Introduction: The Affordable Care Act (ACA) was enacted to expand healthcare access for uninsured & low income/poor, particularly from the expansion of Medicaid. We sought to describe the trends in insurance among non-elderly, low-income adults, with and without cardiovascular disease (CVD) in the US from 2007-2014.
Methods: We included individuals 19-64 years of age in the nationally-representative Medical Expenditure Panel Survey database between 2007-2014. CVD status was based on ≥ 1 diagnoses: coronary heart disease, dysrhythmia, peripheral artery disease, heart failure or other heart disease, either self-reported or available as validated combinations of ICD-9-CM codes. Insurance status was categorized into uninsured, private, or Medicaid; and classified by most months covered per year. Those with Medicare and mixed insurance types per year were excluded from analysis. Low income was defined as a family income ≤138% of the federal poverty level.
Results: A total 37,817 MEPS participants 19-64 years of age (mean: 36.6 ±15 years; 56% female) met inclusion criteria, translating to 124.6 million subjects. Prevalence of CVD in the population was 11.6% during the study period. Between 2007 and 2014, overall uninsured rates decreased in those with and without CVD (18% & 10% respectively). (Figure) The rates of private insurance remained unchanged, while the rates of Medicaid enrollment increase by 22% for those with CVD & 23% for those without CVD.
Conclusion: Our findings reflect on the impact of the ACA on access to health insurance, particularly through Medicaid, among low-income non-elderly adults with and at-risk for CVD.