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Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014
OBJECTIVES: To examine the person‐level impact of Medicaid enrollment on costs, utilization, access, and health across previously uninsured racial/ethnic groups. DATA SOURCE: Medical Expenditure Panel Survey, 2008‐2014. STUDY DESIGN: We pooled multiple 2‐year waves of data to examine the direct impa...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341200/ https://www.ncbi.nlm.nih.gov/pubmed/30394525 http://dx.doi.org/10.1111/1475-6773.13085 |
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author | Winkelman, Tyler N. A. Segel, Joel E. Davis, Matthew M. |
author_facet | Winkelman, Tyler N. A. Segel, Joel E. Davis, Matthew M. |
author_sort | Winkelman, Tyler N. A. |
collection | PubMed |
description | OBJECTIVES: To examine the person‐level impact of Medicaid enrollment on costs, utilization, access, and health across previously uninsured racial/ethnic groups. DATA SOURCE: Medical Expenditure Panel Survey, 2008‐2014. STUDY DESIGN: We pooled multiple 2‐year waves of data to examine the direct impact of Medicaid enrollment among uninsured Americans. We compared changes in outcomes among nonpregnant, uninsured individuals who gained Medicaid (N = 963) to those who remained uninsured (N = 9784) using a difference‐in‐differences analysis. PRINCIPAL FINDINGS: Medicaid enrollment was associated with significant increases in total health care costs and total prescription drug costs and a significant decrease in out‐of‐pocket costs. Among those who gained Medicaid, prescription drug use increased significantly relative to those who remained uninsured. Medicaid enrollment was also associated with a significant increase in reporting a usual source of care, a decrease in foregone care, and significant improvements in severe psychological distress. Changes in total prescription drug costs and total prescription drug fills differed significantly across each racial/ethnic group. CONCLUSIONS: Among a national sample of uninsured individuals, Medicaid enrollment was associated with substantial favorable changes in out‐of‐pocket costs, prescription drug use, and access to care. Our findings suggest Medicaid is an important tool to reduce insurance‐related disparities among Americans. |
format | Online Article Text |
id | pubmed-6341200 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-63412002020-02-01 Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014 Winkelman, Tyler N. A. Segel, Joel E. Davis, Matthew M. Health Serv Res Health Equity OBJECTIVES: To examine the person‐level impact of Medicaid enrollment on costs, utilization, access, and health across previously uninsured racial/ethnic groups. DATA SOURCE: Medical Expenditure Panel Survey, 2008‐2014. STUDY DESIGN: We pooled multiple 2‐year waves of data to examine the direct impact of Medicaid enrollment among uninsured Americans. We compared changes in outcomes among nonpregnant, uninsured individuals who gained Medicaid (N = 963) to those who remained uninsured (N = 9784) using a difference‐in‐differences analysis. PRINCIPAL FINDINGS: Medicaid enrollment was associated with significant increases in total health care costs and total prescription drug costs and a significant decrease in out‐of‐pocket costs. Among those who gained Medicaid, prescription drug use increased significantly relative to those who remained uninsured. Medicaid enrollment was also associated with a significant increase in reporting a usual source of care, a decrease in foregone care, and significant improvements in severe psychological distress. Changes in total prescription drug costs and total prescription drug fills differed significantly across each racial/ethnic group. CONCLUSIONS: Among a national sample of uninsured individuals, Medicaid enrollment was associated with substantial favorable changes in out‐of‐pocket costs, prescription drug use, and access to care. Our findings suggest Medicaid is an important tool to reduce insurance‐related disparities among Americans. John Wiley and Sons Inc. 2018-11-05 2019-02 /pmc/articles/PMC6341200/ /pubmed/30394525 http://dx.doi.org/10.1111/1475-6773.13085 Text en © 2018 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Health Equity Winkelman, Tyler N. A. Segel, Joel E. Davis, Matthew M. Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014 |
title | Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014 |
title_full | Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014 |
title_fullStr | Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014 |
title_full_unstemmed | Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014 |
title_short | Medicaid enrollment among previously uninsured Americans and associated outcomes by race/ethnicity—United States, 2008‐2014 |
title_sort | medicaid enrollment among previously uninsured americans and associated outcomes by race/ethnicity—united states, 2008‐2014 |
topic | Health Equity |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341200/ https://www.ncbi.nlm.nih.gov/pubmed/30394525 http://dx.doi.org/10.1111/1475-6773.13085 |
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