Medicaid Expansion Improved Perinatal Insurance Continuity For Low-Income Women
Medicaid Expansion Improved Perinatal Insurance Continuity For Low-Income Women
复制标题
DOI：
10.1377/hlthaff.2019.01835
复制
发表时间：
2020-09-01
期刊：
影响因子：
9.7
通讯作者：
Admon, Lindsay K.
中科院分区：
文献类型：
--
作者：
Daw, Jamie R.;Winkelman, Tyler N. A.;Admon, Lindsay K.
保险流失，或在不同的保险计划之间或在保险和不保险之间移动，在围产期很常见。我们使用了2012-17年妊娠风险评估监测系统的调查数据，以估计与平价医疗法案相关的州医疗补助计划扩展对低收入妇女在三个时间点（孕前、分娩和产后）的保险覆盖连续性的影响。我们发现，医疗补助的扩大导致保险和不保险之间的流动减少了10.1个百分点，比扩大州的政策前基线减少了28%。这一下降是由于连续投保的妇女比例增加了5.8个百分点，医疗补助和私人保险之间的流动增加了4.2个百分点。医疗补助的扩大改善了低收入妇女围产期的保险连续性，这可能会提高围产期保健的质量，但也增加了公共和私人健康保险之间的搅动。
Insurance churn, or moving between different insurance plans or between insurance and uninsurance, is common during the perinatal period. We used survey data from the 2012-17 Pregnancy Risk Assessment Monitoring System to estimate the impact of Affordable Care Act-related state Medicaid expansions on continuity of insurance coverage for low-income women across three time points: preconception, delivery, and postpartum. We found that Medicaid expansion resulted in a 10.1-percentage-point decrease in churning between insurance and uninsurance, representing a 28 percent decrease from the prepolicy baseline in expansion states. This decrease was driven by a 5.8-percentage-point increase in the proportion of women who were continuously insured and a 4.2-percentage-point increase in churning between Medicaid and private insurance. Medicaid expansion improved insurance continuity in the perinatal period for low-income women, which may improve the quality of perinatal health care, but it also increased churning between public and private health insurance.