In Four ACA Expansion States, The Percentage Of Uninsured Hospitalizations For People With HIV Declined, 2012-14

• Published in: Health Affairs Vol. 34; no. 12; pp. 2061 - 2068
• Main Author: Hellinger, Fred J
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01-12-2015
• Subjects: Acquired immune deficiency syndrome; AIDS; Female; Financing, Personal; Health insurance; Health services; Health Services Accessibility; HIV; HIV Infections; Hospitalization; Human immunodeficiency virus; Humans; Indigent care; Insurance; Insurance coverage; Insurance Coverage - utilization; Logistic Models; Male; Medicaid; Medically Uninsured - statistics & numerical data; Patient Protection & Affordable Care Act 2010-US; Patient Protection and Affordable Care Act; Patients; Studies; Uninsured people; United States; United States > US; Cost of Health Care; AIDS/HIV; Hospitals; Health Reform
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2015.0718

This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. I used data from the State Inpatient Databases of the Healthcare Cost and Utilization Project for all hospitalizations of patients with HIV from 2012 through the first six months of 2014 in four states that expanded their Medicaid programs and two states that did not. I found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent. I also found that hospitalized patients with HIV who did not have insurance were 40 percent more likely to die during their hospital stays than comparable patients with insurance.