Desmond Brian S, Laux Molly A, Levin Carolyn C, Huang Jiaxin, Williams Brent C
Medical Students, University of Michigan Medical School, Ann Arbor, MI, 48109-2800, USA.
Associate Professor of Internal Medicine, Medical Director, Complex Care Management Program, University of Michigan Health System, Ann Arbor, MI, 48109-2800, USA.
J Community Health. 2016 Apr;41(2):417-23. doi: 10.1007/s10900-015-0112-3.
Since the enactment of the Affordable Care Act (ACA), many people remain uninsured. While studies have examined this population, few have explored patients' experiences seeking insurance. To elucidate these individuals' perspectives, we surveyed patients (n = 80) at the University of Michigan Student-Run Free Clinic concerning their activity accessing insurance. Over half of respondents had sought insurance in the past 6 months; 57 % of respondents qualified for Medicaid by self-reported income (≤138 % FPL) and all but one were eligible for tax credits on the Health Insurance Marketplace. However, only 35 % of apparently Medicaid-eligible respondents had recently applied. There was no significant difference in the rate of applying for those above the income cutoff (p = 0.901). Perceived expense of plans and belief of ineligibility for Medicaid discouraged respondents from actively seeking insurance. Personalized outreach emphasizing new Medicaid eligibility requirements and tax credits may be needed to facilitate Medicaid enrollment for some uninsured persons under the ACA.
自《平价医疗法案》（ACA）颁布以来，仍有许多人未参保。尽管已有研究对这一人群进行了调查，但很少有人探讨患者寻求保险的经历。为了阐明这些人的观点，我们对密歇根大学学生运营的免费诊所的患者（n = 80）进行了调查，了解他们获取保险的情况。超过一半的受访者在过去6个月内寻求过保险；57%的受访者根据自我报告的收入（≤138%联邦贫困线）符合医疗补助资格，除一人外，其他人都有资格在医疗保险市场获得税收抵免。然而，在明显符合医疗补助资格的受访者中，最近申请的人仅占35%。收入超过临界值的人群的申请率没有显著差异（p = 0.901）。对保险计划费用的认知以及认为自己不符合医疗补助资格的想法阻碍了受访者积极寻求保险。可能需要开展个性化宣传，强调新的医疗补助资格要求和税收抵免，以促进《平价医疗法案》下一些未参保者加入医疗补助计划。
