Research Roundup: Ethnic Disparities, Heart Health, Postpartum Care And More

Commonwealth Fund: How ACA Narrowed Racial Ethnic Disparities Access To Health Care
The insurance coverage expansion ushered in by the Affordable Care Act (ACA) has significantly increased Americans’ ability to get the health care they need since the law’s main provisions went into effect in 2014. Research also indicates that the ACA narrowed racial and ethnic disparities in insurance coverage — a key objective of the law, and one that enjoys substantial public support.2In this brief, we examine how much the ACA also has reduced disparities in access to health care among black, Hispanic, and white adults. (Baumgartner, 1/16 et al)

JAMA Internal Medicine: Assessment Of Cardiovascular Diagnostic Tests And Procedures Offered In Executive Screening Programs At Top-Ranked Cardiology Hospitals
Very few screening tests have been reported to reduce mortality in asymptomatic individuals. Nevertheless, there is an enduring belief in the benefit of using diagnostic tests to find disease in its earliest stages. Hospitals have responded to the demand for early diagnosis by establishing executive screening programs targeted to wealthy individuals who are able to pay directly for screening tests that are generally not covered by insurance. (Ge and Brown, 1/13)

Health Affairs: Effects Of Medicaid Expansion On Postpartum Coverage And Outpatient Utilization
Timely postpartum care is associated with lower maternal morbidity and mortality, yet fewer than half of Medicaid beneficiaries attend a postpartum visit. Medicaid enrollees are at higher risk of postpartum disruptions in insurance because pregnancy-related Medicaid eligibility ends sixty days after delivery. We used Medicaid claims data for 2013–15 from Colorado, which expanded Medicaid under the Affordable Care Act, and Utah, which did not. We found that after expansion, new mothers in Utah experienced higher rates of Medicaid coverage loss and accessed fewer Medicaid-financed outpatient visits during the six months postpartum, relative to their counterparts in Colorado. (Gordon et al, 1/1)

The Henry J. Kaiser Family Foundation: The Coverage Gap: Uninsured Poor Adults In States That Do Not Expand Medicaid
While millions of people have gained coverage through the expansion of Medicaid under the Affordable Care Act (ACA), state decisions not to implement the expansion leave many without an affordable coverage option. Under the ACA, Medicaid eligibility is extended to nearly all low-income individuals with incomes at or below 138 percent of poverty ($17,236 for an individual in 2019). This expansion fills in historical gaps in Medicaid eligibility for adults and was envisioned as the vehicle for extending insurance coverage to low-income individuals, with premium tax credits for Marketplace coverage serving as the vehicle for covering people with moderate incomes. While the Medicaid expansion was intended to be national, the June 2012 Supreme Court ruling essentially made it optional for states. As of January 2020, 14 states had not expanded their programs. (Garfield, Orgera and Damico, 1/14)

The New York Times: Blood Pressure Patterns Are Different For Women
Blood pressure begins to increase at younger ages in women than in men, and it goes up at a faster rate, a new study reports. On average, women who develop heart disease are about 10 years older than men who develop it. But this report, published in JAMA cardiology, suggests that high blood pressure, one of the most important controllable risk factors for cardiovascular disease, begins at a younger age in women than men, and rises faster. The physiological processes that lead to heart disease, the findings suggest, may start earlier in women than in men. (Bakalar, 1/15)