少数民族拥有的小企业和雇主赞助的医疗保险
Melanie K Tran1, Patrick M Krueger1
1University of Colorado Denver, Department of Health & Behavioral Sciences, 1201 Larimer St, Denver, CO, 80217, USA.
SSM - population health
|September 8, 2025
概括
小企业,特别是少数族裔企业,以较低的费率提供雇主资助医疗保险 (ESI). 这些差异甚至在实惠医疗法案 (ACA) 政策实施后仍然存在,影响了医疗保健的获取.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 健康和疾病的社会学
背景情况:
- 雇主资助的医疗保险 (ESI) 是美国成年工作者医疗保险的主要来源.
- 小企业雇佣了美国劳动力的很大一部分,但以比大企业低得多的价格提供ESI.
- 小企业在ESI提供方面的种族/民族差异尚未得到充分理解,尤其是在不断变化的医疗保健政策背景下.
研究的目的:
- 检查小企业的种族/民族所有权与他们提供ESI的可能性之间的关联.
- 分析在可负担医疗法案 (ACA) 政策实施期间小企业提供ESI的趋势.
- 根据所有者人口统计和业务特征,识别ESI产品中的差异.
主要方法:
- 利用了人口普查局2012年企业主调查和2014-2016年企业家年度调查的受限制数据.
- 采用二元物流回归来评估所有者的种族/民族组成和ESI产品之间的关系.
- 随着时间的推移,ESI提供趋势的可视化趋势,按种族/民族所有权分层,同时控制所有者和公司属性.
主要成果:
- 大多数小企业不提供ESI.
- 存在显著的差异:2012年,白人拥有的企业提供ESI的比例为41%,而黑人拥有的企业为26%,亚裔拥有的企业为26%,西班牙裔拥有的企业为23%.
- 在ACA实施期间,ESI提供中的这些种族/民族差异没有得到改善.
结论:
- 在小型企业中,雇主赞助的医疗保险存在实质性和持久的差异,基于业主的种族/种族.
- 可负担的医疗保健法案 (ACA) 的小企业政策没有减轻这些不平等.
- 针对少数群体拥有的小企业提供ESI的有针对性的政策对于改善服务不足社区的医疗保健机会至关重要.
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