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 Insurance Type and Medicaid Expansion State Status
| Expansion States | ||||
|---|---|---|---|---|
| Gained Medicaid (N = 39,520) | Gained Private (N = 11,187) | |||
| Pre, n (%) | Post, n (%) | Pre, n (%) | Post, n (%) | |
| Alcohol and drug abuse | 5,193 (13.1) | 8,515 (21.5) | 490 (4.4) | 876 (7.8) |
| Asthma, COPD | 6,131 (15.5) | 8,727 (22.1) | 1,368 (12.2) | 1,909 (17.1) |
| Diabetes | 5,669 (14.3) | 6,962 (17.6) | 1,350 (12.1) | 1,617 (14.5) |
| Mental health disorders | 14,537 (36.8) | 19,293 (48.8) | 2,854 (25.5) | 3,827 (34.2) |
| Obesity | 6,852 (17.3) | 10,260 (26.0) | 1,594 (14.2) | 2,363 (21.1) |
| Non-expansion States | ||||
|---|---|---|---|---|
| Gained Medicaid (N = 11,319) | Gained Private (N = 16,033) | |||
| Pre, n (%) | Post, n (%) | Pre, n (%) | Post, n (%) | |
| Alcohol and drug abuse | 812 (7.2) | 1,552 (13.7) | 597 (3.7) | 1,208 (7.5) |
| Asthma, COPD | 1,321 (11.7) | 1,952 (17.2) | 1,497 (9.3) | 2,232 (13.9) |
| Diabetes | 1,494 (13.2) | 1,864 (16.5) | 2,632 (16.4) | 3,217 (20.1) |
| Mental health disorders | 2,540 (22.4) | 3,906 (34.5) | 3,045 (19.0) | 4,465 (27.8) |
| Obesity | 1,671 (14.8) | 2,712 (24.0) | 2,456 (15.3) | 3,877 (24.2) |
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.