UCLA Center for Health Policy Research

Health care workers at safety net facilities can recount endless anecdotes of adverse consequences arising from poor access to health care experienced by marginalized populations in California: The missed preventive care, infrequent screenings, and low use of unaffordable chronic disease medications that result in unnecessary illness, avoidable hospitalizations, late-stage diagnoses, and premature mortality. Each story is tragic, but such anecdotes have not convinced skeptics who in the past have questioned the degree to which expanded health care access has significant concrete benefits. A careful reading of the research literature on this topic, however, leaves no doubt of the critical importance of safety net care. This brief summarizes the evidence on the health benefits of expanded access, with particular attention to the newest studies from recent coverage expansions in Massachusetts, Oregon, and parts of California.