Medicaid Expansion and Emergency Medical Service Transports

Area of Science:

• Health Services Research
• Public Health Policy
• Emergency Medicine

Background:

• The Affordable Care Act (ACA) expanded Medicaid eligibility to increase health insurance coverage.
• Understanding the impact of Medicaid expansion on healthcare utilization, particularly emergency services, is crucial for public health policy.
• Previous research has yielded mixed results on the effects of insurance expansion on emergency medical service (EMS) use.

Purpose of the Study:

• To evaluate the association between Medicaid expansion and changes in EMS utilization.
• To determine if these changes differed between pediatric and adult populations.
• To analyze trends in EMS activations before and after the policy implementation.

Main Methods:

• Utilized the National Emergency Medical Service Information System (NEMSIS) database, covering data from 2010 to 2016.
• Employed an interrupted time series analysis to assess changes in EMS activations.
• Stratified data analysis to differentiate between pediatric and adult EMS activations.

Main Results:

• No statistically significant changes in the level or trend of adult EMS activations were detected post-Medicaid expansion.
• A significant initial increase (level change) in pediatric EMS activations was observed.
• Subsequent trend changes in pediatric EMS activations mitigated the initial level change's impact over the study period.

Conclusions:

• Medicaid expansion under the ACA was not associated with a significant change in adult EMS utilization.
• The observed changes in pediatric EMS activations suggest a potential temporary effect that requires additional research.
• Further studies are recommended to fully understand the long-term impact of Medicaid expansion on pediatric emergency medical service use.