美国医疗补助计划在2023年结束时的覆盖范围变化
Adrianna McIntyre1, Molly Morein1, Jinwoo Kim1
1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
在解散期间,数百万人失去了医疗补助计划的覆盖范围,州差异很大. 调查数据显示,由于重新注册和流行病覆盖意识,覆盖率下降较小,但一些群体面临着负担能力问题.
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:
- 医疗补助持续覆盖条款于2023年4月结束,导致超过2500万个人退出注册.
- 这种放松对整体保险覆盖,医疗补助重新注册和医疗保健负担能力的影响在很大程度上仍未确定.
- 了解这些影响对于评估公共医疗保险计划的稳定性和可访问性至关重要.
研究的目的:
- 分析医疗补助计划在解散期间的医疗补助覆盖损失的州级变化.
- 检查COVID-19公共卫生紧急情况之前,期间和之后新的医疗补助申请的趋势.
- 评估覆盖率变化和对医疗保健负担能力的影响中的人口差异.
主要方法:
- 一项采用医疗保险和医疗补助服务中心 (CMS) 的行政数据和国家健康保险调查 (2019-2023) 的调查数据进行的横截面研究.
- 估计州级医疗补助终止率和分析新的申请趋势.
- 间断时间序列分析自我报告的医疗补助入学,无保险率和低收入人群中与成本相关的护理障碍.
主要成果:
- 解期间州终止率的中位数为26.6%,在州一级有相当大的差异.
- 招生净减少小于总终止,归因于重新招生和先前的覆盖意识.
- 调查数据显示,女性,更健康的个人,年轻人,最近怀孕的成年人和白人之间的覆盖率下降,一些群体的成本相关障碍增加.
结论:
- 数以百万计的人经历了医疗补助计划的退出,但调查数据表明,由于缓解因素,总体覆盖率减少较小.
- 覆盖范围的损失不成比例地影响了特定的人口群体,突出了持续的访问和可负担性挑战.
- 调查结果提供了对政策变化的潜在后果的见解,这可能会增加医疗补助受益人的行政障碍.
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