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Invited Commentary
January 2, 2019

Medicaid Expansion Offers Hope for Improved Postinjury Rehabilitation Among the Underserved

Author Affiliations
  • 1Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
JAMA Surg. 2019;154(5):412. doi:10.1001/jamasurg.2018.5178

Access to, and the provision of, specialized post–short-term care services are critical components of the trauma care continuum aimed at maximizing optimal functional recovery and quality of life for patients with injuries. The association between insurance status and access to rehabilitation services is well documented. Families with low incomes, underrepresented minorities, those with limited English proficiency, and the uninsured face significant barriers in the availability and proximity of outpatient rehabilitation services. The reality is that economic and financial incentives may outweigh medical need and necessity.1,2 The Affordable Care Act (ACA) and its provisions were designed to improve access to care through improved insurance coverage and reductions in health care inequities and disparities. However, heterogeneity in implementation by state confers difficulty in studying the association of Medicaid expansion with outcomes in trauma patients, specifically regarding access to rehabilitation.3

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