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Did Medicaid slow declines in access to health care during the great recession?

OBJECTIVE: We examine whether broadened access to Medicaid helped insulate households from declines in health coverage and health care access linked to the 2007‐2009 Great Recession. DATA SOURCE: 2004‐2010 Behavioral Risk Factor Surveillance System (BRFSS). STUDY DESIGN: Flexible difference‐in‐diffe...

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Autores principales: Benitez, Joseph A., Perez, Victoria E., Chen, Jie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313958/
https://www.ncbi.nlm.nih.gov/pubmed/33660277
http://dx.doi.org/10.1111/1475-6773.13645
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author Benitez, Joseph A.
Perez, Victoria E.
Chen, Jie
author_facet Benitez, Joseph A.
Perez, Victoria E.
Chen, Jie
author_sort Benitez, Joseph A.
collection PubMed
description OBJECTIVE: We examine whether broadened access to Medicaid helped insulate households from declines in health coverage and health care access linked to the 2007‐2009 Great Recession. DATA SOURCE: 2004‐2010 Behavioral Risk Factor Surveillance System (BRFSS). STUDY DESIGN: Flexible difference‐in‐difference regressions were used to compare the impact of county‐level unemployment on health care access in states with generous Medicaid eligibility guidelines versus states with restrictive guidelines. DATA COLLECTION/EXTRACTION METHODS: Nonelderly adults (aged 19‐64) in the BRFSS were linked to county unemployment rates from the Bureau of Labor Statistics’ Local Area Unemployment Statistics Program. We created a Medicaid generosity index by simulating the share of a nationally representative sample of adults that would be eligible for Medicaid under each state's 2007 Medicaid guidelines using data from the 2007 Current Population Survey's Annual Social and Economic Supplement. PRINCIPAL FINDINGS: A percentage point (PPT) increase in the county unemployment rate was associated with a 1.3 PPT (95% CI: 0.9‐1.6, P < .01) increase in the likelihood of being uninsured and a 0.86 PPT (95% CI: 0.6‐1.1, P < .01) increase in unmet medical needs due to cost in states with restrictive Medicaid eligibility guidelines. Conversely, a one PPT increase in unemployment was associated with only a 0.64 PPT (P < .01) increase in uninsurance among states with the most generous eligibility guidelines. Among states in the fourth quartile of generosity (ie, most generous), rises in county‐level unemployment were associated with a 0.68 PPT (P < .10) increase in unmet medical needs due to cost—a 21% smaller decrease relative to states with the most restrictive Medicaid eligibility guidelines. CONCLUSIONS: Increased access to Medicaid during the Great Recession mitigated the effects of increased unemployment on the rate of unmet medical need, particularly for adults with limited income.
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spelling pubmed-83139582021-07-31 Did Medicaid slow declines in access to health care during the great recession? Benitez, Joseph A. Perez, Victoria E. Chen, Jie Health Serv Res Medicaid OBJECTIVE: We examine whether broadened access to Medicaid helped insulate households from declines in health coverage and health care access linked to the 2007‐2009 Great Recession. DATA SOURCE: 2004‐2010 Behavioral Risk Factor Surveillance System (BRFSS). STUDY DESIGN: Flexible difference‐in‐difference regressions were used to compare the impact of county‐level unemployment on health care access in states with generous Medicaid eligibility guidelines versus states with restrictive guidelines. DATA COLLECTION/EXTRACTION METHODS: Nonelderly adults (aged 19‐64) in the BRFSS were linked to county unemployment rates from the Bureau of Labor Statistics’ Local Area Unemployment Statistics Program. We created a Medicaid generosity index by simulating the share of a nationally representative sample of adults that would be eligible for Medicaid under each state's 2007 Medicaid guidelines using data from the 2007 Current Population Survey's Annual Social and Economic Supplement. PRINCIPAL FINDINGS: A percentage point (PPT) increase in the county unemployment rate was associated with a 1.3 PPT (95% CI: 0.9‐1.6, P < .01) increase in the likelihood of being uninsured and a 0.86 PPT (95% CI: 0.6‐1.1, P < .01) increase in unmet medical needs due to cost in states with restrictive Medicaid eligibility guidelines. Conversely, a one PPT increase in unemployment was associated with only a 0.64 PPT (P < .01) increase in uninsurance among states with the most generous eligibility guidelines. Among states in the fourth quartile of generosity (ie, most generous), rises in county‐level unemployment were associated with a 0.68 PPT (P < .10) increase in unmet medical needs due to cost—a 21% smaller decrease relative to states with the most restrictive Medicaid eligibility guidelines. CONCLUSIONS: Increased access to Medicaid during the Great Recession mitigated the effects of increased unemployment on the rate of unmet medical need, particularly for adults with limited income. John Wiley and Sons Inc. 2021-03-03 2021-08 /pmc/articles/PMC8313958/ /pubmed/33660277 http://dx.doi.org/10.1111/1475-6773.13645 Text en © 2021 The Authors. Health Services Research published by Wiley Periodicals LLC on behalf of Health Research and Educational Trust. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Medicaid
Benitez, Joseph A.
Perez, Victoria E.
Chen, Jie
Did Medicaid slow declines in access to health care during the great recession?
title Did Medicaid slow declines in access to health care during the great recession?
title_full Did Medicaid slow declines in access to health care during the great recession?
title_fullStr Did Medicaid slow declines in access to health care during the great recession?
title_full_unstemmed Did Medicaid slow declines in access to health care during the great recession?
title_short Did Medicaid slow declines in access to health care during the great recession?
title_sort did medicaid slow declines in access to health care during the great recession?
topic Medicaid
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313958/
https://www.ncbi.nlm.nih.gov/pubmed/33660277
http://dx.doi.org/10.1111/1475-6773.13645
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