scholarly journals Access to Gynecologic Oncologists in Ohio: The Role of Insurance Marketplaces and the Patient Protection and Affordable Care Act

2020 ◽  
Vol I (1) ◽  
pp. 22-25
Author(s):  
Bogna N. Brzezinska
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Gynecologic Oncology ◽  
Gynecologic Oncologist ◽  
Patient Protection ◽  
Access To Health ◽  
The Affordable Care Act ◽  
Improve Access

Background The Affordable Care Act was passed in 2010, which provided a platform for states to develop insurance marketplaces. The goal of this legislation was to improve insurance coverage by providing more affordable options to patients. One metric of the Affordable Care Act was to improve access to comprehensive cancer care. Objective To identify to the effect of the Affordable Care Act on access to Gynecologic Oncologists in Ohio. Study design The Patient Protection and Affordable Health Care Act increased access to health insurance in Ohio, through Medicaid expansion and creation of a healthcare marketplace. We accessed information on access and usage of the healthcare marketplace in Ohio through Healthinsurance.org. We identified Gynecologic Oncology practices in Ohio through the Society of Gynecologic Oncology, and confirmed these practices by telephone. We communicated with each practice and identified which practices took marketplace health insurance. We also gathered information on changes in usage from 2014-2018. We then used descriptive statistics to identify access to a Gynecologic Oncologist though these exchanges. Results In 2017, there were 238,843 people enrolled in marketplace insurance (2% of the Ohio population). We identified 11 practices in Ohio with 39 Gynecologic Oncologists, and 11 marketplace insurance providers. Of these insurers, 7 could be clearly identified as providing access to 5 different Gynecologic Oncology practices. Of the 11 practices, 5 were confirmed to accept marketplace insurance (46%). Interestingly, 3 practices were unsure whether they took patients on marketplace insurance (27%), and 3 definitively did not take patients on marketplace insurance (27%). Each practice varied with how many exchanges they accepted, with 4 out of 5 accepting insurance through more than one insurer. Conclusions About half of the Gynecologic Oncology practices in Ohio accepted insurance through the insurance marketplace, which may limit patient access to a Gynecologic Oncologist.

scholarly journals The Role of Limited English Proficiency and Access to Health Insurance and Health Care in the Affordable Care Act Era

Health Equity ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 509-517
Author(s):  
Andriana M. Foiles Sifuentes ◽  
Monica Robledo Cornejo ◽  
Nien Chen Li ◽  
Maira A. Castaneda-Avila ◽  
Jennifer Tjia ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Limited English Proficiency ◽  
English Proficiency ◽  
Access To Health ◽  
The Affordable Care Act

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.

Public Opinion

2019 ◽  
pp. 150-181
Author(s):  
Rachel VanSickle-Ward ◽  
Kevin Wallsten
Keyword(s):  
Public Opinion ◽  
Health Insurance ◽  
Political Parties ◽  
Birth Control ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Public Support ◽  
Health Insurance Coverage ◽  
The Affordable Care Act ◽  
The 1950S

Chapter 8 describes the contours of public support for access to birth control over the last 60 years and for the contraceptive mandate of the Affordable Care Act (ACA) between 2011 and 2014. Drawing on data from numerous polling organizations, this chapter shows that majorities of both political parties, both genders, and all races and religious affiliations have had stable and supportive opinions on whether women should have access to birth control and whether contraceptives are morally acceptable since at least the 1950s. Our analysis also reveals, however, that large partisan, gender, and “God-based” gaps in public support for requiring health insurance coverage of contraceptives developed as a result of the 2012 debate over the ACA’s birth control mandate. The divisions in public opinion driven by the competing accusations of a “war on women” and a “war on religion” persist today.

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.

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