J Health Care Poor Underserved. 2020;31(1):424-440. doi: 10.1353/hpu.2020.0031.
Study occurrence and consequences of deductibles and medical debt among privately insured under the Affordable Care Act.
Analysis of 2012-2016 National Health Interview Survey data on privately insured adults younger than age 65 on the effect of deductibles on medical debt, deferred medical care, and office visits, by demographic characteristics, and treatable chronic diseases.
Rates of medical debt and deferred care decreased. Medical debt is greater for those with any type of high deductible (HD) insurance, and among those more vulnerable (lower income, minority, treatable chronic diseases). Medical debt with HD's increased deferred needed medical care 6 fold and is highest for those with more treatable chronic diseases.
While medical debt and deferred care decreased for all privately insured, those HD-insured and vulnerable report higher medical debt rates markedly increasing deferred needed medical care. Highdeductible insurance risks adverse health and social consequences for those vulnerable.
研究平价医疗法案下私人保险中可扣除额和医疗债务的发生情况及其后果。
分析了 2012-2016 年全国健康访谈调查数据，调查了 65 岁以下私人保险成年人的可扣除额对医疗债务、推迟医疗和门诊治疗的影响，分析了人口特征和可治疗慢性病的影响。
医疗债务和推迟治疗的比例有所下降。有任何类型高免赔额保险的人以及更脆弱的人群（收入较低、少数民族、可治疗的慢性病）的医疗债务更高。高免赔额保险增加了 6 倍的推迟治疗的需要，而对于那些有更多可治疗慢性病的人来说，这一比例最高。
尽管所有私人保险的医疗债务和推迟治疗都有所减少，但高免赔额保险的人和弱势群体报告的医疗债务率明显更高，推迟了所需的医疗护理。高免赔额保险给弱势群体带来了不利的健康和社会后果。
