Some Families Who Purchased Health Coverage Through The Massachusetts Connector Wound Up With High Financial Burdens
Some Families Who Purchased Health Coverage Through The Massachusetts Connector Wound Up With High Financial Burdens
复制标题
DOI：
10.1377/hlthaff.2012.0864
复制
发表时间：
2013-05-01
期刊：
影响因子：
9.7
通讯作者：
Lieu, Tracy A.
中科院分区：
文献类型：
--
作者：
Galbraith, Alison A.;Sinaiko, Anna D.;Lieu, Tracy A.
根据平价医疗法案创建的医疗保险交易所将为那些没有雇主赞助的保险或收入太高而没有资格获得医疗补助的人提供保险。然而，通过交易所提供的计划可能包括高水平的成本分担。我们调查了参加马萨诸塞州联邦健康保险连接者管理局(Massachusetts Federal Health Insurance Connector Authority)提供的无补贴计划的家庭，该机构是在2010年全国医改法案之前成立的，我们发现一些参保人的经济负担很高，费用高于预期。对于子女数量较多的家庭和收入低于联邦贫困水平400%的家庭来说，经济负担和意想不到的成本更加明显。我们的结论是，那些收入较低、医疗保健需求增加、儿童较多的人在2014年通过交换获得保险后，将面临特别大的风险。政策制定者应该制定战略，进一步减轻最容易遇到高于预期的自付成本的参保者的财务负担，例如提供成本计算器或价格透明度工具。
Health insurance exchanges created under the Affordable Care Act will offer coverage to people who lack employer-sponsored insurance or have incomes too high to qualify for Medicaid. However, plans offered through an exchange may include high levels of cost sharing. We surveyed families participating in unsubsidized plans offered in the Massachusetts Commonwealth Health Insurance Connector Authority, an exchange created prior to the 2010 national health reform law, and found high levels of financial burden and higher-than-expected costs among some enrollees. The financial burden and unexpected costs were even more pronounced for families with greater numbers of children and for families with incomes below 400 percent of the federal poverty level. We conclude that those with lower incomes, increased health care needs, and more children will be at particular risk after they obtain coverage through exchanges in 2014. Policy makers should develop strategies to further mitigate the financial burden for enrollees who are most susceptible to encountering higher-than-expected out-of-pocket costs, such as providing cost calculators or price transparency tools.