First year report tracks Affordable Care Act impact in Kentucky

First-year findings of a multiyear study, tracking Affordable Care Act (ACA) impact in Kentucky, is now available.
The Foundation for a Healthy Kentucky has contracted with State Health Access Data Assistance Center (SHADAC), a health policy research institute at the University of Minnesota, to study how Kentucky’s implementation of the Affordable Care Act (ACA) is impacting state residents. SHADAC has just released an annual report for the first full year of the study.
“The Foundation’s contract  with SHADAC provides objective information on the impacts of Medicaid expansion and creation of a state-managed insurance portal, kynect, here in Kentucky,” says Susan Zepeda, President and CEO of the Foundation. “In this first annual report, we can see gains in the numbers of Kentuckians with insurance, a decline in emergency room use, and increased information on findings of preventive screenings.  We look forward to future reports under this 34-month study, to help policymakers assess the impacts of governmental policy changes on numbers of Kentuckians with health insurance coverage, access to care, costs of care, and patient experience.”
According to Lynn A. Blewett, PhD Director, State Health Access Data Assistance Center, University of Minnesota, School of Public Health and Principal Director of the study, “Kentucky has made significant gains in health insurance coverage and access to needed care through its commitment to implementation of the Affordable Care Act.  The Commonwealth has been at the forefront in designing effective strategies to get and keep people covered, providing lessons for the rest of the country.  As change continues in KY’s health reform agenda it will be important to monitor and document the impact on Kentuckians and their families over time.”
Click here to view the complete report.
SHADAC is a health policy research center with a focus on state policy. The staff has a broad expertise, ranging from economics, statistics, and evaluation, to sociology and journalism. SHADAC is passionate about the importance of using sound data to inform policy decisions and strives to produce analyses that are rigorous and policy-relevant.
The quarterly snapshots, along with a report on the Affordable Care Act’s impact on children’s insurance in Kentucky are all available online. Along with producing quarterly snapshots during the study timeframe, in the spring, researchers will conduct a telephone survey to better understand the effects of ACA in Kentucky.
The Foundation for a Healthy Kentucky is a non-profit philanthropic organization created in 2001. The Foundation’s mission is to address the unmet health care needs of Kentuckians, working on policy and systems changes to improve access to care, reduce health risks and disparities, and promote health equity.
Highlights from the report include:
Domain #1: Health Insurance Coverage
  • Kentucky’s overall rate of uninsurance fell to 8.7% in 2014–a 4.9 percentage point drop from 2012. Kentucky’s uninsurance rate of 8.7% is statistically significantly lower than the overall U.S. uninsurance rate of 11.6%; it is also significantly lower than the uninsurance rate of a number of neighboring states, including Arizona, Illinois, Indiana, Missouri, Tennessee and Virginia (pg. 4)
  • People with lower incomes saw greatest declines in uninsurance. Those with incomes below 138% of FPG (the Medicaid expansion group) experienced the largest decline with a 11.2 percentage point drop in uninsurance from 2012-2014. (pg. 6)
  • Some disparities in insurance coverage persist: the uninsurance rate for the Hispanic/Latino population (28.9%) is more than triple the state’s overall uninsurance rate. (pg. 5)
Domain #2: Access
  • There was a statistically significant increase in the share of the population reporting having a usual source of care from 2012 to 2013. (pg. 9)
  • The percentage of Kentuckians reporting emergency department visits in the past year dropped from 30.4% in 2012 to 24.9% in 2013, a statistically significant decrease. (pp. 9-10)
    • It will be important to track these measures moving forward to see how they are affected by increased access to coverage through the ACA.
Domain #3: Cost
  • In 2013, Kentucky had a significantly higher percentage of people with trouble paying medical bills compared to the U.S. as a whole (KY: 42.8%, U.S.: 30.2%). (pg. 15)
  • Kentucky’s rate of people with trouble paying medical bills in 2013 was also significantly higher than several neighboring states, including IL, MO, OH, and VA. (pg. 15)
Domain #4: Quality
  • Among all neighboring states, Kentucky was the only state that had a significant increase in the percentage of respondents who reported having a colorectal cancer screening from 2012 (62.4%) to 2014 (66.4%). (pg. 19, pg. 29)
    • ACA is likely not the only factor for this increase-Kentucky has programs promoting colorectal cancer screening.
  • Racial disparities continue in low birth weight: Non-Hispanic blacks continued to have the highest rate of low birth weight in 2014.
Domain #5: Health Outcomes
  • Opportunity for improvement: Kentucky’s adult obesity rate remained stable from 2012-2014, with an obesity rate of 31.6% in 2014.
  • Chronic disease prevalence: 29.1% of adults in Kentucky reported having one or more chronic conditions in 2014, a statistically significant increase from 26.8% in 2012. (pp. 21-22)
    • It’s important to note that increases in reported chronic disease prevalence can be expected with increases in coverage and access to care.