Health Insurance Coverage and Physician Use Among Children With Disabilities: Findings From Probability Samples in Five Metropolitan Areas

PEDIATRICS ◽  
1987 ◽  
Vol 79 (1) ◽  
pp. 89-98
Author(s):  
John A. Butler ◽  
Judith D. Singer ◽  
Judith S. Palfrey ◽  
Deborah K. Walker
Keyword(s):  
Health Insurance ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Children With Disabilities ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Physician Visits ◽  
Significant Difference ◽  
Privately Insured

The effect of insurance coverage on physician use for children in the United States who have been identified as disabled by their schools under the provisions of the Education for All Handicapped Children Act (PL 94-142) is examined. The research is based on identically drawn stratified random samples of children from the elementary school special education populations of five large metropolitan school systems. It was found that (1) health insurance coverage was a predictor of whether a disabled child had seen a doctor in the past year even after adjustment for site, family background characteristics, type and severity of childhood disability, and structural access factors (adjusted odds ratio, 1.76, P < .05); (2) Hispanic children with disabilities were more likely than white children to be without any health insurance (adjusted odds ratio, 3.63; P < .001), but there was no similar statistically significant difference between blacks and whites; and (3) wide variations persist in scope of insurance payment for care, such that parents of publicly insured children paid out of pocket for only 5% of all physician visits as compared to 30% of visits for the privately insured. Even for children with various lowprevalence disabilities, when privately insured, parents paid out of pocket for 23% of all physician visits. These data help clarify the extent of health insurance coverage among children with disabilities and indicate that insurance remains an important predictor of physician use even though it continues to pay for only certain elements of care.

scholarly journals Change in Perceived Health Insurance Coverage Among People with Multiple Sclerosis

2014 ◽  
Vol 16 (3) ◽  
pp. 132-139 ◽  
Author(s):  
Alyssa Pozniak ◽  
Louise Hadden ◽  
William Rhodes ◽  
Sarah Minden
Keyword(s):  
Multiple Sclerosis ◽  
Health Insurance ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Public And Private ◽  
Perceived Change ◽  
Publicly Insured ◽  
Privately Insured

Background: Previous research suggests that most people with multiple sclerosis (MS) in the United States have health insurance. However, little is known about their coverage or how it differs between public and private insurance. We examined whether the perceived change in health insurance coverage from the previous year differs between individuals with MS who are privately insured compared with those who are publicly insured. Methods: We present descriptive statistics and odds ratios (ORs) from a multivariate logistic regression using data from the 2009 wave of the Sonya Slifka Longitudinal Multiple Sclerosis Study. Results: We found that individuals with Medicare were significantly less likely to perceive worse coverage compared with those with private health insurance (OR = 0.53; P < .01). Individuals aged 55 to 64 years were more likely to perceive worse coverage than those aged 18 to 34 years (OR = 2.5; P < .05), while the odds of perceiving worse coverage were significantly lower for individuals who had been diagnosed more than 15 years previously relative to those diagnosed in the past 2 years (OR = 0.48; P < .05). Conclusions: Individuals with MS and other chronic illnesses who can choose between public and private insurance should be aware that there are important differences in perceptions of health insurance coverage between publicly and privately insured individuals.

Data Processing Improvements for Estimates of Health Insurance Coverage in the Current Population Survey Annual Social and Economic Supplement

2021 ◽  
pp. 107755872110008
Author(s):  
Edward R. Berchick ◽  
Heide Jackson
Keyword(s):  
Health Insurance ◽  
Data Processing ◽  
Current Population Survey ◽  
Population Survey ◽  
Insurance Coverage ◽  
Processing System ◽  
Health Insurance Coverage ◽  
The United States ◽  
Health Insurance Data ◽  
Current Population

Estimates of health insurance coverage in the United States rely on household-based surveys, and these surveys seek to improve data quality amid a changing health insurance landscape. We examine postcollection processing improvements to health insurance data in the Current Population Survey Annual Social and Economic Supplement (CPS ASEC), one of the leading sources of coverage estimates. The implementation of updated data extraction and imputation procedures in the CPS ASEC marks the second stage of a two-stage improvement and the beginning of a new time series for health insurance estimates. To evaluate these changes, we compared estimates from two files that introduce the updated processing system with two files that use the legacy system. We find that updates resulted in higher rates of health insurance coverage and lower rates of dual coverage, among other differences. These results indicate that the updated data processing improves coverage estimates and addresses previously noted limitations of the CPS ASEC.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

