在评级区域调整后,德克萨斯州的负担得起的医疗保健法案入学率
Elena Andreyeva, Daniel Marthey, Simon F Haeder
1Department of Health Policy and Management, Texas A&M University, 212 Adriance Lab Rd, College Station, TX 77845.
The American journal of managed care
|June 23, 2025
概括
德克萨斯州将农村县纳入大都市评级地区,在城市和农村地区发现了类似的"平价医疗法案"市场招生增长. 登记者越来越多地选择黄金计划,而不是更便宜的选择.
科学领域:
- 卫生政策研究 卫生政策研究
- 医疗保险市场 医疗保险市场
- 获得农村卫生保健的机会
背景情况:
- 德克萨斯州于2023年重组了其"平价医疗法案" (ACA) 评级区域,将177个农村县合并到相邻的大都市地区.
- 这一政策变化旨在了解其对不同地理区域健康计划入学和选择的影响.
研究的目的:
- 评估德克萨斯州ACA评级区整合与健康计划入学,计划选择和保费之间的关联.
- 为了比较2023年政策变化后的城市和农村县的入学趋势.
主要方法:
- 对2022年至2024年市场公开注册县级公共使用档案的分析.
- 在城市和农村县的入学增长率的计算.
- 应用线性回归模型来确定差异入学变化.
主要成果:
- 总体而言,市场入学率在城市县增长了80%,在农村县增长了76%.
- 在35-44岁的年龄组和收入在联邦贫困线的100%-150%的人群中观察到显著的入学增加.
- 在城市 (70%至95%) 和农村 (51%至93%) 县,黄金计划选择的比例大幅上升.
- 在政策变化后,农村和城市县之间没有发现招生增长的显著差异.
结论:
- 德克萨斯州评级区的整合并没有导致城市和农村县之间的入学人数增长不一致.
- 市场注册者显示出选择更高层次黄金计划的趋势,这可能表明从更便宜的青铜计划转变.
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