Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY.
Department of Consumer Sciences, College of Human Sciences, Alabama Cooperative Extension System, Auburn University, Auburn, AL.
Med Care. 2023 Dec 1;61(12):872-881. doi: 10.1097/MLR.0000000000001933. Epub 2023 Oct 5.
Unemployment associated with the coronavirus disease 2019 (COVID-19) pandemic was linked to financial insecurity and disruptions in access to health care.
To explore whether expanded access to Medicaid mitigated the likelihood of health and non-health financial hardship associated with pandemic-linked job loss.
We estimate linear regression models comparing differences in the levels of outcomes attributable to pandemic-linked joblessness in Medicaid expansion and nonexpansion states.
A total of 20,281 adults aged 19-64 were in the 2021 National Financial Capability Study.
Our key exposure was job loss, layoffs, and furloughs, attributable to the COVID-19 pandemic. Outcomes under evaluation include indicators of health care access and household financial health.
Relative to persons reporting pandemic-linked unemployment in nonexpansion states, adults experiencing pandemic-linked job loss in expansion states were less likely to report as uninsured [-6.2 percentage points (PPs); 95% CI: -10.8, -1.6; P < 0.01], having unpaid medical bills (-4.3 PP; 95% CI: -8, -0.6; P < 0.05), having unmet medical needs due to cost (-5.3 PP; 95% CI: -10.1, -0.5; P < 0.05), and having calls from debt collection agencies (-6.9 PP; 95% CI: -10.6, -3.1; P < 0.01). Patterns consistent with Medicaid acting as a safety net for the adverse financial effects of job loss were more pronounced for middle-income households.
In economic downturns, such as the COVID-19 crisis, Medicaid can help insulate households from diminished health care access and financial distress associated with job loss.
与 2019 年冠状病毒病（COVID-19）大流行相关的失业与财务不安全和获得医疗保健的机会中断有关。
探讨扩大医疗补助（Medicaid）的获取是否减轻了与疫情相关失业导致的健康和非健康经济困难的可能性。
我们估计线性回归模型，比较医疗补助扩大和未扩大州中与疫情相关失业相关的结果水平差异。
共有 20281 名 19-64 岁的成年人参加了 2021 年全国财务能力研究。
我们的主要暴露因素是因 COVID-19 大流行而失业、下岗和休假。正在评估的结果包括医疗保健获取和家庭财务健康指标。
与报告疫情相关失业的非扩张州成年人相比，在扩张州经历疫情相关失业的成年人不太可能报告没有医疗保险[-6.2 个百分点（PP）；95%置信区间：-10.8，-1.6；P<0.01]，有未付医疗账单（-4.3PP；95%置信区间：-8，-0.6；P<0.05），因费用而未满足医疗需求（-5.3PP；95%置信区间：-10.1，-0.5；P<0.05）和接到催债机构的电话（-6.9PP；95%置信区间：-10.6，-3.1；P<0.01）。对于中等收入家庭，医疗补助作为失业不利经济影响的安全网的模式更为明显。
在经济衰退时期，例如 COVID-19 危机，医疗补助可以帮助家庭免受与失业相关的医疗保健获取减少和财务困境的影响。
