Paper All Medicaid expansions are not created equal: The geography and targeting of the Affordable Care Act

Craig Garthwaite, John Graves, Tal Gross, Zeynal Karaca, Victoria Marone, and Matthew J. Notowidigdo study the effect of the Affordable Care Act Medicaid expansion on hospital services, with a focus on the geographic variations of its impact, finding that it increased Medicaid visits, decreased uninsured visits, and lead the uninsured to consume more hospital services overall— primarily through outpatient visits to the ED for deferrable conditions. Notably, the authors found significant heterogeneity across Medicaid-expansion states with some experiencing large changes in utilization and others seeing little change.

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