Reasons Why Patients Remain Uninsured after Massachusetts’ Health Care Reform: A Survey of Patients at a Safety-Net Hospital

Nardin, Rachel; Sayah, Assaad; Lokko, Hermione; Woolhandler, Steffie; McCormick, Danny

doi:10.1007/s11606-011-1868-5

Cited by 13 publications

(16 citation statements)

References 3 publications

(5 reference statements)

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“…5–7 Despite the subsidies available through programs under the Affordable Care Act, health insurance continues to be unaffordable for many. 8,9 …”

mentioning

confidence: 99%

Understanding and Measuring Health Care Insecurity

Tomsik¹,

Smith²,

Mason³

et al. 2014

hpu

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Purpose To define the concept of “health care insecurity,” validate a new self-report measure, and examine the impact of beginning care at a free clinic on uninsured patients’ health care insecurity. Methods Consecutive new patients presenting at a free clinic completed 15 items assessing domains of health care insecurity (HCI) at their first visit and again four to eight weeks later. Psychometrics and change of the HCI measure were examined. Results The HCI measure was found to have high internal consistency (α=0.94). Evidence of concurrent validity was indicated by negative correlation with VR-12 health-related quality of life physical and mental health components and positive correlation with the Perceived Stress Scale. Predictive validity was shown among the 83% of participants completing follow-up: HCI decreased after beginning care at a free clinic (p<.001). Conclusion Reliably assessing patient experience of health care insecurity is feasible and has potential to inform efforts to improve quality and access to care among underserved populations.

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“…5–7 Despite the subsidies available through programs under the Affordable Care Act, health insurance continues to be unaffordable for many. 8,9 …”

mentioning

confidence: 99%

Understanding and Measuring Health Care Insecurity

Tomsik¹,

Smith²,

Mason³

et al. 2014

hpu

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show abstract

“…However, in Massachusetts, lower socioeconomic groups and minorities were disproportionately represented among the 4.8% of residents who remained uninsured in 2009 despite an individual mandate. 19,20 Nationally, these same individuals face a greater burden of trauma than other Americans, possibly because of environmental conditions and health behaviors. 21,22 Our results suggest that although health care reform may decrease rates of uninsured injured patients cared for at our nation's trauma centers, certain Americans will remain in a sort of "double jeopardy" of having both higher injury incidence and worse outcomes because the same sociodemographic factors that place them at high risk for injury may present barriers to compliance with an individual mandate.…”

Section: Discussionmentioning

confidence: 99%

Rates of Insurance for Injured Patients Before and After Health Care Reform in Massachusetts: A Possible Case of Double Jeopardy

et al. 2014

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“…Previous examinations of the effects of the MA law have confirmed that the policy resulted in substantially higher health insurance coverage and improved access to care [3–9]. However, costs associated with maintaining insurance coverage and use of health services continue to be an issue for low-income MA adults, resulting in unstable coverage and persistently lower rates of preventive services use [3,10]. …”

Section: Introductionmentioning

confidence: 99%

Has Massachusetts health care reform worked for the working poor? Results from an analysis of opportunity

Tinsley

Hall

McKinlay

2014

Annals of Epidemiology

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Purpose Health care reform was introduced in Massachusetts (MA) in 2006 and serves as a model for what was subsequently introduced nationally as the Patient Protection and Affordable Care Act. The Boston Area Community Health survey collected data before (2002–2005) and after (2006–2010) introduction of the MA health insurance mandate, providing a unique opportunity to assess its effects in a large, epidemiologic cohort. Methods We report on the apparent effects of the mandate on the same participants over time, focusing specifically on the vulnerable working poor (WP). We evaluated differences in subpopulations of interest at pre- and post-reform periods to explore whether MA health care reform resulted in an overall gain in insurance coverage. Results MA health care reform was associated with net gains in health insurance coverage overall and among the subgroups studied. Our findings suggest that despite being targeted by health care reform legislation, the WP in MA continue to report lower rates of insurance coverage compared with both the nonworking poor and the not poor. Conclusions MA health care reform legislation, including the expansion of Medicaid, resulted in substantial overall gains in coverage. Disparities in insurance coverage persist among some subgroups following health care reform implementation in MA. These results have important implications for health services researchers and policy makers, particularly in light of the ongoing implementation of the Patient Protection and Affordable Care Act.

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Reasons Why Patients Remain Uninsured after Massachusetts’ Health Care Reform: A Survey of Patients at a Safety-Net Hospital

Cited by 13 publications

References 3 publications

Understanding and Measuring Health Care Insecurity

Understanding and Measuring Health Care Insecurity

Rates of Insurance for Injured Patients Before and After Health Care Reform in Massachusetts: A Possible Case of Double Jeopardy

Has Massachusetts health care reform worked for the working poor? Results from an analysis of opportunity

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