A substantial body of research has investigated effects of the Medicaid expansion under the Affordable Care Act (ACA) on coverage; access to care and related measures (including utilization, quality of care and health outcomes, provider capacity, and affordability and financial security); and various economic measures. This issue brief summarizes findings from 324 studies of the impact of state Medicaid expansions under the ACA published beginning in January 2014 (when the coverage provisions of the ACA went into effect) and updates earlier versions of this brief with studies through June 2019.

More recent studies continue to support earlier findings but provide additional findings in key areas, including expansion’s effects on health outcomes, access to services and medications for behavioral health – including opioid use disorder — and other needs, providers’ financial stability, and employment and the labor market.

Research indicates that the expansion is linked to gains in coverage; improvements in access, financial security, and some measures of health status/outcomes; and economic benefits for states and providers.

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