Inequalities in Young Adult Health Insurance Coverage Post-federal Health Reform

Being uninsured affects one's ability to access medical services and maintain health. Using longitudinal data from the Survey of Income and Program Participation, the authors investigated how individual and family insurance coverage affects adult health. They found that health insurance coverage often varies across family members and changes frequently. Employing multivariate analyses that control for personal insurance status, predisposing characteristics, and enabling resources, the authors show that adults who are members of families that include other uninsured members are more likely to report poor health than adults in full-coverage families. Policy makers should consider refocusing public and private insurance coverage goals to include full-family coverage.

Download Full-text

Health Insurance Coverage among Young Adult Survivors of Pediatric Heart Transplantation

The Journal of Pediatrics ◽

10.1016/j.jpeds.2017.06.014 ◽

2017 ◽

Vol 188 ◽

pp. 82-86 ◽

Cited By ~ 1

Author(s):

Dmitry Tumin ◽

Susan S. Li ◽

Deipanjan Nandi ◽

Robert J. Gajarski ◽

Christopher McKee ◽

...

Keyword(s):

Health Insurance ◽

Young Adult ◽

Heart Transplantation ◽

Insurance Coverage ◽

Adult Survivors ◽

Health Insurance Coverage ◽

Young Adult Survivors ◽

Pediatric Heart Transplantation

Download Full-text

Health Reform and the Constitutionality of the Individual Mandate

Policy Politics & Nursing Practice ◽

10.1177/1527154411432645 ◽

2011 ◽

Vol 12 (4) ◽

pp. 236-244 ◽

Cited By ~ 1

Author(s):

Jeffrey J. Lee ◽

Deena Kelly ◽

Matthew D. McHugh

Keyword(s):

Health Insurance ◽

Health Reform ◽

Access To Health Care ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Critical Issue ◽

Economic Effects ◽

Patient Protection ◽

Individual Mandate ◽

The Individual

The Patient Protection and Affordable Care Act (ACA) of 2010 is landmark legislation designed to expand access to health care for virtually all legal U.S. residents. A vital but controversial provision of the ACA requires individuals to maintain health insurance coverage or face a tax penalty—the individual mandate. We examine the constitutionality of the individual mandate by analyzing relevant court decisions. A critical issue has been defining the “activities” Congress is authorized to regulate. Some judges determined that the mandate was constitutional because the decision to go without health insurance, that is, to self-insure, is an activity with substantial economic effects within the overall scheme of the ACA. Opponents suggest that Congress overstepped its authority by regulating “inactivity,” that is, compelling people to purchase insurance when they otherwise would not. The U.S. Supreme Court is set to review the issues and the final ruling will shape the effectiveness of health reform.

Download Full-text

Changes in initiation of adjuvant endocrine therapy for breast cancer after state health reform

BMC Cancer ◽

10.1186/s12885-021-08149-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kirsten Y. Eom ◽

G. J. van Londen ◽

Jie Li ◽

Bassam Dahman ◽

Cathy Bradley ◽

...

Keyword(s):

Breast Cancer ◽

Health Insurance ◽

Endocrine Therapy ◽

Low Income ◽

Health Reform ◽

Insurance Coverage ◽

Recurrence Risk ◽

Health Insurance Coverage ◽

Relative Increase ◽

Adjuvant Endocrine Therapy

Abstract Background Socioeconomic differences in receipt of adjuvant treatment contribute to persistent disparities in breast cancer (BCA) outcomes, including survival. Adjuvant endocrine therapy (AET) substantially reduces recurrence risk and is recommended by clinical guidelines for nearly all women with hormone receptor-positive non-metastatic BCA. However, AET use among uninsured or underinsured populations has been understudied. The health reform implemented by the US state of Massachusetts in 2006 expanded health insurance coverage and increased the scope of benefits for many with coverage. This study examines changes in the initiation of AET among BCA patients in Massachusetts after the health reform. Methods We used Massachusetts Cancer Registry data from 2004 to 2013 for a sample of estrogen receptor (ER)-positive BCA surgical patients aged 20–64 years. We estimated multivariable regression models to assess differential changes in the likelihood initiating AET after Massachusetts health reform by area-level income, comparing women from lower- and higher-income ZIP codes in Massachusetts. Results There was a 5-percentage point (p-value< 0.001) relative increase in the likelihood of initiating AET among BCA patients aged 20–64 years in low-income areas, compared to higher-income areas, after the reform. The increase was more pronounced among younger patients aged 20–49 years (7.1-percentage point increase). Conclusions The expansion of health insurance in Massachusetts was associated with a significant relative increase in the likelihood of AET initiation among women in low-income areas compared with those in high-income areas. Our results suggest that expansions of health insurance coverage and improved access to care can increase the number of eligible patients initiating AET and may ameliorate socioeconomic disparities in BCA outcomes.

Download Full-text