Medicaid Expansion Enhanced Access to Eyecare in United States | AAO 2024

Medicaid expansion under the Affordable Care Act has had a positive impact on patients’ ability to access eyecare, said researchers of a new study presented in a poster at the annual meeting of the American Academy of Ophthalmology (AAO), taking place this week in Chicago.

Lower-income populations and minorities face barriers to accessing eye care, including financial constraints, lack of insurance, and limited access to providers. Minorities and older people are at a higher risk of eye disease, but social determinants of health have been demonstrated to impact the ability of these patients to get the care they need to prevent blindness.

The Affordable Care Act’s Medicaid expansion in 2014 aimed to improve access to healthcare and expanded Medicaid eligibility to adults with incomes up to 138% of the federal poverty level (or about $20,780 annually for an individual or $35,630 for a family of three). As of May 2024, 4 states (plus Washington, D.C.) have adopted the Medicaid expansion and 10 states have not adopted the expansion, according to KFF.

Elliott Vanderford

At the AAO meeting, researchers, led by Elliott Vanderford, a medical student at Yale University School of Medicine, reviewed data from the 2010 to 2018 National Health Interview Survey. They compared data before and after Medicaid expansion. This data included more than 46,000 people before expansion and 44,000 after expansion.

They found that after expansion of Medicaid, there was a significant decrease in the low-income population with no healthcare coverage, with a 40% increase in Medicaid coverage and an increase of 38.9% increase in private health insurance coverage. This resulted in an increase in the ability of participants to see an eye doctor and a decrease in inability to afford glasses.

Among low-income adults, Medicaid expansion decreased the proportion of uninsured by 17.1% (43.1% to 26.0%). Medicaid enrollment rose by 11.9% (29.4% to 41.3%). The proportion of adults with a recent eyecare visit (within one year) increased from 23.9% to 28.7% and inability to afford eyeglasses decreased from 17.9% to 14.1%.

They concluded that Medicaid expansion has a positive impact on access to eye care for lower income people.