{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:21:18Z","timestamp":1787008878871,"version":"build-2736575974"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Health Care Practice and Policy Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In 2014, multiple states expanded Medicaid coverage to low-income adults under the Affordable Care Act. We evaluated the association of Medicaid expansion (ME) with children's insurance coverage and health service utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared changes in children's insurance coverage and health service utilization between 2010-2013 and 2014-2016 in expansion and non-expansion states. Repeated cross-sectional analysis with linear difference-in-differences (DID) models was conducted using the Medical Expenditure Panel Survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Medicaid expansion was not associated with changes in the proportion of children with \u22651 month of insurance coverage (DID: \u22121.9% point [pp], 95% CI \u22124.1 to 0.3) or the proportion of children with continuous coverage for 12 months (DID: \u22121.8 pp, 95% CI \u22125.6 to 2.0). Expansion was not associated with changes in any utilization outcome, including having \u22651 annual well-child visit (DID: \u22121.9 pp, 95% CI \u22126.6 to 2.8) or \u22651 annual dental visit (DID: 1.9 pp, 95% CI \u22122.8 to 6.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Medicaid expansion was not associated with changes in children's coverage and utilization. While policymakers in states that have not yet expanded Medicaid might still consider doing so for other reasons, findings suggest that alternative interventions will be needed to improve coverage and utilization patterns in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/haschl\/qxaf245","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:58:55Z","timestamp":1766149135000},"source":"Crossref","is-referenced-by-count":1,"title":["Association of Medicaid expansion with children's insurance coverage and healthcare utilization"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4972-8871","authenticated-orcid":false,"given":"Kim","family":"Dalziel","sequence":"first","affiliation":[{"name":"Centre for Health Policy, The Melbourne School of Global and Population Health, University of Melbourne, Carlton 3010 ,","place":["Australia"]},{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor 48109 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4081-272X","authenticated-orcid":false,"given":"Kao-Ping","family":"Chua","sequence":"additional","affiliation":[{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor 48109 ,","place":["United States"]},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor 48109 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2102-5461","authenticated-orcid":false,"given":"Xinyang","family":"Hua","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, The Melbourne School of Global and Population Health, University of Melbourne, Carlton 3010 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5365-7899","authenticated-orcid":false,"given":"Li","family":"Huang","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, The Melbourne School of Global and Population Health, University of Melbourne, Carlton 3010 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Ryan","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor 48109 ,","place":["United States"]},{"name":"School of Public Health, Brown University, Providence 02912 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary L","family":"Freed","sequence":"additional","affiliation":[{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor 48109 ,","place":["United States"]},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor 48109 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4316-9143","authenticated-orcid":false,"given":"Helen","family":"Levy","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor 48109 ,","place":["United States"]},{"name":"Institute for Social Research, University of Michigan, Ann Arbor 48106 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5711-9793","authenticated-orcid":false,"given":"John Z","family":"Ayanian","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor 48109 ,","place":["United States"]},{"name":"Division of General Medicine, University of Michigan Medical School, Ann Arbor 48109 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"issue":"5","key":"2026010713293566000_qxaf245-B1","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1377\/hlthaff.2016.1650","article-title":"Medicaid expansion increased coverage, improved affordability, and reduced psychological distress for low-income parents","volume":"36","author":"McMorrow","year":"2017","journal-title":"Health Aff (Millwood)"},{"issue":"5","key":"2026010713293566000_qxaf245-B2","doi-asserted-by":"publisher","first-page":"e14625","DOI":"10.1111\/1475-6773.14625","article-title":"Examining the impact of ACA Medicaid expansion on insurance coverage, access to care and health of low-income 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