One of the central tenets of the Affordable Care Act (ACA) is Medicaid expansion, bringing previously uninsured and underinsured Americans under the umbrella of health care coverage based on income. Prior experience with Medicaid expansion programs (eg, in Oregon1) demonstrated increased use of health care services, improved rates of diabetes mellitus detection and management, lower rates of depression, and reduced financial strain in the newly insured. As more Medicaid patients enter the system, hospitals that care for these patients expect to expand workloads, see decreased volumes of the uninsured, and experience a shifting payer mix.
Campbell BH, Levine PA. Could the Affordable Care Act Medicaid Expansion Affect Otolaryngology–Head and Neck Surgery?. JAMA Otolaryngol Head Neck Surg. 2014;140(9):801. doi:10.1001/jamaoto.2014.1456