Arlington, VA—If pharmacies are somewhat busier these days, here’s one possible explanation why.
With the Affordable Care Act reducing their barriers to care, formerly uninsured patients —especially those with chronic conditions—are filling substantially more prescriptions, according to a report in the journal Health Affairs.
“A growing body of literature describes how the Affordable Care Act (ACA) has expanded health insurance coverage,” write the RAND Corp.-led researchers. “What is less well known is how these coverage gains have affected populations that are at risk for high health spending.”
To determine that, the study team employed prescription transaction data for a panel of 6.7 million prescription drug users, comparing changes in coverage, prescription fills, plan spending, and out-of-pocket spending before and after the implementation of the ACA’s coverage expansion.
Results indicate a 30% reduction in the proportion of that population which was uninsured in 2014, compared to 2013. The study furthermore found that uninsured Americans who gained private coverage filled, on average, 28% more prescriptions and had 29% less out-of-pocket spending per prescription in 2014 compared to 2013.
Medicaid beneficiaries had even larger increases in fill rates, 79%, and reductions in out-of-pocket spending per prescription, 58%. That was also the case with those with at least one chronic condition—diabetes, high cholesterol, anxiety or depression, asthma or chronic obstructive pulmonary disease, and hormone therapy for breast cancer—who gained health insurance coverage. Those patients sharply increased the number of prescriptions filled after gaining coverage but had lower annual out-of-pocket expenses.
For example, the study states, individuals with high cholesterol who acquired private coverage had $200 less in annual out-of-pocket spending, while those newly covered under Medicaid had $359 less in out-of-pocket spending.
“This is strong evidence that the Affordable Care Act has increased treatment rates while reducing out-of-pocket spending, particularly for people with chronic health conditions,” said lead author Andrew W. Mulcahy, a health policy researcher at RAND. “Improving the treatment of people with chronic conditions is an important step in improving health outcomes.”
The study also points out that opting to expand Medicaid by early 2014 had significantly larger declines in percentages of uninsured residents (39%) when compared to states that had not (23%).
“These results demonstrate that by reducing financial barriers to care, the ACA has increased treatment rates while reducing out-of-pocket spending, particularly for people with chronic conditions,” study authors conclude.
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