The Role of the Medicaid Expansion in the Use of Preventive Health Care Services in California Men

Abstract

Men’s use of preventive care services may be constrained due to a number of factors including lack of health care insurance. California used the Medicaid expansion provisions of the Affordable Care Act (ACA) to enroll low-income men between the ages of 18 and 64 years in publicly funded health insurance. Most studies on the effect of the ACA on health care services have focused on racial/ethnic differences rather than gender. Data from the California Health Interview Survey for the 2015–2016 survey period were used to model the use of preventive health care services in the year prior to interview. Population weights were used in the analysis which was done using PROC SURVEY LOGISTIC in SAS software, version 9.4. The sample consisted of men between the ages of 18 and 64 years ( N = 6,180). Of these 66% ( n = 4,088) reporting receiving any preventive care services in the year prior to interview. The largest proportions of respondents fell into the youngest group aged 18–25 (17%) followed by the oldest group aged 60–64 (16.9%); 43% reported they were married, 57% had incomes at greater than 300% of the federal poverty level. There was no effect of race or ethnicity on receiving preventive care services. Having a chronic condition such as hypertension or diabetes was associated with a greater odds of receiving preventive care. Expanding Medicaid to include low-income men below the age of 65 is associated with increased use of preventive health care, especially among those with chronic conditions.