The Effect of the Affordable Care Act on Access to Care for Children in the South

Abstract

The Affordable Care Act (ACA) has resulted in millions of Americans gaining healthcare coverage, including increased coverage among children primarily through the welcome mat effect. However, the lack of the ACA’s Medicaid expansion in many Southern states may have affected children’s access to care based on the hypothesized, smaller welcome mat effect compared to other regions. Despite the documented coverage gains for children, it is unclear whether the ACA had an effect on access to or utilization of care among children and whether their access to care varied by region. Using National Health Interview Survey (NHIS) data from 2010-2017, I examine whether the ACA increased access to care for children in the South.

Results show no significant effect of the ACA on the access to care among children and specifically, no evidence of regional differences as a result of the policy. Despite the lack of ACA-specific effects, this study has meaningful findings of regional differentials in overall access to care as well as the importance of insurance coverage for children in accessing care. The findings in this paper are consistent with previous literature showing the welcome mat effect and the positive effect of healthcare coverage on a child’s access to care.