Do those with chronic health conditions benefit from the Affordable Care Act Medicaid expansion?

We evaluate the impact of Affordable Care Act Medicaid expansion on coverage, access to care, and self-reported health, for the vulnerable and chronically ill using data from the behavioral risk factor surveillance system (BRFSS). Using 5 years of post-reform data between 2014 and 2018 and a difference-in-differences identification strategy, we find that the Medicaid expansion improved coverage and access to care among both those with and without chronic conditions. While the effect sizes are mostly larger for those with a chronic condition, the differences in magnitude are not statistically significant. We also find statistically significant improvements in self-assessed health for those without chronic conditions. Finally, we find larger improvements in coverage and access to care among those with chronic conditions in states with higher-than-average pre-ACA uninsured rates for those with chronic conditions, though these coverage and access gains did not translate into health improvements for this group.