Effects of the Affordable Care Act's Dependent Coverage Mandate on Private Health Insurance Coverage in Urban and Rural Areas
Effects of the Affordable Care Act's Dependent Coverage Mandate on Private Health Insurance Coverage in Urban and Rural Areas
复制标题
DOI：
10.1111/jrh.12183
复制
发表时间：
2017-12-01
影响因子：
4.9
通讯作者：
Arora, Prachi
中科院分区：
文献类型：
--
作者：
Look, Kevin A.;Kim, Nam Hyo;Arora, Prachi
PurposeTo评估的影响，平价医疗法案（ACA）的依赖覆盖的任务，在大都市和nonmetropolitan areas.MethodsA横截面分析的年轻成年人之间的保险覆盖范围进行了使用数据从2006-2009年和2011年波的医疗支出小组调查。使用差异分析比较了19-25岁的年轻人与27-34岁的老年人全年私人健康保险覆盖率的变化。单独的回归估计为个人在大都市和非大都市地区，并进行了测试的差异影响由areas of residence. FindingsFull-year私人医疗保险覆盖率显着增加了9.2个百分点的年轻成年人相比，老年人的ACA任务后（P = .00）。当按居住地区对回归模型进行分层时，大都市地区年轻人的保险覆盖率显着增加了9.0个百分点（P = .00），非大都市地区增加了10.1个百分点（P = .03）。这些变化并没有显着不同的彼此（P = .82），这表明ACA的任务的影响是没有统计学差异的residence.ConclusionsAlthough在大都市和非大都市地区的年轻人经历了增加获得私人医疗保险后ACA的依赖覆盖任务，它似乎并没有直接影响城乡差异的健康保险覆盖范围。尽管这两个地区的居民都获得了保险，但超过三分之一的年轻人仍然无法获得全年的医疗保险。
PurposeTo evaluate the impact of the Affordable Care Act's (ACA) dependent coverage mandate on insurance coverage among young adults in metropolitan and nonmetropolitan areas.MethodsA cross-sectional analysis was conducted using data from 2006-2009 and 2011 waves of the Medical Expenditure Panel Survey. A difference-in-difference analysis was used to compare changes in full-year private health insurance coverage among young adults aged 19-25 years with an older cohort aged 27-34 years. Separate regressions were estimated for individuals in metropolitan and nonmetropolitan areas and were tested for a differential impact by area of residence.FindingsFull-year private health insurance coverage significantly increased by 9.2 percentage points for young adults compared to the older cohort after the ACA mandate (P = .00). When stratifying the regression model by residence area, insurance coverage among young adults significantly increased by 9.0 percentage points in metropolitan areas (P = .00) and 10.1 percentage points in nonmetropolitan areas (P = .03). These changes were not significantly different from each other (P = .82), which suggests the ACA mandate's effects were not statistically different by area of residence.ConclusionsAlthough young adults in metropolitan and nonmetropolitan areas experienced increased access to private health insurance following the ACA's dependent coverage mandate, it did not appear to directly impact rural-urban disparities in health insurance coverage. Despite residents in both areas gaining insurance coverage, over one-third of young adults still lacked access to full-year health insurance coverage.