Gonzales Gilbert, Golberstein Ezra, Hill Steven C, Zuvekas Samuel H
Department of Health Policy, Vanderbilt University School of Medicine, 2525 West End Ave Suite 1200, Nashville, TN, 37203, USA.
Division of Health Policy & Management, University of Minnesota School of Public Health, 420 Delaware St. SE, MMC 729, Minneapolis, MN, 55455, USA.
J Behav Health Serv Res. 2017 Oct;44(4):523-535. doi: 10.1007/s11414-016-9532-9.
Adults with poor mental health may want and need insurance to obtain care, but symptoms may impede enrollment into public health insurance. This study compares Medicaid enrollment responses to eligibility expansions by mental health status using a sample of non-elderly adults in both the 2000-2011 Medical Expenditure Panel Survey and the National Health Interview Survey (N = 27,494). The impact of Medicaid income eligibility thresholds (defined as the maximum family income level allowed in each state to be considered eligible for Medicaid) on Medicaid enrollment was estimated from linear regression models allowing for differential enrollment responses by mental and physical health status. Increasing income eligibility thresholds by 100% of the federal poverty level (FPL) was associated with a five-percentage-point increase in the probability of Medicaid enrollment in the non-disabled population under 300% FPL. The enrollment response to Medicaid expansions prior to the Affordable Care Act was stronger for adults symptomatic of psychological distress compared with adults without distress and compared to adults with chronic physical health problems.
心理健康状况不佳的成年人可能希望并需要保险来获得医疗服务，但症状可能会阻碍他们加入公共医疗保险。本研究使用2000 - 2011年医疗支出面板调查和国家健康访谈调查中的非老年成年人样本（N = 27,494），比较了按心理健康状况划分的医疗补助参保对资格扩大的反应。通过线性回归模型估计了医疗补助收入资格阈值（定义为每个州被视为有资格获得医疗补助的最高家庭收入水平）对医疗补助参保的影响，该模型考虑了心理健康和身体健康状况的不同参保反应。将收入资格阈值提高100%的联邦贫困线（FPL）与FPL低于300%的非残疾人群中医疗补助参保概率提高五个百分点相关。与无心理困扰的成年人以及患有慢性身体健康问题的成年人相比，在《平价医疗法案》之前，有心理困扰症状的成年人对医疗补助扩大的参保反应更强。
