The impact of the Affordable Care Act Medicaid Expansion in Medicare beneficiaries with peripheral artery disease.

This article examines the impact of the Affordable Care Act Medicaid Expansion (ME) on 1-year all-cause mortality and leg amputation rates among Medicare beneficiaries diagnosed with peripheral artery disease (PAD). Using a state-level difference-in-differences analysis of nearly 38 million patients from 2011 to 2018, the study found that ME was not associated with significant reductions in mortality or amputation rates overall, even when stratified by sex, race, region, or dual Medicare/Medicaid eligibility. A subanalysis showed a modest decrease in amputation rates among dual-eligible men in ME states, but no similar benefit for women. These findings suggest that despite improved healthcare coverage through ME, PAD patients have not experienced measurable improvements in these clinical outcomes, indicating a need for targeted interventions beyond insurance expansion.