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医疗补助计划扩大覆盖范围,提高了可负担性,减少了低收入父母的心理困扰。

Medicaid Expansion Increased Coverage, Improved Affordability, And Reduced Psychological Distress For Low-Income Parents.

机构信息

Stacey McMorrow is a senior research associate in the Health Policy Center at the Urban Institute, in Washington, D.C.

Jason A. Gates is a research assistant in the Health Policy Center, Urban Institute.

出版信息

Health Aff (Millwood). 2017 May 1;36(5):808-818. doi: 10.1377/hlthaff.2016.1650.

Abstract

Despite receiving less attention than their childless counterparts, low-income parents also experienced significant expansions of Medicaid eligibility under the Affordable Care Act (ACA). We used data for the period 2010-15 from the National Health Interview Survey to examine the impacts of the ACA's Medicaid expansion on coverage, access and use, affordability, and health status for low-income parents. We found that eligibility expansions increased coverage, reduced problems paying medical bills, and reduced severe psychological distress. We found only limited evidence of increased use of care among parents in states with the smallest expansions, and no significant effects of the expansions on general health status or problems affording prescription drugs or mental health care. Together, our results suggest that the improvements in mental health status may be driven by reduced stress associated with improved financial security from insurance coverage. We also found large missed opportunities for low-income parents in states that did not expand Medicaid: If these states had expanded Medicaid, uninsurance rates for low-income parents would have fallen by an additional 28 percent.

摘要

尽管与没有孩子的同龄人相比,低收入父母受到的关注较少,但他们也在平价医疗法案(ACA)下经历了医疗补助资格的显著扩大。我们使用了 2010-15 年全国健康访谈调查的数据,研究了 ACA 医疗补助扩大对低收入父母的覆盖范围、获得医疗服务的机会和使用情况、可负担性和健康状况的影响。我们发现,资格扩大增加了覆盖范围,减少了医疗账单支付问题,并降低了严重的心理困扰。我们发现,在扩大规模最小的州,父母的护理使用量仅略有增加,而扩大规模对一般健康状况或处方药和精神保健费用的负担能力没有显著影响。总的来说,我们的研究结果表明,心理健康状况的改善可能是由于保险覆盖带来的财务保障改善所带来的压力减轻所致。我们还发现,在没有扩大医疗补助的州,低收入父母错过了很多机会:如果这些州扩大了医疗补助,那么低收入父母的保险覆盖率将额外下降 28%。

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