Medicaid Expansion Increased Coverage, Improved Affordability, And Reduced Psychological Distress For Low-Income Parents
Medicaid Expansion Increased Coverage, Improved Affordability, And Reduced Psychological Distress For Low-Income Parents
复制标题
DOI：
10.1377/hlthaff.2016.1650
复制
发表时间：
2017-05-01
期刊：
影响因子：
9.7
通讯作者：
Kenney, Genevieve M.
中科院分区：
文献类型：
--
作者：
McMorrow, Stacey;Gates, Jason A.;Kenney, Genevieve M.
尽管受到的关注比无子女的父母少，但根据《平价医疗法案》（ACA），低收入父母的医疗补助资格也大幅扩大。我们使用了2010-15年期间的数据，从全国健康访谈调查，以检查ACA的医疗补助扩大对覆盖范围，获得和使用，负担能力和健康状况的影响低收入父母。我们发现，资格扩大增加了覆盖面，减少了支付医疗费用的问题，并减少了严重的心理困扰。我们发现，只有有限的证据表明，在扩张最小的州，父母使用护理的情况有所增加，而且扩张对一般健康状况或提供处方药或心理健康护理的问题没有显着影响。总之，我们的研究结果表明，心理健康状况的改善可能是由与保险覆盖范围的财务安全改善相关的压力减少所驱动的。我们还发现，在没有扩大医疗补助的州，低收入父母错过了大量机会：如果这些州扩大了医疗补助，低收入父母的无保险率将再下降28%。
Despite receiving less attention than their childless counterparts, low-income parents also experienced significant expansions of Medicaid eligibility under the Affordable Care Act (ACA). We used data for the period 2010-15 from the National Health Interview Survey to examine the impacts of the ACA's Medicaid expansion on coverage, access and use, affordability, and health status for low-income parents. We found that eligibility expansions increased coverage, reduced problems paying medical bills, and reduced severe psychological distress. We found only limited evidence of increased use of care among parents in states with the smallest expansions, and no significant effects of the expansions on general health status or problems affording prescription drugs or mental health care. Together, our results suggest that the improvements in mental health status may be driven by reduced stress associated with improved financial security from insurance coverage. We also found large missed opportunities for low-income parents in states that did not expand Medicaid: If these states had expanded Medicaid, uninsurance rates for low-income parents would have fallen by an additional 28 percent.