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Access and Quality of Care by Insurance Type for Low-Income Adults Before the Affordable Care Act

Bibliographic Data

ID11019081
AuthorsKevin H Nguyen (0000-0001-7417-6322, Kevin H. Nguyen and Benjamin D. Sommers are with the Health Policy and Management Department, Harvard T. H. Chan School of Public Health, Boston, MA. Benjamin D. Sommers is also with the Department of Medicine, Brigham and Women’s Hospital, Boston.), Benjamin D Sommers (0000-0001-6507-6047, Kevin H. Nguyen and Benjamin D. Sommers are with the Health Policy and Management Department, Harvard T. H. Chan School of Public Health, Boston, MA. Benjamin D. Sommers is also with the Department of Medicine, Brigham and Women’s Hospital, Boston.)
Year2016
Volume106
Issue8
Pages1409-1415
Publication date2016-08-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2016.303156
PMID27196646
OpenAlexW2396126400
LanguageEN
Citations received9
References cited22

Objectives. To compare access to care and perceived health care quality by insurance type among low-income adults in 3 southern US states, before Medicaid expansion under the Affordable Care Act. Methods. We conducted a telephone survey in 2013 of 2765 low-income US citizens, aged 19 to 64 years, in Arkansas, Kentucky, and Texas. We compared 11 measures of access and quality of care for respondents with Medicaid, private insurance, Medicare, and no insurance with adjustment for sociodemographics and health status. Results. Low-income adults with Medicaid, private insurance, and Medicare reported significantly better health care access and quality than uninsured individuals. Medicaid beneficiaries reported greater difficulty accessing specialists but less risk of high out-of-pocket spending than those with private insurance. For other outcomes, Medicaid and private coverage performed similarly. Conclusions. Low-income adults with insurance report significantly greater access and quality of care than uninsured adults, regardless of whether they have private or public insurance. Access to specialty care in Medicaid may require policy attention. Public Health Implications. Many states are still considering whether to expand Medicaid under the Affordable Care Act and whether to pursue alternative models for coverage expansion. Our results suggest that access to quality health care will improve under the Affordable Care Act's coverage expansions, regardless of the type of coverage

Actuarial science · Business · Economic growth · Economics · Environmental health · Family medicine · Health care · Health insurance · Medicaid · Patient Protection and Affordable Care Act · Quality (philosophy) · Specialty · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Primary Care and Health Outcomes

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Unique citing works9
Citations per year0,9
Citation span2016 - 2024 (9)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 8
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