Capilouto E, Dailey T E
University of Alabama School of Public Health, Lister Hill Center for Health Policy.
J Health Soc Policy. 1993;5(1):33-42. doi: 10.1300/J045v05n01_04.
The lack of health insurance represents a significant barrier to timely, preventive medical services. In addition, certain providers risk financial viability as their uncompensated care burdens worsen. These issues are particularly troublesome in southern states because the population is disproportionately represented by greater numbers of poor uninsured individuals. This study examines the consequences of three alternative proposals to reduce the number of uninsureds in five southern states. Program 1 raises the AFDC income eligibility threshold to the federal poverty level. Program 2 drops Medicaid categorical eligibility requirements in favor of a poverty-level income standard. Program 3 requires employers to insure all employees, and their dependents, who work 25 hours or more per week. Surprisingly, Program 1 produces a modest 16 percent reduction in the uninsured. Programs 2 and 3, however, reduce the uninsured population by 41 and 57 percent, respectively. Nonetheless, these last two programs reach very different income groups. Program 2 captures all the poor uninsureds whereas Program 3 includes 40 percent of this same population. From this analysis it is clear that a combination of these programs would be necessary to effectively cover the uninsured.
缺乏医疗保险是及时获得预防性医疗服务的重大障碍。此外，随着无偿医疗负担的加重，某些医疗服务提供者面临财务生存能力的风险。这些问题在南部各州尤为棘手，因为贫困人口中未参保者的比例过高。本研究考察了三项替代方案在五个南部州减少未参保人数的后果。方案1将对有子女家庭的援助计划（AFDC）的收入资格门槛提高到联邦贫困线水平。方案2取消医疗补助的类别资格要求，转而采用贫困线收入标准。方案3要求雇主为所有每周工作25小时或以上的员工及其家属提供保险。令人惊讶的是，方案1仅使未参保人数适度减少了16%。然而，方案2和方案3分别将未参保人口减少了41%和57%。尽管如此，后两个方案覆盖的收入群体截然不同。方案2覆盖了所有贫困未参保者，而方案3涵盖了这同一群体中的40%。从这一分析可以清楚地看出，有必要结合这些方案才能有效地覆盖未参保者。
