More than 20 million Americans now have access to critical health care services thanks to the Affordable Care Act, enacted in 2010. A new study published online in the Journal of the American Board of Family Medicine finds more than 75% of low-income patients have chronic, pre-existing conditions, such as asthma, diabetes, obesity or mental health disorders, that could leave them uninsured should the ACA be dismantled.
“The potential removal of ACA protection could be increasingly detrimental to the overall health of our most vulnerable patient populations,” said Nathalie Huguet, Ph.D., lead author and an assistant professor of family medicine in the OHSU School of Medicine. “The requirement to pay for more health care expense out-of-pocket could mean that patients refrain from seeking medical care altogether, become more ill, and likely develop preventable secondary diagnoses.”
Huguet and team followed a diverse group of more than 78,000 low-income patients across the United States who were uninsured prior to the ACA but gained either Medicaid or private insurance post-ACA. They assessed the fraction of patients with one or more pre-existing conditions and found the proportion of these patients increased from 58% before, to 76% after ACA implementation. Notably, both percentages are much higher than the estimated 27% in the general population.
The research team also found that visits to clinics and community health centers surged in the months immediately following ACA implementation.
“This increase in access likely resulted in new diagnoses and needed treatment for chronic conditions,” said Huguet. “This highlights that community health centers – which were strengthened by the ACA – are essential to ensuring the health and well-being of Americans.”
The research is supported by the Centers for Disease Control and Prevention; National Institute of Diabetes and Digestive and Kidney Disease (U18DP006116), National Cancer Institute (R01 CA204267) and National Health, Lung, and Blood Institute (R01 HL136575), all parts of the National Institutes of Health; and the Agency for Healthcare Research and Quality (R01 HS024270).
This research was conducted with the ADVANCE (Accelerating Data Value Across a National Community Health Center Network) Clinical Research Network, a member of the People-Centered Research Foundation Consortium, an initiative of the Patient Centered Outcomes Research Institute (PCORI). The ADVANCE network is led by OCHIN in partnership with the Health Choice Network, Fenway Health, Oregon Health and Science University, and the Robert Graham Center/HealthLandscape. ADVANCE is funded through PCRF contract number 1237.