Effects of the Affordable Care Act Insurance Expansions on Health Care Coverage, Access, and Health Status of 50–64-Year-Old Adults: Evidence From the First Six Years

Abstract

Individuals aged 50–64 face a higher burden of chronic conditions and an increased probability of insurance coverage loss, making them particularly vulnerable to limited access than younger adults. This study examines the effects of the Affordable Care Act (ACA) insurance expansions, including both Medicaid eligibility and other expansions, on health care coverage, access, and health status of adults aged 50–64 years over 6 years since the initial expansions in 2014. Using a triple difference-in-difference-in-differences model and nationally representative data, we find that the ACA increased private insurance and Medicaid coverage. There is evidence of improved access based on having a personal provider, completing a routine checkup, and reducing forgoing medical care due to cost. There is little evidence for the effects on self-reported health outcomes. Findings suggest that coverage expansions have improved access to care but have thus far not had discernible and consistent effects on self-reported health for 50–64-year-olds.