Out of Time and Out of Pocket: Experiences of Women Seeking State-Subsidized Insurance for Abortion Care in Massachusetts
Out of Time and Out of Pocket: Experiences of Women Seeking State-Subsidized Insurance for Abortion Care in Massachusetts
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DOI：
10.1016/j.whi.2011.02.008
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发表时间：
2011-05-01
影响因子：
3.2
通讯作者：
Peterson, Megan J.
中科院分区：
文献类型：
--
作者：
Bessett, Danielle;Gorski, Katey;Peterson, Megan J.
背景：马萨诸塞州实施了旨在提供全民医疗保健覆盖的改革，并通过补贴的国家保险计划涵盖堕胎。马萨诸塞州的三个堕胎基金于 2010 年 4 月至 10 月评估了低收入妇女的转介流程，以了解妇女申请补贴保险的经历，并查明获得保险或将其用于堕胎服务的障碍。方法：对 39 名低收入妇女进行后续访谈，这些妇女在初次接触基金后至少 1 个月认为有资格获得补贴保险。结果：健康保险知识水平较低，参与者报告对区分补贴水平感到困惑。保险。申请补贴保险的过程中耽误了相当大比例的手续。超过三分之二申请国家保险的女性已经参保或预计很快参保，但只有三分之一的申请者能够及时为堕胎护理获得保险。由于延误，两名妇女无法堕胎。延误还限制了低收入妇女获得药物堕胎的能力。结论：这项分析表明，加入补贴保险的过程目前无法满足及时为妇女提供堕胎护理（和其他健康需求）的目标。需要进行系统性改进，以确保快速处理登记并将覆盖范围的中断降至最低。应开发信息资源，帮助妇女及其家人了解健康保险和服务范围。版权所有 (C) 2011，雅各布斯妇女健康研究所。由爱思唯尔公司出版
Background: Massachusetts has implemented reforms aimed at providing universal health care coverage and covers abortion through subsidized state insurance programs. Three Massachusetts abortion funds evaluated their referral processes for low-income women from April to October 2010 to learn about women's experiences applying for subsidized insurance and to identify barriers to obtaining insurance or its use for abortion services.Methods: Follow-up interviews were conducted with 39 low-income women thought eligible for subsidized insurance at least 1 month after their initial contact with the funds.Results: Health insurance literacy was low, and participants reported confusion distinguishing between levels of subsidized insurance. The process of applying for subsidized insurance delayed a substantial proportion of procedures. More than two thirds of the women who applied for state coverage had become insured or expected to become insured shortly, but only one third of respondents who applied were able to secure insurance in time for their abortion care. Two women were unable to obtain abortions as a result of delays. Delays also limited low-income women's ability to obtain medication abortion.Conclusion: This analysis suggests that the process for enrolling in subsidized insurance does not currently meet the goal of providing women with coverage for abortion care (and other health needs) in a timely way. Systemic improvements are needed to ensure that enrollments are processed quickly and disruptions in coverage are minimized. Information resources should be developed to help women and their families understand health insurance and coverage of services. Copyright (C) 2011 by the Jacobs Institute of Women's Health. Published by Elsevier Inc.