在马萨诸塞州医疗保健改革下申请和理解医疗保险的经历。
Experiences applying for and understanding health insurance under Massachusetts health care reform.
作者信息
Nardin Rachel, Zallman Leah, Sayah Assaad, McCormick Danny
机构信息
Cambridge Health Alliance, 1493 Cambridge St; Macht 420, Cambridge, MA, 02139, USA.
Harvard Medical School, Boston, MA, USA.
出版信息
Int J Equity Health. 2016 Jul 18;15(1):110. doi: 10.1186/s12939-016-0397-6.
BACKGROUND
The Affordable Care Act was modeled on the Massachusetts Health Reform of 2006, which reduced the number of uninsured largely through a Medicaid expansion and the provision of publicly subsidized insurance obtained through a Health Benefits Exchange.
METHODS
We surveyed a convenience sample of 780 patients seeking care in a safety-net system who obtained Medicaid or publicly subsidized insurance after the Massachusetts reform, as well as a group of employed patients with private insurance.
RESULTS
We found that although most patients with Medicaid or publicly subsidized exchange-based plans were able to obtain assistance with applying for and choosing an insurance plan, substantial proportions of respondents experienced difficulties with the application process and with understanding coverage and cost features of plans.
CONCLUSIONS
Under the Affordable Care Act, efforts to simplify the application process and reduce the complexity of plans may be warranted, particularly for vulnerable patient populations cared for by the medical safety net.
背景
《平价医疗法案》是以2006年马萨诸塞州医疗改革为蓝本制定的，该改革主要通过扩大医疗补助计划以及提供通过健康福利交易所获得的公共补贴保险，来减少未参保人数。
方法
我们对在安全网系统中寻求治疗的780名患者进行了便利抽样调查，这些患者在马萨诸塞州改革后获得了医疗补助或公共补贴保险，同时还调查了一组有私人保险的在职患者。
结果
我们发现，尽管大多数参加医疗补助或基于交易所的公共补贴计划的患者能够在申请和选择保险计划方面获得帮助，但相当一部分受访者在申请过程以及理解保险计划的覆盖范围和费用特点方面遇到困难。
结论
根据《平价医疗法案》，或许有必要努力简化申请流程并降低保险计划的复杂性，尤其是对于由医疗安全网照顾的弱势群体。
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