During the first year and a half of the Affordable Care Act, the number of prescriptions filled by adults using Medicaid coverage increased by 19 percent in states that expanded Medicaid compared to states that did not, according to a new study from a Harvard T.H. Chan School of Public Health researcher and colleagues.
The largest increases were for medications to manage chronic conditions such as diabetes, and for birth control.
The ACA expanded Medicaid eligibility in participating states to millions of low-income adults in 2014. Previous studies by Benjamin Sommers, the T.H. Chan School's associate professor of health policy and economics and lead author of the study, have demonstrated that expansion has resulted in improved access to care and improved affordability.
Researchers analyzed pharmacy transaction data from 2013–2015, comparing the number of prescriptions filled in expansion versus non-expansion states before and after Medicaid expansion took effect, as well as the source of insurance for each prescription.
They found that over the first year and a half of the ACA's Medicaid expansion, medications used for treating diabetes accounted for the largest growth among all drug classes, with an increase of 24 percent. Other classes of medications that showed large increases included contraceptives at 22 percent, cardiovascular drugs at 21 percent, and mental health drugs at 19 percent. Within expansion states, increases in prescription drug utilization were larger in geographical areas with higher uninsured rates prior to the ACA.
The findings also demonstrated that increases in prescription drug utilization were greater in areas with larger Hispanic and black populations, indicating that Medicaid expansion may be reducing ethnic and racial disparities in access to medications, according to the researchers.