Affordable care act: comparison of healthcare indicators among different insurance beneficiaries with new coverage eligibility

Abstract

BackgroundHealth coverage in the United States will be increased to nearly universal levels under the Affordable Care Act (ACA). In order to better understand the impact of the type of health insurance and health outcomes, there is a need to examine health disparities and inequalities between the insured and the uninsured based on their eligibility for coverage.MethodsThe current study used the data from the Medical Expenditure Panel Survey 2012 (MEPS). Selected health characteristics and access to care items were compared in regard to the insurance status: private, public, the uninsured, but likely eligible for Medicaid expansion (EME), and the uninsured, but likely required to purchase health plans through the health insurance exchanges (RPIE).ResultsAnalyses showed that 17.2 % of US adults ages 27–64 were eligible as EME and 12.9 % as RPIE in 2012. Compared to the insured groups, the uninsured who were eligible for coverage reported fewer health problems than those insured privately and publicly. However, they also reported less use of health care, including preventive health service, screenings, and unmet health care needs.ConclusionsThe ACA aims to increase coverage options and access to treatment and preventive health care services for the majority of the uninsured US population. However, it may not play as significant of a role in improving health among the uninsured, in particular, those eligible for the Medicaid expansion.

Health Care Access by Weight Status in the State of Georgia

“…Though there are individual variation, there is a predictable pattern. Studies have found that those with higher incomes and higher education levels were more likely to be insured (Swinburn, 2011 andHong et al, 2016). This is consistent with our findings.…”

“…They may also live in areas where insurance is more accessible than less educated individuals (Zimmerman et al, 2015). Males having less insurance is consistent with other research (Day et al, 2015;Long et al, 2011;Hong et al, 2016;Dahlen, 2015). Each study reported similar numbers and that the percentage of men and women having insurance grew closer after the ACA was passed.…”

Out-of-Pocket Payments and Subjective Unmet Need of Healthcare

“…The interaction between needs, OOP payments and financial position of the household determines whether there will be SUN, with the important proviso that each of these are influenced by the subjective perception of the respondents. Striking results are found for the USA, in which individuals who lack insurance coverage tend to postpone healthcare (medical as well as dental care) because of cost more often than insured individuals [5][6][7][8][9][10][11]. The literature also shows that charity care is not an adequate substitute for insurance coverage [6,7].…”

“…We discuss this issue in the following section. In a more recent cross-sectional study, Hong et al [8] tried to assess the possibly diverse impact of the Affordable Care Act on differently insured individuals. They found that publicly insured people had poorer physical and mental health conditions than uninsured individuals (eligible for Medicaid or for purchasing health plans through the health insurance exchanges) but that the latter were more likely to report unmet healthcare needs.…”

Distrust in health care and cultural factors are associated with uptake of colorectal cancer screening in Hispanic and Asian Americans

“…Third, how do the examined associations vary among HAs and AAs? Based on the literature, we primarily hypothesized that predisposing characteristics (education, economic status, and cultural factors), [4][5][6]8,12,13,16,19 enabling factors (health insurance), 14,16,19,22 and health needs (perceived risks of health status and the number of comorbid conditions) 5,14,16,19 would affect CRC screening uptake. We also hypothesized that cultural factors would have indirect effects (ie, mediation) on screening uptake through perceived quality of health services, 18,20,23 access to care, 16,24 or distrust in health care.…”