Association for Public Policy Analysis & Management

Despite the large growth in the per-capita number of physicians nationally in the past three decades, there has been a persistent shortage in the availability of primary care physicians, dentists, and psychiatrists in areas known as Health Professional Shortage Areas. The lack of health professionals in these areas may be associated with less access and utilization of care and subsequent reductions in physical and mental health. In this paper, I examine the changes in the supply of health professionals including advanced practice nurses, registered nurses, physician assistants, dentists, and primary care physicians and county health professional shortage designation status following the ACA Medicaid expansion using county-level data from the Area Health Resource File. I use a difference-in-differences approach and find that, compared to non-Medicaid-expansion counties, the per capita number of advanced practice registered nurses, full-time registered nurses, physician assistants, dentists, and full-time facility employment increased (by between 2.3 – 7.5%) in Medicaid expansions counties. However, there were no significant differences in the supply of primary care physicians and surgeons.