Knowledge as a Predictor of Insurance Coverage Under the Affordable Care Act.
Knowledge as a Predictor of Insurance Coverage Under the Affordable Care Act.
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DOI：
10.1097/mlr.0000000000000671
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发表时间：
2017-04
期刊：
影响因子：
3
通讯作者：
Carman KG
中科院分区：
文献类型：
--
作者：
Hoerl M;Wuppermann A;Barcellos SH;Bauhoff S;Winter JK;Carman KG
《平价医疗法》建立了政策机制，以增加美国的医疗保险覆盖面。虽然保险覆盖范围有所增加，但仍有10%至15%的美国人口没有保险。评估健康保险知识和金融知识是否预测没有保险，由医疗补助覆盖，或由市场保险覆盖，保持人口特征，对风险的态度和政治派别不变。分析2013年秋季和2015年春季的纵向数据，包括2013年收集的财务和健康保险知识以及关键协变量。2013年秋季，2,742名年龄在18岁至64岁之间的美国居民，525人没有保险，参加了全国代表性的互联网小组兰德美国生活小组。自2015年春季以来自我报告的健康保险状态和类型。在2013年没有保险的人中，更高的金融和健康保险知识与2015年更大的保险概率相关。对于2013年未投保的典型个人，2015年投保的概率高金融知识比低金融知识高8.3个百分点，高健康保险知识比低健康保险知识高9.2个百分点。对于一般人群来说，那些具有较高财务和健康保险知识的人更有可能通过医疗补助或市场获得保险，而不是没有保险。这些预测因子的系数大小与常用的人口统计学协变量相似。缺乏对健康保险概念的理解和金融文盲预测谁仍然没有保险。推广和消费者教育计划应该考虑这些特征。
The Affordable Care Act established policy mechanisms to increase health insurance coverage in the United States. While insurance coverage has increased, 10 to 15% of the U.S. population remains uninsured. To assess whether health insurance literacy and financial literacy predict being uninsured, covered by Medicaid, or covered by Marketplace insurance, holding demographic characteristics, attitudes toward risk, and political affiliation constant. Analysis of longitudinal data from fall 2013 and spring 2015 including financial and health insurance literacy and key covariates collected in 2013. 2,742 U.S. residents ages 18-64, 525 uninsured in fall 2013, participating in the RAND American Life Panel, a nationally representative internet panel. Self-reported health insurance status and type as of spring 2015. Among the uninsured in 2013, higher financial and health insurance literacy were associated with greater probability of being insured in 2015. For a typical uninsured individual in 2013, the probability of being insured in 2015 was 8.3 percentage points higher with high compared to low financial literacy, and 9.2 percentage points higher with high compared to low health insurance literacy. For the general population, those with high financial and health insurance literacy were more likely to obtain insurance via Medicaid or the Marketplaces compared to being uninsured. The magnitude of coefficients for these predictors was similar to that of commonly used demographic covariates. A lack of understanding about health insurance concepts and financial illiteracy predict who remains uninsured. Outreach and consumer-education programs should consider these characteristics.