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.

scholarly journals Depressive Symptoms in Older African Immigrants: A Descriptive Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 335-335
Author(s):  
Manka Nkimbeng ◽  
Zachary Baker ◽  
Janiece Taylor ◽  
Sarah Szanton ◽  
Tetyana Shippee ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Insurance Coverage ◽  
Severe Depression ◽  
Secondary Data ◽  
African Immigrants ◽  
Health Insurance Coverage ◽  
The United States ◽  
Health Study ◽  
Related Factors ◽  
Significant Difference

Abstract In FY 2018-2019, the National Institutes of Health devoted $2,387,505,711 to projects studying depression. Before and following their arrival into the United States stressful life circumstances may render African immigrants particularly at risk for depression. The objective of this study is to provide an estimate and identify correlates of depressive symptoms in older (≥50 years) African immigrants. We performed secondary data analyses of the Older African Immigrant Health study (n = 148). Bivariate analyses evaluated associations between depressive symptoms and sociodemographic and immigration-related factors. Depressive symptoms were measured with the PHQ-8 scale and scores of ≥ 5 were considered indicative of depressive symptoms. The mean age of participants was 62 years (SD:8.2), 61% were female, 30% had less than high school education, and 58% reported having health insurance coverage. Thirty percent of the sample had depressive symptoms (PHQ-8 score of ≥ 5) but only one individual would be classified as having moderately severe or severe depression (PHQ-8 ≥15). Depressive symptoms did not differ by age, marital status, education, or income. There was a statistically significant difference in depressive symptoms by reason for migration, recruitment location, and employment status. Although only one participant would be classified as severely depressive, a large proportion of this sample had depressive symptoms. Mental health concerns were reported as a significant health problem for African immigrants visiting a community service organization in New York. More research is needed to examine the prevalence, immigration-related correlates, predictors, and health ramifications of depression in older African immigrants.

scholarly journals Union Effects on Health Insurance Provision and Coverage in the United States

ILR Review ◽  
2002 ◽  
Vol 55 (4) ◽  
pp. 610-627 ◽  
Author(s):  
Thomas C. Buchmueller ◽  
John Dinardo ◽  
Robert G. Valletta
Keyword(s):  
United States ◽  
Health Insurance ◽  
Survey Data ◽  
Insurance Coverage ◽  
Health Benefits ◽  
Union Density ◽  
Health Insurance Coverage ◽  
The United States ◽  
Health Coverage ◽  
Private Sector Union

During the past two decades, union density has declined in the United States and employer provision of health benefits has changed substantially in extent and form. Using individual survey data spanning the years 1983–97 combined with employer survey data for 1993, the authors update and extend previous analyses of private-sector union effects on employer-provided health benefits. They find that the union effect on health insurance coverage rates has fallen somewhat but remains large, due to an increase over time in the union effect on employee “take-up” of offered insurance, and that declining unionization explains 20–35% of the decline in employee health coverage. The increasing union take-up effect is linked to union effects on employees' direct costs for health insurance and the availability of retiree coverage.

scholarly journals Measurement Error in Health Insurance Reporting

2008 ◽  
Vol 45 (4) ◽  
pp. 422-437 ◽  
Author(s):  
Joanne Pascale
Keyword(s):  
Health Insurance ◽  
Survey Methods ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Household Level ◽  
Testing Protocol ◽  
Life Circumstances ◽  
Rich Data

In the United States, surveys serve as the only source of data for the number of uninsured people; they also provide rich data for exploring the relationships between health insurance coverage and individuals' life circumstances, such as employment, income, and health status, enabling researchers to assess the effectiveness of various aspects of the health care system. The Current Population Survey (CPS) is one of the most influential surveys measuring health insurance, but it is not without critics. To address outstanding questions about the data quality of the CPS health insurance questions, qualitative testing was conducted to assess various aspects of the questionnaire from the respondent's perspective. A testing protocol was developed largely based on previous health survey methods literature, and test subjects were probed about their comprehension of the questions, particular terms and phrases, and their strategies for formulating an answer. Several design features were identified as problematic, including the overall questionnaire structure, the calendar year reference period, the household-level design, and the wording of questions on public coverage.

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