Healthcare and the Wellbeing of Low-income Families

医疗保健和低收入家庭的福祉

• 批准号: 9130594
• 负责人: Sarah Marie Miller
• 金额: $ 20.94万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-20 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9130594
• 关键词: Adult; Affect; Affordable Care Act; Age; Bankruptcy; Behavior; Caring; Characteristics; Code; Collection; Consumption; Costs and Benefits; Data; Data Set; Dimensions; Education; Equilibrium; Event; Expenditure; Family; Goals; Health; Health Expenditures; Health Insurance; Health Policy; Healthcare; Household; Individual; Injury; Insurance; Insurance Coverage; Knowledge; Link; Living Standards; Low income; Measures; Medicaid; Medical; Methods; Natural experiment; Onset of illness; Outcome; Patients; Personal Satisfaction; Persons; Population; Probability; Public Health; Reporting; Research; Resources; Role; Sampling; Savings; Security; Services; Sum; Supreme Court Decisions; Testing; Uncertainty; Uninsured; Variant; base; cost; court; financial decision making; health care service utilization; health knowledge; improved; innovation; payment; programs; public health relevance; response; safety net

 DESCRIPTION: There is a critical gap in our understanding of how public health insurance coverage affects the financial well- being of households. Because financial protection is a fundamental purpose of health insurance coverage, the costs and benefits of major public health insurance programs such as Medicaid cannot be assessed without credible, generalizable evidence on the impact of public health insurance coverage on household financial well-being. Despite its importance, there are no studies conducted at a national level on this topic. The long- term goal of this project is to better understand the effect of public heath insurance coverage on household financial well-being. The objective in this particular application is to assess the effect of the expansion of the Medicaid program resulting from the Affordable Care Act (ACA) on household debt, credit score, delinquency, bankruptcy and other measures of financial stability. The recent Supreme Court decision allowed states to choose whether or not to expand their Medicaid program as the ACA intended, and to date, twenty-two states have announced that they will not participate in the Medicaid expansion. This variation in expansion choices by states provides an opportunity to evaluate the effect of Medicaid coverage on the financial outcomes of low- income adults. The central hypothesis is that gaining Medicaid coverage will improve financial outcomes among low-income adults, and that these improvements will vary across demographic groups and across the pre-expansion characteristics of the state. Guided by strong preliminary results from a previous public health insurance expansion, this hypothesis will be tested by pursuing three specific aims: 1) Obtain national estimates of the effect of the Medicaid expansions of the ACA on a broad set of measures of financial well- being including credit score, delinquency behavior, debt, third-party collections, and bankruptcy; 2) Evaluate the differential effect of Medicaid coverage on financial well-being across individuals with different demographic characteristics and 3) Evaluate the differential effect of Medicaid coverage on financial well-being across localities that differ by te generosity of the state Medicaid program and the availability of safety net services. To accomplish these aims, we will use an innovative, powerful, new data set of over 38 million individual credit reports observed each quarter containing detailed financial data. This research will provide timely, relevant public health knowledge that will help policymakers at all levels accurately assess the costs and benefits of public health insurance expansions.

 描述：我们对公共医疗保险覆盖范围如何影响家庭财务状况的理解存在重大差距。由于财务保护是健康保险覆盖范围的基本目的，因此如果没有关于公共健康保险覆盖范围对家庭财务状况影响的可信、普遍的证据，就无法评估医疗补助等主要公共健康保险计划的成本和收益。尽管它很重要，但目前还没有在国家层面上对此主题进行研究。该项目的长期目标是更好地了解公共医疗保险覆盖范围对家庭财务状况的影响。此特定应用程序的目的是评估平价医疗法案 (ACA) 带来的医疗补助计划扩展对家庭债务、信用评分、拖欠、破产和其他财务稳定措施的影响。最近最高法院的裁决允许各州选择是否按照 ACA 的意图扩大其医疗补助计划，迄今为止，已有 22 个州宣布不会参与医疗补助计划的扩大。各州扩展选择的这种差异提供了一个评估医疗补助覆盖范围对低收入成年人财务状况的影响的机会。核心假设是，获得医疗补助覆盖将改善低收入成年人的财务状况，并且这些改善将因人口群体和国家扩张前的特征而异。在之前公共健康保险扩张的强有力的初步结果的指导下，这一假设将通过追求三个具体目标来进行检验：1）获得关于 ACA 医疗补助扩张对一系列广泛的财务福祉指标（包括信用评分、拖欠行为、债务、第三方催收和破产）影响的全国估计； 2) 评估医疗补助覆盖范围对具有不同人口特征的个人财务状况的差异影响，以及 3) 评估医疗补助覆盖范围对不同地区财务状况的差异影响，这些地区因州医疗补助计划的慷慨程度和安全网服务的可用性而异。为了实现这些目标，我们将使用创新、强大的新数据集，其中包含每个季度观察到的超过 3800 万份个人信用报告，其中包含详细的财务数据。这项研究将提供及时、相关的公共卫生知识，帮助各级政策制定者准确评估公共医疗保险扩张的成本和收益。