* hypercholesterolemia is the presence of high cholesterol in the blood.
The authors added that low-income adults with one of these chronic conditions were more likely to be unaware of their health status or have their disease controlled.
The ACA (Affordable Care Act) could add millions of new Medicaid enrollees, because states can now expand Medicaid coverage to include the majority of low-income adults.
As background information to the article, the researchers wrote:
"In states choosing to implement the expansion, with full federal financing from 2014 through 2016, this would expand Medicaid's traditional focus away from low-income pregnant women and children, very-low-income parents, and the severely disabled to new population groups. These include childless adults and parents whose incomes are too high to qualify for Medicaid under current state eligibility criteria.
This is likely to affect the type of Medicaid patients seen by physicians in states choosing to expand Medicaid. State decisions regarding Medicaid expansion will likely consider the anticipated costs and health benefits to their populations. Uncertainty exists regarding the scope of medical services required for new enrollees."
Sandra L. Decker, Ph.D., and team set out to determine what the health care needs and health risks might be of uninsured adults who are eligible for Medicaid coverage under the ACA. They gathered and examined data from NHANES (National Health and Nutrition Examination Survey) 2007-2010, specifically the health conditions of 1,042 uninsured adults aged from 19 to 64 years whose income did not exceed 138% of the federal poverty level. They were compared with 471 adults, also with similar incomes, who were Medicaid enrollees.
The nationally representative sample of 1,042 uninsured respondents corresponds to a weighted estimate of 14.7 million uninsured American adults who are probably eligible for Medicaid coverage.
The team looked at these people's medical examination records, laboratory tests, measures of self-reported mental and physical health status, as well as some risk factors, including body weight.
The authors found that the uninsured low-income adults had better overall health than Medicaid enrollees. Fewer of them were obese, they appeared to have a lower risk of developing physical, mental or emotional problems, and were 15.1% less likely to suffer from several health conditions at the same time.
Below are some highlighted data the researchers reported:
- 30.1% of uninsured respondents had diabetes, hypertension or hypercholesterolemia (high blood cholesterol levels)
- 38.8% of Medicaid enrollees had diabetes, hypertension or hypercholesterolemia
- Uninsured people with one chronic condition were less likely to have it controlled or diagnosed
- 80.1% of uninsured respondents with at least one of these conditions had at least one uncontrolled condition
- 63.4% of Medicaid enrollees with at least one of these conditions had at least one uncontrolled condition
- 1.4 million uninsured adults who are probably eligible for Medicaid who live with at least one undiagnosed chronic condition
- 3.5 million uninsured adults potentially eligible for Medicaid with at least one chronic condition that is not controlled
- 0.6 million Medicaid enrollees with at least one undiagnosed chronic condition
- 1.4 million Medicaid enrollees with at least one condition that is not controlled
"One-third of potential new Medicaid enrollees are obese, half currently smoke, one-fourth report a functional limitation, and one-fourth report their health as fair or poor - all factors that could require attention from clinicians.
If Medicaid uptake is low, the uninsured adults who do enroll in Medicaid may be disproportionately drawn from those with more health problems than average among those made newly eligible.
Because many of the uninsured adults have not seen a physician in the past year and do not have a place they usually go for routine health care, they are likely to need care on first enrolling in Medicaid."
Uninsured young adult population fallingThe Commonwealth Fund 2012 Biennial Health Insurance Survey, published in April 2013, reported that the percentage of 19 to 25 year-olds with no health insurance dropped from 48% to 41% between 2010 and 2012, reversing a decade-long trend.
The authors explained that this reversal is due to the implementation of the 2010 ACA that allowed young adults to remain on their parents' insurance plans up to 26 years of age.
The report added that last year, nearly 84 million Americans had no health insurance at one point.
Written by Christian Nordqvist