Preventive service use among Medicaid expansion adults, 2014-2019

In 2014, the Affordable Care Act (ACA) mandated that newly eligible Medicaid expansion beneficiaries receive recommended preventive services at no cost. Yet, evidence regarding the Medicaid expansion population's use of preventive services is limited.

Medicaid claims data from 2011 to 2019. We focused on 12 selected preventive services that received new, revised, or upheld A or B USPSTF ratings since 2010.

We find that receipt of preventive services among the Medicaid Expansion population increased from 22% in 2014 to 26% in 2019, with 41% of beneficiaries receiving at least one of the 12 examined services from 2014 to 2019. The most received services were screening tests for HIV infection, cervical cancer, chlamydia and gonorrhea, and hepatitis C virus infection. Receipt of at least one preventive service was highest among non-Hispanic Asian, non-Hispanic Black, and Hispanic beneficiaries.

Future changes to Medicaid expansion eligibility or preventive services recommendations could potentially disrupt these utilization patterns, with possible disproportionate effects on people from racial and ethnic minority populations.