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SSRC Library

The SSRC Library allows visitors to access materials related to self-sufficiency programs, practice and research. Visitors can view common search terms, conduct a keyword search or create a custom search using any combination of the filters at the left side of this page. To conduct a keyword search, type a term or combination of terms into the search box below, select whether you want to search the exact phrase or the words in any order, and click on the blue button to the right of the search box to view relevant results.

Writing a paper? Working on a literature review? Citing research in a funding proposal? Use the SSRC Citation Assistance Tool to compile citations.

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The SSRC Library includes resources which may be available only via journal subscription. The SSRC may be able to provide users without subscription access to a particular journal with a single use copy of the full text.  Please email the SSRC with your request.

The SSRC Library collection is constantly growing and new research is added regularly. We welcome our users to submit a library item to help us grow our collection in response to your needs.


  • Individual Author: Wherry, Laura R.; Miller, Sarah
    Reference Type: Journal Article
    Year: 2016

    Background: In 2014, only 26 states and the District of Columbia chose to implement the Patient Protection and Affordable Care Act (ACA) Medicaid expansions for low-income adults.

    Objective: To evaluate whether the state Medicaid expansions were associated with changes in insurance coverage, access to and utilization of health care, and self-reported health.

    Design: Comparison of outcomes before and after the expansions in states that did and did not expand Medicaid.

    Setting: United States.

    Participants: Citizens aged 19 to 64 years with family incomes below 138% of the federal poverty level in the 2010 to 2014 National Health Interview Surveys.

    Measurements: Health insurance coverage (private, Medicaid, or none); improvements in coverage over the previous year; visits to physicians in general practice and specialists; hospitalizations and emergency department visits; skipped or delayed medical care; usual source of care; diagnoses of diabetes,...

    Background: In 2014, only 26 states and the District of Columbia chose to implement the Patient Protection and Affordable Care Act (ACA) Medicaid expansions for low-income adults.

    Objective: To evaluate whether the state Medicaid expansions were associated with changes in insurance coverage, access to and utilization of health care, and self-reported health.

    Design: Comparison of outcomes before and after the expansions in states that did and did not expand Medicaid.

    Setting: United States.

    Participants: Citizens aged 19 to 64 years with family incomes below 138% of the federal poverty level in the 2010 to 2014 National Health Interview Surveys.

    Measurements: Health insurance coverage (private, Medicaid, or none); improvements in coverage over the previous year; visits to physicians in general practice and specialists; hospitalizations and emergency department visits; skipped or delayed medical care; usual source of care; diagnoses of diabetes, high cholesterol, and hypertension; self-reported health; and depression.

    Results: In the second half of 2014, adults in expansion states experienced increased health insurance (7.4 percentage points [95% CI, 3.4 to 11.3 percentage points]) and Medicaid (10.5 percentage points [CI, 6.5 to 14.5 percentage points]) coverage and better coverage than 1 year before (7.1 percentage points [CI, 2.7 to 11.5 percentage points]) compared with adults in nonexpansion states. Medicaid expansions were associated with increased visits to physicians in general practice (6.6 percentage points [CI, 1.3 to 12.0 percentage points]), overnight hospital stays (2.4 percentage points [CI, 0.7 to 4.2 percentage points]), and rates of diagnosis of diabetes (5.2 percentage points [CI, 2.4 to 8.1 percentage points]) and high cholesterol (5.7 percentage points [CI, 2.0 to 9.4 percentage points]). Changes in other outcomes were not statistically significant.

    Limitation: Observational study may be susceptible to unmeasured confounders; reliance on self-reported data; limited post-ACA time frame provided information on short-term changes only.

    Conclusion: The ACA Medicaid expansions were associated with higher rates of insurance coverage, improved quality of coverage, increased utilization of some types of health care, and higher rates of diagnosis of chronic health conditions for low-income adults. (Author abstract)

  • Individual Author: Sommers, Benjamin; Baicker, Katherine; Epstein, Arnold
    Reference Type: Journal Article
    Year: 2012

    Medicaid currently insures 60 million people, and the Affordable Care Act (ACA) will extend Medicaid eligibility to millions more starting in 2014. The recent Supreme Court ruling enables states to choose whether to expand Medicaid under the ACA, and many states facing budget pressures are considering cutbacks instead. Yet evidence regarding Medicaid's effect on health remains surprisingly sparse, particularly for adults. Previous research showed that Medicaid expansions in the 1980s reduced mortality among infants and children, though other studies showed little effect. Numerous observational studies have documented a correlation between Medicaid coverage and adverse outcomes among adults prompting some observers to claim that Medicaid coverage is worse than no coverage. However, such studies are plagued by unmeasured confounders that make Medicaid patients sicker than others. One ongoing randomized trial of an expansion of Medicaid in Oregon showed significant improvements in self-reported health and access to care in the first year.

    Traditionally, Medicaid covers only...

    Medicaid currently insures 60 million people, and the Affordable Care Act (ACA) will extend Medicaid eligibility to millions more starting in 2014. The recent Supreme Court ruling enables states to choose whether to expand Medicaid under the ACA, and many states facing budget pressures are considering cutbacks instead. Yet evidence regarding Medicaid's effect on health remains surprisingly sparse, particularly for adults. Previous research showed that Medicaid expansions in the 1980s reduced mortality among infants and children, though other studies showed little effect. Numerous observational studies have documented a correlation between Medicaid coverage and adverse outcomes among adults prompting some observers to claim that Medicaid coverage is worse than no coverage. However, such studies are plagued by unmeasured confounders that make Medicaid patients sicker than others. One ongoing randomized trial of an expansion of Medicaid in Oregon showed significant improvements in self-reported health and access to care in the first year.

    Traditionally, Medicaid covers only low-income children, parents, pregnant women, and disabled persons. During the past decade, however, several states have expanded Medicaid to cover nondisabled adults without dependent children (“childless adults”), a group that is similar to the population gaining eligibility under the ACA (i.e., all adults with incomes up to 138% of the federal poverty level). We used this natural experiment to determine whether state expansions of Medicaid were associated with decreased mortality. We hypothesized that Medicaid expansions would reduce mortality, rates of uninsurance, and cost-related barriers to care and would improve self-reported health, particularly among minority and lower-income populations. (author abstract)