在医疗补助终止期间,覆盖范围和获取权限的变化
Adrianna McIntyre1, Benjamin D Sommers1,2, Gabriella Aboulafia1
1Harvard University T.H. Chan School of Public Health, Department of Health Policy and Management, Boston, Massachusetts.
JAMA health forum
|June 29, 2024
概括
八分之一的成年人在疫情时代的连续覆盖的解开期间失去了医疗补助覆盖. 失去医疗补助计划导致保险差距增加和获得护理的挑战增加,特别是由于成本.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 健康 公平 卫生 公平
背景情况:
- 在COVID-19公共卫生紧急情况期间暂停后,各州在2023年恢复了医疗补助资格重新确定.
- 连续的医疗补助覆盖范围的解除引起了人们对潜在的覆盖范围损失及其对低收入人群获得护理的影响的担忧.
研究的目的:
- 评估医疗补助终止期间在四个南方州的低收入人群中保险状况和获得护理的早期变化.
- 确定与医疗补助损失相关的因素,并比较失去了覆盖范围的人和继续入学的人之间的护理准入和负担能力.
主要方法:
- 从2023年9月到11月,在阿肯色州,肯塔基州,路易斯安那州和德克萨斯州进行了一项多式调研.
- 该调查包括19至64岁的美国公民,他们的收入与联邦贫困线的138%或以下,使用随机数字拨号和基于地址的抽样.
- 使用多变量后勤回归来评估与医疗补助损失相关的因素,并比较获得护理的机会.
主要成果:
- 在接受了医疗补助的成年受访者中,有12.5%的受访者在调查时不再参加医疗补助,而这在各州有很大的差异.
- 失去医疗补助覆盖的成年人中,近一半 (47.8%) 没有保险,而其他人则获得了不同形式的保险,往往有差距.
- 失去医疗补助计划与由于成本和更大的难度而导致寻求护理的延迟增加有关.
结论:
- 在医疗补助计划解散的六个月后,显著比例的受益人失去了覆盖范围,突出了州一级的差异.
- 许多失去医疗补助的个人没有保险或有保险缺口,这影响了他们获得必要医疗保健的能力.
- 该研究强调了医疗补助覆盖率和获得负担得起的医疗保健之间的关键联系,特别是在弱势,低收入人群中.
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