Both authors are with the Division of Health Interview Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.
Am J Public Health. 2018 Mar;108(3):361-367. doi: 10.2105/AJPH.2017.304212. Epub 2018 Jan 18.
To describe long-term national trends in health insurance coverage among US veterans from 2000 to 2016 in the context of recent health care reform.
We used 2000 to 2016 National Health Interview Survey data on veterans aged 18 to 64 years to examine trends in insurance coverage and uninsurance by year, income, and state Medicaid expansion status. We also explored the current proportions of veterans with each type of insurance by age group.
The percentage of veterans with private insurance decreased from 70.8% in 2000 to 56.9% in 2011, whereas between 2000 and 2016 Department of Veterans Affairs (VA) health care coverage (only) almost tripled, Medicaid (without concurrent TRICARE or private coverage) doubled, and TRICARE coverage of any type tripled. After 2011, the percentage of veterans who were uninsured decreased. In 2016, low-income veterans in Medicaid expansion states had double the Medicaid coverage (41.1%) of low-income veterans in nonexpansion states (20.1%).
Our estimates, which are nationally representative of noninstitutionalized veterans, show marked increases in military-related coverage through TRICARE and VA health care. In 2016, only 7.2% of veterans aged 18 to 64 years and 3.7% of all veterans (aged 18 years or older) remained uninsured.
在最近医疗改革的背景下，描述 2000 年至 2016 年美国退伍军人健康保险覆盖范围的长期全国趋势。
我们使用了 2000 年至 2016 年年龄在 18 至 64 岁之间的退伍军人的国家健康访谈调查数据，以研究按年份、收入和州医疗补助扩展状况划分的保险覆盖范围和未保险的趋势。我们还探讨了当前每种保险类型的退伍军人的比例。
2000 年至 2011 年，拥有私人保险的退伍军人比例从 70.8%下降至 56.9%，而同期退伍军人事务部（VA）医疗保健覆盖范围（仅）几乎翻了三倍，医疗补助（无同时的 TRICARE 或私人保险）增加了一倍，TRICARE 的任何类型的保险都增加了两倍。2011 年之后，未保险的退伍军人比例下降。2016 年，在医疗补助扩展州的低收入退伍军人的医疗补助覆盖率（41.1%）是未扩展州的低收入退伍军人（20.1%）的两倍。
我们的估计结果在全国范围内代表了非机构化的退伍军人，表明通过 TRICARE 和 VA 医疗保健，军事相关的保险覆盖范围显著增加。2016 年，只有 7.2%的 18 至 64 岁的退伍军人和 3.7%的所有退伍军人（18 岁及以上）未参保。
