits, and specifying preventative services without cost sharing, which made 76 million people eligible for free preventative services [5].

Expanded access to health care translated into higher availability of vascular-related care as well, with rates of vascular surgery and admission increasing in states that expanded Medicaid under the ACA [6]. These rates increased even more among patients with low SES, as well as among racial minority patient in states that expanded Medicaid under the ACA [6]. In this review, we will examine the effects of the ACA and Medicaid expansion on the disparities that exist in PAD and its associated outcomes, including revascularization, limb salvage, and major amputation rates.

留言 (0)

沒有登入
gif