新的和以前有资格的医疗补助登记者不同,但不是医疗保健支出
Journal of health care for the poor and underserved
|August 12, 2024
概括
负担得起的医疗保健法案扩大了医疗补助,但一些州选择退出. 新入选的成年人最初有更高的医疗费用和更糟糕的健康状况,但随着时间的推移,成本变得可比.
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
- 卫生经济学 卫生经济学
背景情况:
- "负担得起的医疗法案" (ACA) 从2014年开始,扩大了低收入成年人的医疗补助资格.
- 截至2024年,有10个州没有采用这些ACA医疗补助扩展条款,理由是担心国家支出.
- 了解ACA医疗补助扩张对入学者的健康和医疗保健利用的影响,对于政策评估至关重要.
研究的目的:
- 为了比较新的有资格和以前有资格的医疗补助登记者之间的医疗保健利用率,支出和健康状况.
- 分析这些指标在ACA医疗补助扩张后随着时间的推移而发生的变化.
- 调查招生组成在群体间观察到的差异中的作用.
主要方法:
- 利用了2014-16年和2017-19年医疗支出小组调查 (MEPS) 的数据.
- 与ACA之前有资格的新符合条件的医疗补助入学者 (在ACA扩展下) 进行了比较.
- 分析了六种人均医疗支出类型.
主要成果:
- 与以前符合条件的入学者相比,2014-2016年,新的医疗补助入学者表现出更糟糕的健康状况,更高的利用率和更高的支出.
- 到2017年至2019年,人均医疗支出在各种支出类别中,在新的和以前有资格的群体之间变得可比.
- 有证据表明,医疗补助入学人数组成的变化影响了符合资格组之间的观察到的差异.
结论:
- 初步发现表明,ACA医疗补助扩张招募了有更大的医疗保健需求的个人.
- 随着时间的推移,医疗保健支出正常化,这表明扩大人口中的潜在长期利益或适应.
- 医疗补助招生组成的变化可能会缓解扩张对医疗保健支出差异的明显影响.
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