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Several US states have expanded Medicaid under the Patient Protection and Affordable Care Act (ACA), extending Medicaid coverage to millions of previously uninsured low-income individuals[2] including those with non-dialysis-dependent kidney disease.[3] The goal of this study was to determine whether Medicaid expansion was associated with changes in Medicaid coverage for pre-emptive living-donor KT (LDKT) and deceased-donor KT (DDKT) in the US. After Medicaid expansion, Medicaid-covered pre-emptive KT recipients from expansion states were more likely to be minorities and to be employed than those from non-expansion states (Table 1). To account for different calendar dates of Medicaid expansion, results are presented as the number of quarters before and after a standardized Medicaid expansion date, where the date of Medicaid expansion is set to equal zero. [Extracted from the article]

Health insurance and health systems literacy needs are evolving with changes to the U.S. healthcare system. Following the implementation of the Affordable Care Act, many residents in West Louisville, Kentucky, a predominantly African American community, gained health insurance coverage for the first time. A qualitative study was conducted to assess residents’ health insurance and health systems needs and to identify ways of assisting residents with navigating the healthcare system and utilizing their health insurance coverage. Twelve focus groups were conducted with a total of eighty-seven residents. Round one explored participants’ experiences with health insurance, and round two examined their health information delivery preferences. An inductive thematic analysis was performed. Participants revealed the complexity of the health insurance system, many citing difficulty understanding health insurance concepts and finding suitable healthcare providers. High costs, mistrust in the healthcare system, and perceived public-private disparities were barriers to effective health insurance utilization. Health insurance materials in their current form have limited value in translating health insurance and health systems information to the West Louisville population. Alternative forms of information delivery, such as locally accessible and culturally competent community health workers may be better received and more successfully utilized by the community. [ABSTRACT FROM AUTHOR]

Introduction: Despite increasing rates of opioid misuse and hospitalizations, rates of treatment for those with opioid use disorder (OUD) are very low. This study examined the impact of the Patient Protection and Affordable Care Act's (ACA) insurance expansion on improving rates of insurance, health care access, and treatment for those with OUD.Methods: Data on individuals ages 18-64 with OUD come from the 2008-2014 National Survey on Drug Use and Health (N=4100). Multivariable logistic regression analyses were performed to estimate the trends of health care insurance, treatment and barriers to care across the stages of ACA implementation: pre-ACA (2008-2009), partial-ACA (2010-2013), and national implementation (2014). All models were adjusted for predisposing, enabling, and need factors.Results: In both adjusted and unadjusted comparisons, national implementation of the ACA was associated with significant improvements in outcome measures for those with OUD. Multivariable analyses indicate that, after national implementation, those with OUD were significantly less likely to be uninsured and were less likely to report financial barriers as a reason for not receiving substance use treatment, relative to the pre-ACA period. Individuals were also more likely to receive substance use treatment and were more likely to report that insurance paid for treatment after national implementation of the ACA relative to the pre-ACA period. These results persisted when national implementation was compared relative to partial-implementation.Conclusions: National implementation of the ACA has helped to reduce rates of uninsurance, barriers to care, and improve rates of substance use treatment for those with OUD. [ABSTRACT FROM AUTHOR]

The article discusses the legal aspects of emergency contraceptives and "abortion-inducing" drugs in America as of 2014, focusing on the apparent efforts to empower women to make informed decisions about issues such as abortion, pregnancy, and abortifacients. Employer-mandated health insurance coverage for certain contraceptive drugs and devices is addressed in relation to the U.S. Patient Protection and Affordable Care Act. U.S. abortion laws and drug-related religious objections are examined.

The article aims to determine the degree of knowledge and attitude of medical students toward the Patient Protection and Affordable Care Act (ACA), in relation to the student' political affiliation, specialty choice, and financial standing. It states that an online survey was e-mailed to all Minnesota medical students asking to specify their level of agreement to ACA through the 5-point Likert scale. Result of the study shows ignorance and indecisiveness but an obligation to implement the ACA.

We examine changes in health insurance coverage and access to and utilization of health care before and after the national implementation of the Patient Protection and Affordable Care Act (ACA) among the U.S. adult immigrant population. Data from the 2011–2016 National Health Interview Survey are used to compare adult respondents in 2011–2013 (before the ACA implementation) and 2014–2016 (after the ACA implementation). Multivariable logistic regression analyses are used to compare changes over time. This study shows that the ACA has closed the coverage gap that previously existed between U.S. citizens and non-citizen immigrants. We find that naturalized citizens, non-citizens with more than 5 years of U.S. residency, and non-citizens with 5 years or less of U.S. residency reduced their probability of being uninsured by 5.81, 9.13, and 8.23%, respectively, in the first 3 years of the ACA. Improvements in other measures of access and utilization were also observed. [ABSTRACT FROM AUTHOR]

Physicians play a key role in implementing health policy, and US physicians were split in their opinions about the Affordable Care Act (ACA) soon after its implementation began. We readministered elements of a prior survey of US physicians to a similar sample to understand how US physicians' opinions of the ACA may have changed over a crucial five-year implementation period (2012-17), and we compared responses across both surveys. Of the 1,200 physicians to whom we sent a survey in the summer of 2017, 489 responded (a response rate of 41 percent). A majority of respondents (60 percent) believed that the ACA had improved access to care and insurance, yet many (43 percent) felt that it had reduced the affordability of coverage. More physicians agreed in 2017 than in 2012 that the ACA "would turn United States health care in the right direction" (53 percent versus 42 percent), despite reporting perceived worsening in several practice conditions over the same time period. After we adjusted for specialty, political party affiliation, practice setting type, perceived social responsibility, age, and sex, we found that only political party affiliation was a significant predictor of support for the ACA in the 2017 results. [ABSTRACT FROM AUTHOR]