scholarly journals Racial/Ethnic Variation in the Impact of the Affordable Care Act on Insurance Coverage and Access Among Young Adults

2018 ◽  
Vol 108 (4) ◽  
pp. 544-549 ◽  
Author(s):  
Aurora VanGarde ◽  
Jangho Yoon ◽  
Jeff Luck ◽  
Carolyn A. Mendez-Luck
Keyword(s):  
Young Adults ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Ethnic Variation ◽  
The Affordable Care Act ◽  
The Impact ◽  
Racial Ethnic

The Affordable Care Act Appears to Have Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Care Among Young Adults

2017 ◽  
Vol 76 (1) ◽  
pp. 32-55 ◽  
Author(s):  
Brandy J. Lipton ◽  
Sandra L. Decker ◽  
Benjamin D. Sommers
Keyword(s):  
Young Adults ◽  
Access To Care ◽  
Ethnic Groups ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Ethnic Disparities ◽  
Percentage Point Increase ◽  
The Affordable Care Act ◽  
Dependent Coverage ◽  
Racial Ethnic

Prior to the Affordable Care Act, one in three young adults aged 19 to 25 years were uninsured, with substantial racial/ethnic disparities in coverage. We analyzed the separate and cumulative changes in racial/ethnic disparities in coverage and access to care among young adults after implementation of the Affordable Care Act’s 2010 dependent coverage provision and 2014 Medicaid and Marketplace expansions. We find that the dependent coverage provision was associated with similar gains across racial/ethnic groups, but the 2014 expansion was associated with larger gains in coverage among Hispanics and Blacks relative to Whites. After the 2014 expansion, coverage increased by 11.0 and 10.1 percentage points among Hispanics and Blacks, respectively, compared with a 5.6 percentage point increase among Whites. The percentage with a usual source of care and a recent doctor’s visit also increased more for Blacks relative to Whites. Increases in coverage were larger in Medicaid expansion compared with nonexpansion states for most racial/ethnic groups.

scholarly journals Patterns of Coverage Gains Among Young Adult Cancer Patients Following the Affordable Care Act

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Leticia M Nogueira ◽  
Neetu Chawla ◽  
Xuesong Han ◽  
Ahmedin Jemal ◽  
K Robin Yabroff
Keyword(s):  
Young Adult ◽  
Cancer Patients ◽  
Affordable Care Act ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Temporal Patterns ◽  
Patients Âgés ◽  
The Affordable Care Act ◽  
Young Adult Cancer ◽  
The Impact

Abstract The dependent coverage expansion (DCE) and Medicaid expansions (ME) under the Affordable Care Act (ACA) may differentially affect eligibility for health insurance coverage in young adult cancer patients. Studies examining temporal patterns of coverage changes in young adults following these policies are lacking. We used data from the National Cancer Database 2003–2015 to conduct a quasi-experimental study of cancer patients ages 19–34 years, grouped as DCE-eligible (19- to 25-year-olds) and DCE-ineligible (27- to 34-year-olds). Although private insurance coverage in DCE-eligible cancer patients increased incrementally following DCE implementation (0.5 per quarter; P < .001), an immediate effect on Medicaid coverage gains was observed after ME in all young adult cancer patients (3.01 for DCE-eligible and 1.62 for DCE-ineligible, both P < .001). Therefore, DCE and ME each had statistically significant and distinct effects on insurance coverage gains. Distinct temporal patterns of ACA policies’ impact on insurance coverage gains likely affect patterns of receipt of cancer care. Temporal patterns should be considered when evaluating the impact of health policies.

scholarly journals Early Impact of the Affordable Care Act on Health Insurance Coverage of Young Adults

2012 ◽  
Vol 47 (5) ◽  
pp. 1773-1790 ◽  
Author(s):  
Joel C. Cantor ◽  
Alan C. Monheit ◽  
Derek DeLia ◽  
Kristen Lloyd
Keyword(s):  
Young Adults ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The Affordable Care Act

Association of the Affordable Care Act with survival among adolescents and young adults with lymphomas in California.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6532-6532
Author(s):  
Renata Abrahão ◽  
Julianne J.P. Cooley ◽  
Frances Belda Maguire ◽  
Cyllene Morris ◽  
Arti Parikh-Patel ◽  
...  
Keyword(s):  
Young Adults ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Adolescents And Young Adults ◽  
Stage At Diagnosis ◽  
Medicaid Enrollment ◽  
Race Ethnicity ◽  
The Affordable Care Act

