Increasing Medicaid enrollment among formerly incarcerated adults
Increasing Medicaid enrollment among formerly incarcerated adults
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DOI：
10.1111/1475-6773.13634
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发表时间：
2021-02-09
影响因子：
3.4
通讯作者：
Westergaard, Ryan P.
中科院分区：
文献类型：
--
作者：
Burns, Marguerite E.;Cook, Steven T.;Westergaard, Ryan P.
目的：为了估计实施扩大的医疗补助资格和预释放医疗补助登记援助对最近被监禁的成年人的医疗补助登记之间的增量关联。数据来源/研究设置：数据包括来自威斯康星州惩教部和威斯康星州医疗补助计划2013年至2015年的个人水平合并纵向数据。研究设计：我们使用一个中断的时间序列设计来估计两个自然实验和最近被监禁的成年人的医疗补助注册之间的关联。首先，在2014年4月，威斯康星州医疗补助计划扩大了资格，包括所有收入低于联邦贫困线100%的成年人。第二，在2015年1月，威斯康星州惩教署实施prerelease医疗补助招生援助在所有国家correctionalfacilities.Data Collection/Extraction Methods：我们收集了医疗补助招生，和国家监狱行政和风险评估数据，所有非老年人监禁的国家谁被释放之间的2013年1月和2015年12月。整个样本包括24235人。有物质使用史的成年人构成了我们的次要样本。该样本包括12 877人。主要研究结果是在释放的一个月内的Medicaid登记。主要发现：从州立监狱释放的一个月内的Medicaid登记从基线时的8%增长到资格扩展后的36%（P值< .01）和引入登记援助后的61%（P值< .01）。有药物使用史的成年人的结果相似。黑人成年人比白色成年人（P值<0.01）在释放的月份更有可能参加医疗补助计划（3.5个百分点）。结论：医疗补助资格和释放前的入学援助与出狱后增加的医疗补助计划入学率相关。各国应考虑将这两项政策作为潜在的工具，以改善个人从监狱向社区过渡时获得及时医疗保健的机会。
Objective: To estimate the incremental associations between the implementation of expanded Medicaid eligibility and prerelease Medicaid enrollment assistance on Medicaid enrollment for recently incarcerated adults.Data Sources/Study Setting: Data include person-level merged, longitudinal data from the Wisconsin Department of Corrections and the Wisconsin Medicaid program from 2013 to 2015.Study Design: We use an interrupted time series design to estimate the association between each of two natural experiments and Medicaid enrollment for recently incarcerated adults. First, in April 2014 the Wisconsin Medicaid program expanded eligibility to include all adults with income at or below 100% of the federal poverty level. Second, in January 2015, the Wisconsin Department of Corrections implemented prerelease Medicaid enrollment assistance at all state correctional facilities.Data Collection/Extraction Methods: We collected Medicaid enrollment, and state prison administrative and risk assessment data for all nonelderly adults incarcerated by the state who were released between January 2013 and December 2015. The full sample includes 24 235 individuals. Adults with a history of substance use comprise our secondary sample. This sample includes 12 877 individuals. The primary study outcome is Medicaid enrollment within the month of release.Principal Findings: Medicaid enrollment in the month of release from state prison grew from 8 percent of adults at baseline to 36 percent after the eligibility expansion (P-value < .01) and to 61 percent (P-value < .01) after the introduction of enrollment assistance. Results were similar for adults with a history of substance use. Black adults were 3.5 percentage points more likely to be enrolled in Medicaid in the month of release than White adults (P-value < .01).Conclusions: Medicaid eligibility and prerelease enrollment assistance are associated with increased Medicaid enrollment upon release from prison. States should consider these two policies as potential tools for improving access to timely health care as individuals transition from prison to community.