The ACA’s Individual Mandate In Retrospect: What Did It Do, And Where Do We Go From Here?

Fiedler, Matthew

doi:10.1377/hlthaff.2019.01433

Cited by 13 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whether these improvements persist remains to be seen, especially with the abolishment of the ACA individual mandate in 2017, ongoing legal challenges to the ACA, and economic fallout secondary to the novel coronavirus pandemic. [42][43][44] Our study extends previous work by directly comparing the impact of ACA implementation on reported financial barriers in cancer survivors age 18-64 years against those age . 65 years.…”

Section: Discussionsupporting

confidence: 55%

See 1 more Smart Citation

Affordable Care Act and Cancer Survivors' Financial Barriers to Care: Analysis of the National Health Interview Survey, 2009-2018

Okullo

Hingtgen

et al. 2021

JCO Oncology Practice

View full text Add to dashboard Cite

PURPOSE: Since Affordable Care Act (ACA) implementation in 2014, studies have demonstrated gains in insurance coverage for cancer survivors < 65 years. We assessed the impact of ACA implementation on financial barriers to care by stratifying survivors at age 65 years, when individuals typically become Medicare-eligible. METHODS: We used data from respondents with cancer in the 2009-2018 National Health Interview Survey. We identified 21,954 respondents representing approximately 7.4 million survivors, who were then age-stratified at age 65 years. Survey responses regarding financial barriers to medical care and medications were analyzed, and age-stratified multivariable logistic regression modeling was performed, which evaluated the impact of ACA implementation on these measures, adjusted for demographic and socioeconomic variables. RESULTS: After multivariable logistic regression, ACA implementation was associated with higher adjusted odds of Medicaid insurance (odds ratio [95% CI] 2.02 [1.72 to 2.36]; P < .0001) and lower adjusted odds of no insurance (0.57 [0.48 to 0.68]; P < .0001). Regarding financial barriers, ACA implementation was associated with lower adjusted odds of inability to afford medications (0.68 [0.59 to 0.79]; P < .0001), inability to afford dental care (0.83 [0.73 to 0.94]; P = .004), and delaying care (0.78 [0.69 to 0.89]; P = .002) in the 18-64 years group. Similarly, ACA implementation was associated with lower adjusted odds of secondary outcomes such as delaying refills, skipping doses, and anxiety over medical bills. Similar associations were not seen in the > 65 years group. CONCLUSION: Survivor-reported measures of financial barriers in cancer survivors age 18-64 years significantly improved following ACA implementation. Similar changes were not seen in the Medicare-eligible cohort, likely because of high Medicare enrollment and few uninsured.

show abstract

Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Affordable Care Act and Cancer Survivors' Financial Barriers to Care: Analysis of the National Health Interview Survey, 2009-2018

Okullo

Hingtgen

et al. 2021

JCO Oncology Practice

View full text Add to dashboard Cite

show abstract

“…An original provision of the Affordable Care Act (ACA) imposed a tax penalty on uninsured individuals. The provision, commonly known as the “individual mandate,” intended to increase insurance coverage and reduce adverse selection by incentivizing healthier people to enroll (Fiedler, 2020 ). However, the mandate’s opponents viewed it as “…a stunning assault on liberty” and an attempt to “…trample on the freedoms of Americans” (Young, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

The impact of the repeal of the federal individual insurance mandate on uninsurance

Soni

2022

Int J Health Econ Manag.

View full text Add to dashboard Cite

The federal individual mandate of the Affordable Care Act, which required people to pay a tax penalty if they did not have health insurance, was repealed in 2019. However, some states implemented state-level insurance mandates which essentially replaced the federal mandate. I use nationally representative survey data from the 2015–19 Annual Social and Economic Supplement to the Current Population Survey to compare the probability of becoming newly uninsured among people living in states without state-level insurance mandates versus states with a mandate, before and after the 2019 repeal. In a sample of 214,821 lower-income, nonelderly adults, the repeal of the federal mandate was associated with a 0.5% point, or 24%, increase in the year-over-year probability of becoming newly uninsured. These results suggest that people respond to financial incentives when making insurance enrollment decisions. In the absence of a federal mandate, state-level mandates may reduce transitions to uninsurance.

show abstract

“…For example, several states in the US have demonstrated that individual mandates could be an effective tool to increase insurance coverage and reduce premiums (Hackmann et al, 2015;Fung et al, 2019). However, more recent research on the ACA suggests that the individual mandate meaningfully increased insurance coverage, but likely by less than was projected before its implementation (Frean et al, 2017;Collins et al, 2018;Fiedler, 2020).…”

Section: Introductionmentioning

confidence: 99%

Age Penalties and Take-Up of Private Health Insurance

Kettlewell

Zhang

2021

SSRN Journal

View full text Add to dashboard Cite

The ACA’s Individual Mandate In Retrospect: What Did It Do, And Where Do We Go From Here?

Cited by 13 publications

References 16 publications

Affordable Care Act and Cancer Survivors' Financial Barriers to Care: Analysis of the National Health Interview Survey, 2009-2018

Affordable Care Act and Cancer Survivors' Financial Barriers to Care: Analysis of the National Health Interview Survey, 2009-2018

The impact of the repeal of the federal individual insurance mandate on uninsurance

Age Penalties and Take-Up of Private Health Insurance

Contact Info

Product

Resources

About