6532 Background: Our recent study showed that the implementation of the Affordable Care Act (ACA) was associated with increased health insurance coverage among adolescents and young adults (AYAs, 15–39 years) diagnosed with lymphomas in California and decreased likelihood of late stage at diagnosis. However, AYAs of Black or Hispanic race/ethnicity (vs Whites) and those living in lower socioeconomic (SES) neighborhoods were at higher risk of presenting with advanced stage. We aimed to determine whether the increased insurance coverage under the ACA was associated with improved survival, and to identify the main predictors of survival among AYAs with lymphomas. Methods: We used data from the California Cancer Registry linked to Medicaid enrollment files on AYAs diagnosed with a primary non-Hodgkin (NHL) or Hodgkin (HL) lymphoma during March 2005–September 2010 (pre-ACA), October 2010–December 2013 (early ACA) or 2014–2017 (full ACA). Patients were followed from lymphoma diagnosis until death, loss to follow-up or end of the study (12/31/2018). Health insurance was categorized as continuous Medicaid, discontinuous Medicaid, Medicaid enrollment at diagnosis/uninsured, other public or private. We used multivariable Cox proportional regression to examine the associations between all-cause survival and era of diagnosis, adjusting for sex, age and stage at diagnosis, health insurance, race/ethnicity, neighborhood SES, treatment facility, comorbidities, and marital status. Results: Of 11,221 AYAs, 5,878 were diagnosed with NHL and 5,343 with HL. Most patients were male (56%), White (45%), presented with earlier stage (I/II, 56%), and had private insurance (57%). The proportion of AYAs who received initial care at National Cancer Institute-Designated Cancer Centers (NCI-CCs) increased from 24% pre-ACA to 31% after full ACA implementation (p < 0.001). AYAs diagnosed in the early (aHR = 0.76, 95% CI 0.67–0.88) and full ACA (aHR = 0.55, 95%CI 0.47–0.64) eras had better survival than those diagnosed pre-ACA. Compared to those with private insurance, survival was worse among patients with no insurance (HR = 2.13, 95% CI 1.83–2.49), discontinuous Medicaid (HR = 2.17, 95% CI 1.83–2.56) and continuous Medicaid (HR = 1.93, 95% CI 1.63–2.29) at diagnosis. Regardless of their insurance, older AYAs, males, unmarried, those with later stage (II–IV), residents in lower SES neighborhoods, and those of Black, Hispanic, Asian/Pacific Islander, and American Indian/Alaskan Native race/ethnicity experienced worse survival. Conclusions: Following the ACA implementation in California, AYAs diagnosed with lymphomas experienced increased access to care at NCI-CCs and improved survival. Yet, racial/ethnic and socioeconomic survival disparities persisted. Moving forward, policy actions are required to mitigate structural and social determinants of health disparities in this population.

scholarly journals Did the Affordable Care Act Young Adult Provision Affect Labor Market Outcomes? Analysis Using Tax Data

ILR Review ◽  
2017 ◽  
Vol 71 (5) ◽  
pp. 1154-1178 ◽  
Author(s):  
Bradley Heim ◽  
Ithai Lurie ◽  
Kosali Simon
Keyword(s):  
Young Adults ◽  
Labor Market ◽  
Young Adult ◽  
Affordable Care Act ◽  
Labor Market Outcomes ◽  
Full Time ◽  
Market Outcomes ◽  
Data Set ◽  
The Affordable Care Act ◽  
The Impact

Using a data set of US tax records spanning 2008 to 2013, the authors study the impact of the Affordable Care Act (ACA) young adult dependent coverage requirement on labor market–related outcomes, including measures of employment status, job characteristics, and postsecondary education. They find that the ACA provision did not result in substantial changes in labor market outcomes. Results show that employment and self-employment are not statistically significantly affected. Although some evidence supports the increased likelihood of young adults earning lower wages, not receiving fringe benefits, enrolling as full-time or graduate students, and young men being self-employed, the magnitudes imply extremely small impacts on these outcomes in absolute terms and when compared to other estimates in the literature. The authors find these results to be consistent with health insurance being less salient to young adults, compared to other populations, when making labor market decisions.

546 Impact of the Affordable Care Act on Burn Outcomes

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S112-S113
Author(s):  
Jamie Oh ◽  
Amali Fernando ◽  
Stephen Sibbett ◽  
Gretchen J Carrougher ◽  
Barclay T Stewart ◽  
...  
Keyword(s):  
Affordable Care Act ◽  
Injury Severity ◽  
Burn Injury ◽  
Insurance Coverage ◽  
Complication Rates ◽  
Patient Disposition ◽  
Burn Center ◽  
The Affordable Care Act ◽  
Chi Square Analysis ◽  
The Impact

Abstract Introduction With changes in insurance coverage after the implementation of the Affordable Care Act (ACA) in 2014, we aim to analyze the impact of Medicaid expansion on clinical outcomes and patient disposition after burn injury. We hypothesize that with increased insurance coverage, more patients are discharged to a skilled nursing facility (SNF) or rehabilitation center. Methods Under IRB approval, we reviewed trauma registry data for patients with burn injuries admitted to a regional burn center from 2011 to 2018. Patients were grouped into two categories: before (2011–2014) and after (2015–2018) ACA; we excluded data from 2014 to serve as a washout period. Outcomes of interest were length of hospital stay controlled for burn size (LOS/TBSA), number of complications, patient disposition (Home, SNF, or Rehab), and mortality. Chi square analysis and student t-tests were performed to determine differences between the two groups. Multivariate logistic regression including age, sex, race, distance from medical center, burn size, and etiology of the burn as covariates were used to determine the impact of ACA implementation on patient disposition. Results Inpatient mortality rates did not change following ACA implementation. Average LOS/TBSA and number of complications increased, which may be due to increased average age, burn size, and distance from the burn center after ACA. Fewer patients were discharged home and more patients were sent to rehabilitation centers and SNF, which may relate to more patients being insured. Even after adjusting for covariates, discharge to inpatient rehabilitation was significantly increased and discharge to a SNF approached significance. Conclusions Since ACA implementation, there has been no change in mortality after a burn injury, but an increase in average LOS and complication rates, consistent with increased injury severity. Rates of discharge to rehab centers and SNF improved with the increase in overall insurance coverage in the burn population. Applicability of Research to Practice This work highlights changes in patient outcomes with ACA implementation and can help to guide understanding of health disparity and resource utilization in this population.

scholarly journals The Affordable Care Act and Insurance Coverage for Young Adults

JAMA ◽  
2012 ◽  
Vol 307 (9) ◽  
Author(s):  
Benjamin D. Sommers ◽  
Richard Kronick
Keyword(s):  
Young Adults ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
The Affordable Care Act
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