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WASHINGTON — A first look at the Affordable Care Act (ACA)’s Medicaid expansion finds that despite expectations, there was no increased use of complex surgical procedures at high volume hospitals–a proxy for high quality hospitals–among ethnic/racial minorities and low-income populations.

The findings came from comparing surgery records from high-volume hospitals in three states that opted in to the ACA’s Medicaid expansion with similar hospitals in two states that did not expand their Medicaid program.

The study, published in Journal of the American College of Surgeons, suggests that, in its infancy, Medicaid expansion under the ACA does not appear to reduce disparities in use of regionalized surgical care among vulnerable persons, says the study’s senior investigator, Waddah B. Al-Refaie, MD, FACS, Georgetown Lombardi Comprehensive Cancer Center Surgeon-In-Chief, and Regional Chief of Surgical Oncology at MedStar Georgetown University Hospital.

Georgetown Lombardi Comprehensive Cancer Center

“We are surprised at the results, because we already know, from other studies, that the ACA’s Medicaid expansion has increased access to surgical care overall,” says Al-Refaie, who also leads the MedStar-Georgetown Surgical Outcomes Research Center. “But we found that the expansion did not improve access to complex surgery that are typically centralized to high volume hospitals. Medicaid expansion under the ACA

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