LAUSR

Distance traveled to a provider has been associated with access to and timely use of health care services. Medicaid expansion has been previously linked to an increase in the number of providers accepting Medicaid patients. We hypothesized that by increasing the density of providers accepting Medicaid in any area, Louisiana's Medicaid expansion in July 2016 may have increased access to health care services for Medicaid patients already eligible for Medicaid in Louisiana by decreasing distances traveled to reach health care providers. We tested our hypothesis using a regression discontinuity model on all continuously enrolled Louisiana Medicaid beneficiaries' transactions from the period 2015-17 across eight different service lines. Distance traveled to appointments declined across all service lines, with declines ranging from -3.46 miles for general practices to -0.70 miles for specialty care. The most robust declines in distance traveled were among Black enrollees living in nonmetropolitan areas, with the largest being a decline of 9.25 fewer miles traveled for general practice care. Medicaid expansion has the potential to address racial and geographic disparities in health care access through decreased travel distances.