The impact of the Affordable Care Act’s medicaid expansion on patients admitted for burns: An analysis of national data

•Burn patients saw significantly higher rates of Medicaid coverage after Medicaid Expansion.•Those living in the Northeast and West regions had the largest increases.•No changes seen in discharge disposition or hospital length of stay. The first states began implementing the Medicaid expansion provisions of the Patient Protection and Affordable Care Act (ACA) in 2014. Studies have yet to address its impact on burn patients. Burn patients in geographic regions that expanded Medicaid coverage were compared to patients in regions that did not expand Medicaid before and after implementation of the ACA using bivariate statistics and a difference-in-differences model. A multivariable logistic regression was used to identify factors associated with having Medicaid insurance. The primary outcome of this study was the rate of Medicaid insurance. Of 25,331 discharges, we found greater increases in Medicaid coverage after the ACA in the Medicaid expander regions (23.4–40.2%) compared to the non-expander regions (18.5–20.1%). The difference-in-differences estimate between the expander and non-expander regions was 0.15 (95% CI: 0.11–0.18, p