1 U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health , Office of Population Affairs, Rockville, Maryland.
2 RTI International, Research Triangle Park , North Carolina.
J Womens Health (Larchmt). 2018 May;27(5):684-690. doi: 10.1089/jwh.2017.6465. Epub 2017 Dec 13.
The federal Title X Family Planning Program supports the delivery of family planning services and related preventive care to 4 million individuals annually in the United States. The implementation of the 2010 Affordable Care Act's (ACA's) Medicaid expansion and provisions expanding access to health insurance, which took effect in January 2014, resulted in higher rates of health insurance coverage in the U.S. population; the ACA's impact on individuals served by the Title X program has not yet been evaluated.
Using administrative data we examined changes in health insurance coverage among Title X clinic patients during 2005-2015.
We found that the percentage of clients without health insurance decreased from 60% in 2005 to 48% in 2015, with the greatest annual decrease occurring between 2013 and 2014 (63% to 54%). Meanwhile, between 2005 and 2015, the percentage of clients with Medicaid or other public health insurance increased from 20% to 35% and the percentage of clients with private health insurance increased from 8% to 15%.
Although clients attending Title X clinics remained uninsured at substantially higher rates compared with the national average, the increase in clients with health insurance coverage aligns with the implementation of ACA-related provisions to expand access to affordable health insurance.
联邦 Title X 计划生育项目每年为美国 400 万人提供计划生育服务和相关预防保健。2010 年《平价医疗法案》(ACA)的 Medicaid 扩大和扩大医疗保险覆盖范围的规定于 2014 年 1 月生效,导致美国人口的医疗保险覆盖率提高;ACA 对 Title X 项目服务对象的影响尚未得到评估。
我们使用行政数据,研究了 2005 年至 2015 年间 Title X 诊所患者的医疗保险覆盖情况的变化。
我们发现,没有医疗保险的客户比例从 2005 年的 60%下降到 2015 年的 48%,最大的年度降幅发生在 2013 年至 2014 年之间(63%降至 54%)。与此同时,2005 年至 2015 年间,拥有 Medicaid 或其他公共医疗保险的客户比例从 20%增加到 35%,拥有私人医疗保险的客户比例从 8%增加到 15%。
尽管在 Title X 诊所就诊的患者的未保险率仍然远远高于全国平均水平,但医疗保险覆盖范围的增加与实施 ACA 相关规定以扩大负担得起的医疗保险的可及性一致。