State Health Access Data Assistance Center (SHADAC), University of Minnesota, Minneapolis, MN, USA.
Health Aff (Millwood). 2013 Jul;32(7):1319-25. doi: 10.1377/hlthaff.2013.0360. Epub 2013 Jun 26.
The Affordable Care Act will have important impacts on state Medicaid programs, likely increasing participation among populations that are currently eligible but not enrolled. The size of this "welcome-mat" effect is of concern for two reasons. First, the eligible but uninsured constitute a substantial share of the uninsured population in some states. Second, the newly eligible population will affect states' Medicaid caseloads and budgets. Using the Massachusetts 2006 health reforms as a case study and controlling for other factors, we found that among low-income parents who were previously eligible for Medicaid in Massachusetts, Medicaid enrollment increased by 16.3 percentage points, and Medicaid participation by those without private coverage increased by 19.4 percentage points, in comparison to a group of control states. In many states the potential size of the welcome-mat effect could be even larger than what we observed in Massachusetts. Our analysis has potentially important implications for other states attempting to predict the impact of this effect on their budgets.
平价医疗法案将对各州的医疗补助计划产生重要影响，可能会增加目前符合条件但未参保的人群的参保率。这种“欢迎效应”的规模令人担忧，原因有二。首先，符合条件但未参保的人群在一些州的未参保人口中占有相当大的比例。其次，新符合条件的人群将影响各州的医疗补助参保人数和预算。我们使用马萨诸塞州 2006 年的医疗改革作为案例研究，并控制了其他因素，发现与对照组相比，在马萨诸塞州之前有资格享受医疗补助的低收入父母中，医疗补助的参保率增加了 16.3 个百分点，而没有私人保险的参保率则增加了 19.4 个百分点。在许多州，这种“欢迎效应”的潜在规模可能比我们在马萨诸塞州观察到的还要大。我们的分析对其他试图预测这一效应对其预算影响的州具有重要意义。
