scholarly journals Access to Accredited Cancer Hospitals Within Federal Exchange Plans Under the Affordable Care Act

2017 ◽  
Vol 35 (6) ◽  
pp. 645-651 ◽  
Author(s):  
Kenneth L. Kehl ◽  
Kai-Ping Liao ◽  
Trudy M. Krause ◽  
Sharon H. Giordano
Keyword(s):  
Affordable Care Act ◽  
Cancer Care ◽  
The United States ◽  
Metal Level ◽  
Network Data ◽  
Exchange Networks ◽  
Health Maintenance ◽  
Cancer Centers ◽  
Provider Networks ◽  
The Affordable Care Act

Purpose The Affordable Care Act expanded access to health insurance in the United States, but concerns have arisen about access to specialized cancer care within narrow provider networks. To characterize the scope and potential impact of this problem, we assessed rates of inclusion of Commission on Cancer (CoC) –accredited hospitals and National Cancer Institute (NCI) –designated cancer centers within federal exchange networks. Methods We downloaded publicly available machine-readable network data and public use files for individual federal exchange plans from the Centers for Medicare and Medicaid Services for the 2016 enrollment year. We linked this information to National Provider Identifier data, identified a set of distinct provider networks, and assessed the rates of inclusion of CoC-accredited hospitals and NCI-designated centers. We measured variation in these rates according to geography, plan type, and metal level. Results Of 4,058 unique individual plans, network data were available for 3,637 (90%); hospital information was available for 3,531 (87%). Provider lists for these plans reduced into 295 unique networks for analysis. Ninety-five percent of networks included at least one CoC-accredited hospital, but just 41% of networks included NCI-designated centers. States and counties each varied substantially in the proportion of networks listed that included NCI-designated centers (range, 0% to 100%). The proportion of networks that included NCI-designated centers also varied by plan type (range, 31% for health maintenance organizations to 49% for preferred provider organizations; P = .04) but not by metal level. Conclusion A large majority of federal exchange networks contain CoC-accredited hospitals, but most do not contain NCI-designated cancer centers. These results will inform policy regarding access to cancer care, and they reinforce the importance of promoting access to clinical trials and specialized care through community sites.

Implementing the Affordable Care Act: State Regulation of Marketplace Plan Provider Networks

2015 ◽  
Author(s):  
Sabrina Corlette Corlette ◽  
Kevin W. Lucia Lucia ◽  
Justin Giovannelli Giovannelli
Keyword(s):  
Affordable Care Act ◽  
State Regulation ◽  
Provider Networks ◽  
The Affordable Care Act

scholarly journals Health Insurance Coverage before and after the Affordable Care Act in the USA

Sci ◽  
2021 ◽  
Vol 3 (2) ◽  
pp. 25
Author(s):  
Jesse Patrick ◽  
Philip Q. Yang
Keyword(s):  
Health Insurance ◽  
National Health ◽  
Affordable Care Act ◽  
The United States ◽  
Insurance Status ◽  
Health Insurance Status ◽  
Full Implementation ◽  
Before And After ◽  
The Affordable Care Act ◽  
Partial Implementation

The Affordable Care Act (ACA) is at the crossroads. It is important to evaluate the effectiveness of the ACA in order to make rational decisions about the ongoing healthcare reform, but existing research into its effect on health insurance status in the United States is insufficient and descriptive. Using data from the National Health Interview Surveys from 2009 to 2015, this study examines changes in health insurance status and its determinants before the ACA in 2009, during its partial implementation in 2010–2013, and after its full implementation in 2014 and 2015. The results of trend analysis indicate a significant increase in national health insurance rate from 82.2% in 2009 to 89.4% in 2015. Logistic regression analyses confirm the similar impact of age, gender, race, marital status, nativity, citizenship, education, and poverty on health insurance status before and after the ACA. Despite similar effects across years, controlling for other variables, youth aged 26 or below, the foreign-born, Asians, and other races had a greater probability of gaining health insurance after the ACA than before the ACA; however, the odds of obtaining health insurance for Hispanics and the impoverished rose slightly during the partial implementation of the ACA, but somewhat declined after the full implementation of the ACA starting in 2014. These findings should be taken into account by the U.S. Government in deciding the fate of the ACA.

The Impact of the Affordable Care Act Medicaid Expansions on the Sources of Health Insurance Coverage of Undergraduate Students in the United States

2021 ◽  
pp. 107755872110158
Author(s):  
Priyanka Anand ◽  
Dora Gicheva
Keyword(s):  
United States ◽  
Health Insurance ◽  
Undergraduate Students ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Medicaid Expansions

This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions—that is, some students substituted their private and employer-sponsored coverage for Medicaid.

Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care

2021 ◽  
pp. 1-9
Author(s):  
Jacob K. Greenberg ◽  
Derek S. Brown ◽  
Margaret A. Olsen ◽  
Wilson Z. Ray
Keyword(s):  
United States ◽  
Spine Surgery ◽  
Surgical Procedures ◽  
Affordable Care Act ◽  
Surgical Care ◽  
The United States ◽  
Medicaid Expansion ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
The Impact

OBJECTIVE The Affordable Care Act expanded Medicaid eligibility in many states, improving access to some forms of elective healthcare in the United States. Whether this effort increased access to elective spine surgical care is unknown. This study’s objective was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. METHODS This study evaluated elective spine surgical procedures performed from 2011 to 2016 and included in the all-payer State Inpatient Databases of 10 states that expanded Medicaid access in 2014, as well as 4 states that did not expand Medicaid access. Adult patients aged 18–64 years who underwent elective spine surgery were included. The authors used a quasi-experimental difference-in-difference design to evaluate the impact of Medicaid expansion on hospital procedure volume and payer mix, independent of time-dependent trends. Subgroup analysis was conducted that stratified results according to cervical fusion, thoracolumbar fusion, and noninstrumented surgery. RESULTS The authors identified 218,648 surgical procedures performed in 10 Medicaid expansion states and 118,693 procedures performed in 4 nonexpansion states. Medicaid expansion was associated with a 17% (95% CI 2%–35%, p = 0.03) increase in mean hospital spine surgical volume and a 23% (95% CI −0.3% to 52%, p = 0.054) increase in Medicaid volume. Privately insured surgical volumes did not change significantly (incidence rate ratio 1.13, 95% CI −5% to 34%, p = 0.18). The increase in Medicaid volume led to a shift in payer mix, with the proportion of Medicaid patients increasing by 6.0 percentage points (95% CI 4.1–7.0, p < 0.001) and the proportion of private payers decreasing by 6.7 percentage points (95% CI 4.5–8.8, p < 0.001). Although the magnitude of effects varied, these trends were similar across procedure subgroups. CONCLUSIONS Medicaid expansion under the Affordable Care Act was associated with an economically and statistically significant increase in spine surgery volume and the proportion of surgical patients with Medicaid insurance, indicating improved access to care.

Conclusion

2020 ◽  
pp. 223-226
Author(s):  
Dan Royles
Keyword(s):  
Climate Change ◽  
United States ◽  
Health Equity ◽  
Affordable Care Act ◽  
The United States ◽  
First Year ◽  
Communities Of Color ◽  
History Of ◽  
The Affordable Care Act ◽  
Hiv Aids

This chapter considers what it means to write the history of a crisis that has not yet ended, and briefly traces connections among the stories told in previous chapters. It connects these stories to the ongoing fight for health equity in the United States, including the author’s involvement in the fight to preserve the Affordable Care Act in the first year of Donald Trump’s presidency. Finally, it compares HIV/AIDS to climate change, as both are existential crises that will disproportionately affect poor communities of color.

scholarly journals PIN71 VACCINATION AND POTENTIAL MISSED OPPORTUNITIES AMONG ADULTS IN THE UNITED STATES DURING THE AFFORDABLE CARE ACT ERA

2019 ◽  
Vol 22 ◽  
pp. S205-S206
Author(s):  
E. Aris ◽  
M. Montourcy ◽  
E. Esterberg ◽  
S.K. Kurosky ◽  
S. Poston ◽  
...  
Keyword(s):  
United States ◽  
Affordable Care Act ◽  
The United States ◽  
Missed Opportunities ◽  
The Affordable Care Act

scholarly journals The adult vaccination landscape in the United States during the Affordable Care Act era: Results from a large retrospective database analysis

Vaccine ◽  
2020 ◽  
Vol 38 (14) ◽  
pp. 2984-2994 ◽  
Author(s):  
Emmanuel Aris ◽  
Marion Montourcy ◽  
Elizabeth Esterberg ◽  
Samantha K. Kurosky ◽  
Sara Poston ◽  
...  
Keyword(s):  
United States ◽  
Affordable Care Act ◽  
The United States ◽  
Database Analysis ◽  
Adult Vaccination ◽  
Retrospective Database Analysis ◽  
The Affordable Care Act ◽  
Retrospective Database

The Affordable Care Act and assisted reproductive technology use

2015 ◽  
Vol 34 (2) ◽  
pp. 71-90 ◽  
Author(s):  
Patricia Stapleton ◽  
Daniel Skinner
Keyword(s):  
Affordable Care Act ◽  
Technology Use ◽  
Assisted Reproductive Technologies ◽  
Insurance Coverage ◽  
The United States ◽  
Reproductive Technologies ◽  
Gender And Sexuality ◽  
Insurance Markets ◽  
The Affordable Care Act ◽  
American Society

The Affordable Care Act (ACA) has prompted numerous gender and sexuality controversies. We describe and analyze those involving assisted reproductive technologies (ART). ART in the United States has been regulated in piecemeal fashion, with oversight primarily by individual states. While leaving state authority largely intact, the ACA federalized key practices by establishing essential health benefits (EHBs) that regulate insurance markets and prohibit insurance-coverage denials based on pre-existing conditions. Whatever their intentions, the ACA’s drafters thus put infertility in a subtly provocative new light clinically, financially, normatively, politically, and culturally. With particular attention to normative and political dynamics embedded in plausible regulatory trajectories, we review—and attempt topreview—the ACA’s effects on infertility-related delivery of health services, on ART utilization, and on reproductive medicine as a factor in American society.

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