Prevalence of Top 5 Conditions Pre- and Post-ACA, Among a Cohort of Established CHC Patients Pre- and Post-Implementation of the Affordable Care Act (ACA) Insurance Expansions in 2014, by Race/Ethnicity and Medicaid Expansion State Status
| Expansion States | ||||||
|---|---|---|---|---|---|---|
| Non-Hispanic White (N = 22,835) | Hispanic (N = 19,512) | Non-Hispanic Black (N = 4,787) | ||||
| Pre, n (%) | Post, n (%) | Pre, n (%) | Post, n (%) | Pre, n (%) | Post, n (%) | |
| Alcohol and drug abuse | 3,927 (17.2) | 6,449 (28.2) | 765 (3.9) | 1,336 (6.8) | 672 (14.0) | 1,060 (22.1) |
| Asthma, COPD | 4,489 (19.7) | 6,395 (28.0) | 1,797 (9.2) | 2,558 (13.1) | 752 (15.7) | 1,018 (21.3) |
| Diabetes | 2,515 (11.0) | 3,112 (13.6) | 3,238 (16.6) | 3,929 (20.1) | 782 (16.3) | 941 (19.7) |
| Mental health disorders | 10,372 (45.4) | 13,336 (58.4) | 4,918 (25.2) | 6,897 (35.3) | 1,145 (23.9) | 1,586 (33.1) |
| Obesity | 3,787 (16.6) | 5,632 (24.7) | 3,482 (17.8) | 5,189 (26.6) | 785 (16.4) | 1,185 (24.8) |
| Non-expansion States | ||||||
|---|---|---|---|---|---|---|
| Non-Hispanic White (N = 6,929) | Hispanic (N = 10,784) | Non-Hispanic Black (N = 8,303) | ||||
| Pre, n (%) | Post, n (%) | Pre, n (%) | Post, n (%) | Pre, n (%) | Post, n (%) | |
| Alcohol & drug abuse | 649 (9.4) | 1,196 (17.3) | 260 (2.4) | 545 (5.1) | 439 (5.3) | 913 (11.0) |
| Asthma, COPD | 1,072 (15.5) | 1,565 (22.6) | 721 (6.7) | 1,139 (10.6) | 901 (10.9) | 1,296 (15.6) |
| Diabetes | 918 (13.2) | 1,100 (15.9) | 1,423 (13.2) | 1,751 (16.2) | 1,606 (19.3) | 1,992 (24.0) |
| Mental health disorders | 2,435 (35.1) | 3,330 (48.1) | 1,739 (16.1) | 2,715 (25.2) | 1,235 (14.9) | 2,033 (24.5) |
| Obesity | 956 (13.8) | 1,554 (22.4) | 1,368 (12.7) | 2,202 (20.4) | 1,695 (20.4) | 2,635 (31.7) |
COPD, chronic obstructive pulmonary disease, & emphysema, CHC, community health center.
Data from 386 community health centers in 19 states (11 expansion, 8 non-expansion). Expansion states include CA, HI, MD, MN, NM, NV, OH, OR, RI, WI, WA; Non-expansion states include AK, FL, IN, KS, MO, MT, NC, TX. The retrospective cohort of established patients included those who were uninsured at their last visit pre-ACA (2012 to 2013) and gained insurance coverage post-ACA (2014 to 2015). Conditions identified by ICD 9/10 codes in patients' problem lists or encounter diagnoses based on the Henry J Kaiser Family Foundation list of declinable conditions.