The Kaiser Family Foundation this morning reported results from a multi-state hospital system, Ascension Health, showing a marked decline in visits by uninsured patients in states that expanded Medicaid under the Affordable Care Act.

Using data provided by Ascension Health—a not-for-profit health system with 131-acute-care hospitals in 16 states and the District of Columbia—researchers found that states with that expanded Medicaid saw a 32 percent decline in hospital visits, compared with a 4 percent decline in hospital visits in visits in non-expansion states. Charity care costs plummeted 40 percent in Medicaid states, versus 6 percent in non-expansion states.

According to Kaiser, the Medicaid spend increased 7 percent in Ascension hospitals within expansion states, compared with a 1-percent increase in non-expansion states.

The study analyzes changes in discharge volumes, hospital finances and other outcomes between the last three quarters of 2013 (before implementation of the ACA coverage expansions) and the first three quarters of 2014, through Sept. 30.

Our Take: So far this is the strongest evidence of the positive effect of providing insurance access to the uninsured population stemming from the Affordable Care Act. Fewer visits and a declining spend on charity care means better margins for Ascension and lower taxpayer expenses, even with the marginal increase in state Medicaid costs. 

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