Millions Still Lack CVD Coverage Despite the Affordable Care Act

A new report in the Journal of General Internal Medicine indicates that despite some improvement in coverage with the implementation of the Affordable Care Act, there are still millions of Americans without adequate coverage for cardiovascular disease (CVD).

The researchers put the study in context of the passage of the Affordable Care Act, which they noted improved access to care for CVD and its risk factors (such as smoking, diabetes, and obesity). The study looked at a nationally representative, non-institutionalized sample of more than one million adults with CVD or at least two cardiovascular risk factors prior to implementation of the Affordable Care Act (2012-2013) and after (2015-2016).

The analysis showed a 6.9% increase in coverage after the implementation. Not having to forego physician visits due to cost improved by 3.6%, and check-ups increased by 2.1%. Patients with lower incomes saw the greatest improvements. While racial and ethnic minorities saw improvements due to the law’s implementation, approximately 13% of black and 29% of Hispanic adults still lacked coverage post-Affordable Care Act.

Implications for Millions

“Patients with existing cardiovascular conditions require regular medical care and daily medications to prevent another heart attack or stroke,” lead study author Ameen Barghi, of Harvard Medical School, said in a press release. “The good news is that the medications for CVD are very effective, and millions of Americans gained some coverage under the ACA. Unfortunately, despite these gains, millions of Americans with these conditions remain uncovered, and many of those will likely suffer serious complications and even death because they cannot get the care they need.”

Study co-author Dr. Hugo Torres, of Massachusetts General Hospital and Harvard Medical School, added that current efforts to repeal the Affordable Care Act by the Trump Administration could be more carefully considered, given these findings.

“The data show that insurance coverage increased more in states that opted to expand Medicaid, and also that coverage rates were already lowest in non-expansion states before the Affordable Care Act, highlighting the importance of the Medicaid expansion for people with serious pre-existing medical conditions,” Dr. Torres said. “If more states expanded Medicaid, many more people with CVD would be covered, particularly among people with low incomes, and in communities of color.”

20 million people with CVD or major risk factors still don't have insurance in America.

New research from Ameen Barghi, @mccormick_danny, and @hugotorres_md #MedicareForAll #DemDebate https://t.co/25F3RNpHXm pic.twitter.com/66TPG87lcj

— Dr. Unburnt Poorman (@DrPoorman) June 28, 2019

Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study https://t.co/mdP51blDnE

— JGIM Journal of General Internal Medicine (@JournalGIM) June 27, 2019

What did the ACA do for people with cardiovascular disease or risk factors? The good news: 10 million newly covered. The bad news: 20 million remain without coverage. Partial reforms like the ACA will not cut it. See our new paper in JGIM: https://t.co/BhyfNy2nPq

— Danny McCormick (@mccormick_danny) June 28, 2019