Pinar Karaca-Mandic (
Andrew Wilcock is a doctoral student in the Division of Health Policy and Management, School of Public Health, University of Minnesota.
Health Aff (Millwood). 2017 Apr 1;36(4):747-754. doi: 10.1377/hlthaff.2016.1440. Epub 2017 Mar 15.
The launch of the Affordable Care Act was accompanied by major insurance information campaigns by government, nonprofit, political, news media, and private-sector organizations, but it is not clear to what extent these efforts were associated with insurance gains. Using county-level data from the Census Bureau's American Community Survey and broadcast television airings data from the Wesleyan Media Project, we examined the relationship between insurance advertisements and county-level health insurance changes between 2013 and 2014, adjusting for other media and county- and state-level characteristics. We found that counties exposed to higher volumes of local insurance advertisements during the first open enrollment period experienced larger reductions in their uninsurance rates than other counties. State-sponsored advertisements had the strongest relationship with declines in uninsurance, and this relationship was driven by increases in Medicaid enrollment. These results support the importance of strategic investment in advertising to increase uptake of health insurance but suggest that not all types of advertisements will have the same effect on the public.
平价医疗法案推出之际，政府、非营利组织、政治团体、新闻媒体和私营部门组织开展了大规模的保险信息宣传活动，但尚不清楚这些努力在多大程度上与保险收益有关。利用美国人口普查局的美国社区调查的县级数据和卫斯理媒体项目的广播电视播出数据，我们在考虑其他媒体以及县和州级特征的情况下，研究了保险广告与 2013 年至 2014 年期间县级医疗保险变化之间的关系。我们发现，在第一个开放参保期内接触到更多本地保险广告的县，其未参保率的降幅要大于其他县。由州政府资助的广告与未参保率下降之间的关系最为密切，而这种关系是由医疗补助计划参保人数的增加所驱动的。这些结果表明，在广告宣传方面进行战略投资以增加医疗保险的参保率非常重要，但也表明并非所有类型的广告对公众都会产生相同的效果。
