Away from the Hospital: Evaluating the Impact of the Affordable Care Act in New York and Florida on Preventable Hospitalizations

Abstract

The Affordable Care Act was passed in March 2010, with many of the most significant provisions implemented in 2014. The key provision addressed in this thesis was the Medicaid expansion. Two of the largest states, New York and Florida, adopted different policies, with New York expanding Medicaid and Florida not doing so. This thesis uses this quasi-experimental design to determine the impact of the Medicaid expansion on preventable hospitalization using New York and Florida. This thesis found that preventable hospitalization rates reduced significantly more in New York than in Florida after 2014. This difference was not found to be significant in a difference-in-differences-in-differences analysis comparing those ages 60-64 and those ages 65-69, the latter which should not be directly affected by the Medicaid expansion. However, further difference-in-differences analysis considering the top seven reasons for preventable hospitalization saw that those ages 60-64 saw a reduction in hospitalization rate compared to the baseline Florida case for cardiac, diabetes, asthma, and convulsion- related hospitalizations whereas those ages 65-69 did not. Thus, the data suggested that the impact of the Medicaid expansion on those ages 60-64 was stronger than those ages 65-69. Overall, this thesis concluded that from a public health perspective, the Medicaid expansion had provided promising evidence by reducing preventable hospitalization in New York significantly more than in Florida. Keywords: Affordable Care Act, Preventable Hospitalization