How have Hospital Closures in Tennessee Affected Communities?
The Affordable Care Act (ACA), enacted in March 2010, aimed to provide more Americans with better health security through health insurance reforms. One major provision of the ACA aimed to expand Medicaid. However, the Supreme Court struck down that provision and left it up to the state to decide whether to accept federal funds and expand Medicaid. Tennessee, along with other states with conservative electorates, chose not to expand the government Medicaid program. Many of the safety-net organizations in Tennessee that serve a large amount of their communities’ uninsured and/or poor patients are both losing money and in jeopardy of closing. To assess the extent of hospital closures in Tennessee around the Affordable Care Act and to investigate their impact on hospital safety-net care provision and community economic indicators. We will create a database of hospital closures in Tennessee and will link it to hospital characteristics, community characteristics and economic data. Compare communities that lose a hospital in Tennessee to those that don’t, before and after the ACA. We will assess differences with t-tests with assumed unequal variances.