OBJECTIVES : About 2.2 million people nationwide were estimated to be in the Medicaid Coverage Gap, because of state decisions not to expand Medicaid program. Consequently, it might impact patients’ affordability of necessary healthcare, especially among patients with chronic conditions. However, this patient group is under researched due to the lack of data availability. This preliminary study aimed to identify and characterize such patients from a nationally representative survey.

METHODS : The two most recent panels (Panels 19 and 20) of the Medical Expenditure Panel Survey were used to extract data. Only survey respondents with a complete consecutive 2-year period of data were included. To be defined as in the Medicaid Coverage Gap, a survey respondent had to be between ages 18 and 65 during both years, stayed below or at 100% of Federal Poverty Level in year 1 (baseline), and either uninsured or covered by any private insurance in year 1. Of those, only individuals with at least one of the following chronic conditions were included as the final study sample: hypertension, diabetes, hyperlipidemia, mood disorder, and anxiety. Descriptive analysis was conducted to characterize the patients of interest, using SAS 9.4.

RESULTS : A total of 229 patients were identified. The majority were female (64.2%) with an average age of 48 and had hypertension (47.6%). About a third of them were Hispanics (32.3%), and another third were non-Hispanic blacks (32.8%). The majority were uninsured (57.6%). At baseline, on average, identified patients’ families earned $10,463 (± $7,906) annually, had out-of-pocket spending of $950 (± $3,885) in healthcare, and had a total healthcare expenditure of $5,053 (± $9,891).

CONCLUSIONS : It appeared that most patients with selected chronic conditions in the Medicaid Coverage Gap were uninsured. Follow-on research will be conducted to assess medication adherence in year 2 (follow-up) among the identified patient cohort.