The Impact of Pandemic Era Health Care Policy on Uninsured Non-Elderly Adult Americans in an ACA Medicaid Expansion and a Non-Expansion State

This paper reviews pre-pandemic, pandemic era, and post-pandemic health care policy and health care access barriers for uninsured non-elderly adult Americans between two cities. One in a Medicaid expansion state and one in a non-expansion state. A comparison will be made of institutional health care access policy, local, state, and federal policy, access disparities, and social determinant factors among uninsured non-elderly adult Americans. Factors will be identified using quantitative analysis of U.S. Department of Health and Human Services (DHHS). A summary of factors influencing the uninsured in the presence of pandemic era local, state, and federal policy. A quasi-experimental mixed methods analysis will be provided to show the impact of pre-, intra-, and post-COVID-19 pandemic era health policy on the uninsured living in Baltimore City and the City of Milwaukee. Original literature shows a significant increase in access to health care for the uninsured following the implementation of Patient Protection and Affordable Care Act (ACA) in 2010 with gradual decreases in access overtime resulting in a negative impact on health care delivery for uninsured non-elderly Americans living in the two subject cities. Local-, state-, and federal level health care policy demonstrate resources available to offset costs of caring for the uninsured with comparative examples of two cities. community organizations, leveraging state, federal and private funding, facilitate health care for uninsured Americans experiencing homelessness. Comparative data will be examined to show if there is a significant disparity in access to health care between the states of Maryland and Wisconsin and specifically focusing on Baltimore City and the City of Milwaukee.