医疗补助可以解决这个问题吗? 医疗补助扩张中的不足保险与不扩张的州相比
Aniyar Izguttinov1, Justin G Trogdon1
1University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Policy and Management, Chapel Hill, NC, USA.
Inquiry : a journal of medical care organization, provision and financing
|September 30, 2023
概括
医疗补助扩张最初并没有显著减少低收入成年人的不足保险. 长期数据表明可能存在时间延迟,这表明仅仅覆盖范围可能无法防止不充分的健康保险带来的财务风险.
科学领域:
- 卫生政策 卫生政策
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 众所周知,医疗补助计划的扩展具有积极的影响,但其对不足保险的影响尚不清楚.
- 不足保险被定义为拥有医疗保险,其覆盖范围不足或存在重大财务风险.
- 尽管覆盖范围扩大,数百万低收入的美国人仍然面临不足保险的风险.
研究的目的:
- 估计医疗补助扩张对美国非老年人低收入成年人低保险概率的影响.
- 调查医疗补助扩张对不足保险的短期和潜在的长期影响.
- 为有关弱势群体获得医疗保健和金融保护的政策决策提供信息.
主要方法:
- 使用了一种准实验性的差异差异方法.
- 分析了来自美国人口全国代表样本的数据.
- 专注于非老年低收入成年人群.
主要成果:
- 在可负担医疗法案 (ACA) 实施后的前四年中,没有观察到不足保险可能性的显著减少.
- 补充分析表明,医疗补助扩张对不足保险的影响可能存在时间滞后 (2018-2019年数据).
- 仅仅扩大保险范围可能不足以保护低收入人群免受不足保险的影响.
结论:
- 医疗补助扩张对不足保险的影响并不立即,可能需要更长的时间来表现.
- 政策制定者必须考虑立法框架超越覆盖范围的扩大,以减轻医疗保健费用,防止延迟或避免治疗.
- 解决不足保险问题需要采取多方面的方法,以确保低收入人群获得足够的财务保护和获得护理.
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