scholarly journals The Convergence of Racial and Income Disparities in Health Insurance Coverage in the United States

2020 ◽  
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 ObjectiveThis study applies the vulnerability framework and examines the combined effect of race and income on health insurance coverage in the US. Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage.Data sourcesThe household component of the US Medical Expenditure Panel Survey (MEPS-HC) in 2017 was used for the study.Study designLogistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or partially insured, partially insured only, and uninsured only, respectively.Data collection/extraction methodsWe constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findingsWhile 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 66% less odds of being insured instead of uninsured or partially insured than high-income Whites with good health.ConclusionsPolicymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and are racial/ethnic minorities.

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.

scholarly journals Health Insurance Coverage Disruptions and Cancer Care and Outcomes: Systematic Review of Published Research

2020 ◽  
Vol 112 (7) ◽  
pp. 671-687 ◽  
Author(s):  
K Robin Yabroff ◽  
Katherine Reeder-Hayes ◽  
Jingxuan Zhao ◽  
Michael T Halpern ◽  
Ana Maria Lopez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Low Income ◽  
Cancer Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Stage At Diagnosis ◽  
Data Infrastructure ◽  
Study Characteristics

Abstract Background Lack of health insurance coverage is associated with poor access and receipt of cancer care and survival in the United States. Disruptions in coverage are common among low-income populations, but little is known about associations of disruptions with cancer care, including prevention, screening, and treatment, as well as outcomes of stage at diagnosis and survival. Methods We conducted a systematic review of studies of health insurance coverage disruptions and cancer care and outcomes published between 1980 and 2019. We used the PubMed, EMBASE, Scopus, and CINAHL databases and identified 29 observational studies. Study characteristics and key findings were abstracted and synthesized qualitatively. Results Studies evaluated associations between coverage disruptions and prevention or screening (31.0%), treatment (13.8%), end-of-life care (10.3%), stage at diagnosis (44.8%), and survival (20.7%). Coverage disruptions ranged from 4.3% to 32.8% of patients age-eligible for breast, cervical, or colorectal cancer screening. Between 22.1% and 59.5% of patients with Medicaid gained coverage only at or after cancer diagnosis. Coverage disruptions were consistently statistically significantly associated with lower receipt of prevention, screening, and treatment. Among patients with cancer, those with Medicaid disruptions were statistically significantly more likely to have advanced stage (odds ratios = 1.2-3.8) and worse survival (hazard ratios = 1.28-2.43) than patients without disruptions. Conclusions Health insurance coverage disruptions are common and adversely associated with receipt of cancer care and survival. Improved data infrastructure and quasi-experimental study designs will be important for evaluating the associations of federal and state policies on coverage disruptions and care and outcomes.

scholarly journals Health Insurance Coverage Better Protects Blacks than Whites against Incident Chronic Disease

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 40 ◽  
Author(s):  
Shervin Assari ◽  
Hamid Helmi ◽  
Mohsen Bazargan
Keyword(s):  
Health Insurance ◽  
Protective Effect ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Relative Advantage ◽  
Linear Regression Models ◽  
Socioeconomic Resources ◽  
Health Insurance Status ◽  
Race Ethnicity

Although the protective effect of health insurance on population health is well established, this effect may vary based on race/ethnicity. This study had two aims: (1) to test whether having health insurance at baseline protects individuals over a 10-year period against incident chronic medical conditions (CMC) and (2) to explore the race/ethnic variation in this effect. Midlife in the United States (MIDUS) is a national longitudinal study among 25–75 year-old American adults. The current study included 3572 Whites and 133 Blacks who were followed for 10 years from 1995 to 2004. Race, demographic characteristics (age and gender), socioeconomic status (educational attainment and personal income), and health insurance status were measured at baseline. Number of CMC was measured in 1995 and 2005. Linear regression models were used for data analysis. In the overall sample, having health insurance at baseline was inversely associated with an increase in CMC over the follow up period, net of covariates. Blacks and Whites differed in the magnitude of the effect of health insurance on CMC incidence, with a stronger protective effect for Blacks than Whites. In the U.S., health insurance protects individuals against incident CMC; however, the health return of health insurance may depend on race/ethnicity. This finding suggests that health insurance may better protect Blacks than Whites against developing more chronic diseases. Increasing Blacks’ access to health insurance may be a solution to eliminate health disparities, given they are at a relative advantage for gaining health from insurance. These findings are discussed in the context of Blacks’ diminished returns of socioeconomic resources. Future attempts should test replicability of these findings.

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.

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.

Autism and Families' Financial Burden: The Association With Health Insurance Coverage

2015 ◽  
Vol 120 (2) ◽  
pp. 166-175 ◽  
Author(s):  
Susan L. Parish ◽  
Kathleen C. Thomas ◽  
Christianna S. Williams ◽  
Morgan K. Crossman
Keyword(s):  
Health Insurance ◽  
Medical Expenditure Panel Survey ◽  
Financial Burden ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Autism Spectrum ◽  
Medical Expenditure ◽  
Outpatient Services ◽  
Raising Children

Abstract We examined the relationship between family financial burden and children's health insurance coverage in families (n  =  316) raising children with autism spectrum disorders (ASD), using pooled 2000–2009 Medical Expenditure Panel Survey data. Measures of family financial burden included any out-of-pocket spending in the previous year, and spending as a percentage of families' income. Families spent an average of $9.70 per $1,000 of income on their child's health care costs. Families raising children with private insurance were more than 5 times as likely to have any out-of-pocket spending compared to publicly insured children. The most common out-of-pocket expenditure types were medications, outpatient services, and dental care. This study provides evidence of the relative inadequacy of private insurance in meeting the needs of children with ASD.

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.

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