Brantley Erin, Ku Leighton
The George Washington University, Washington, DC, USA.
Med Care Res Rev. 2022 Jun;79(3):404-413. doi: 10.1177/10775587211021172. Epub 2021 Sep 16.
Fluctuating insurance coverage, or churning, is a recognized barrier to health care access. We assessed whether state policies that allow children to remain covered in Medicaid for a 12-month period, regardless of fluctuations in income, are associated with health and health care outcomes, after controlling for individual factors and other Medicaid policies. This cross-sectional study uses a large, nationally representative database of children ages 0 to 17. Continuous eligibility was associated with improved rates of insurance, reductions in gaps in insurance and gaps due to application problems, and lower probability of being in fair or poor health. For children with special health care needs, it was associated with increases in use of medical care and preventive and specialty care access. However, continuous eligibility was not associated with health care utilization outcomes for the full sample. Continuous eligibility may be an effective strategy to reduce gaps in coverage for children and reduce paperwork burden on Medicaid agencies.
保险覆盖范围的波动,即参保状态不稳定,是公认的获得医疗保健服务的障碍。我们评估了那些允许儿童无论收入如何波动均可在医疗补助计划下连续参保12个月的州政策,在控制个体因素和其他医疗补助政策后,是否与健康及医疗保健结果相关。这项横断面研究使用了一个大型的、具有全国代表性的0至17岁儿童数据库。连续参保资格与保险覆盖率提高、保险缺口及因申请问题导致的缺口减少以及健康状况为一般或较差的概率降低相关。对于有特殊医疗保健需求的儿童,它与医疗服务使用增加以及预防和专科护理可及性提高相关。然而,连续参保资格与整个样本的医疗保健利用结果无关。连续参保资格可能是减少儿童保险覆盖缺口和减轻医疗补助机构文书工作负担的有效策略。