Medicaid Expansion in Louisiana Reduces Travel for Care Among Minority Groups

Louisiana’s Medicaid expansion decreased the distance between beneficiaries and service providers with the greatest effects being seen in general practice visits in nonmetropolitan areas and for Black patients, according to study findings.

“…the fact that the policy had a stronger effect on the Black population has important public health implications, given that members of racial and ethnic minority groups are consistently found to face longer travel times to obtain health care services,” stated authors of the study. “Medicaid expansion increased access, in particular, for these most vulnerable populations.”

For this study, in metropolitan areas, 51.2% of beneficiaries were Black and 34.2% were White and in nonmetropolitan areas, 45.1% of beneficiaries were Black and 45.5% were White. Authors of the study noted that age distribution was similar in both areas and of the total nonmetropolitan sample, 58.8% of beneficiaries were women and in the metropolitan sample 58.9% were women.

Study authors compared mean distances traveled both pre- and post-expansion and results showed a decline for all service lines after the expansion. Due to expansion in nonmetropolitan areas, Black patients traveled 9.25 fewer miles for general practices and 2.93 fewer miles for primary care services, while White patients traveled 4.29 fewer miles for internal medicine services and 3.32 fewer miles for primary care services.

Results were significant in all service lines for Black enrollees in metropolitan areas and in 5 service lines for white enrollees, according to authors of the study. Other notable benefits stemming from the expansion include improvement of quality of life for Medicaid beneficiaries, as well as patients receiving appropriate screenings and follow-ups, and better health outcomes.

“We provide evidence for the fact that Medicaid expansion contributed to the amelioration of preexisting race and ethnicity-based inequalities that were contributing to higher barriers to obtain health care services for Black Medicaid beneficiaries,” concluded authors.

Reference:
Karletsos D, Stoecker C. Louisiana Medicaid expansion associated with reduced travel for care among minority groups and rural residents. Health Aff (Millwood). 2022;41(1). doi:10.1377/hthhaff.2021.00708.