Golberstein Ezra, Gonzales Gilbert, Sommers Benjamin D
Ezra Golberstein (
Gilbert Gonzales is an assistant professor in the Department of Health Policy at the Vanderbilt University School of Medicine, in Nashville, Tennessee. While working on this article he was a doctoral candidate in the Division of Health Policy and Management at the University of Minnesota School of Public Health.
Health Aff (Millwood). 2015 Oct;34(10):1688-94. doi: 10.1377/hlthaff.2015.0290.
The Affordable Care Act (ACA) expanded eligibility for Medicaid to millions of low-income adults. While many expanding states implemented their expansion in 2014, five states and the District of Columbia expanded eligibility as early as 2010 by taking advantage of provisions in the ACA and Medicaid waivers. We used restricted data from the National Health Interview Survey to examine the impact of California's Low Income Health Program, an early expansion program that began in 2011. Our study demonstrates that the county-by-county rollout of expanded public insurance coverage in California significantly increased coverage, by 7 percentage points, and significantly reduced the likelihood of any family out-of-pocket medical spending in the previous year, by 10 percentage points, among low-income adults.
《平价医疗法案》（ACA）将医疗补助的资格范围扩大到数百万低收入成年人。虽然许多扩大资格范围的州在2014年实施了扩张，但有五个州和哥伦比亚特区早在2010年就利用《平价医疗法案》的条款和医疗补助豁免扩大了资格范围。我们使用了来自国家健康访谈调查的受限数据，以研究始于2011年的早期扩张项目——加利福尼亚州低收入健康项目的影响。我们的研究表明，加利福尼亚州逐县推出的扩大公共保险覆盖范围的举措显著提高了覆盖率，提高了7个百分点，并显著降低了低收入成年人中任何家庭上一年自掏腰包支付医疗费用的可能性，降低了10个百分点。
