The Effects of State Medicaid Expansion on Low-Income Individuals' Access to Health Care: Multilevel Modeling
DC Field | Value | Language |
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dc.contributor.author | Choi, Sunha | - |
dc.contributor.author | Lee, Sungkyu | - |
dc.contributor.author | Matejkowski, Jason | - |
dc.date.available | 2019-03-13T01:43:44Z | - |
dc.date.created | 2018-09-12 | - |
dc.date.issued | 2018-06 | - |
dc.identifier.issn | 1942-7891 | - |
dc.identifier.uri | http://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/31637 | - |
dc.description.abstract | This study aimed to examine how states' Medicaid expansion affected insurance status and access to health care among low-income expansion state residents in 2015, the second year of the expansion. Data from the 2012 and 2015 Behavioral Risk Factor Surveillance System were linked to state-level data. A nationally representative sample of 544,307 adults (ages 26-64 years) from 50 states and Washington, DC were analyzed using multilevel modeling. The results indicate substantial increases in health care access between 2012 and 2015 among low-income adults in Medicaid expansion states. The final conditional multilevel models with low-income adults who had income at or below 138% of the poverty line indicate that, after controlling for individual- and state-level covariates, those who resided in the Medicaid expansion states were more likely to have health insurance (OR=1.97, P<.001), have a usual source of care (OR=1.37, P<.01), and receive a routine checkup (OR=1.24, P<.01), and were less likely to not see a doctor because of cost (OR=0.66, P<.001) compared with low-income residents in non-expansion states in 2015. Moreover, the significant interaction terms indicate that adults living in non-expansion states with income below 100% of the poverty line are the most vulnerable compared with their counterparts in expansion states and with those with income between 100%-138% of the poverty line. This study demonstrates that state-level Medicaid expansion improved health care access among low-income US residents. However, residents with income below 100% of the poverty line in non-expansion states were disproportionately negatively affected by states' decision to not expand Medicaid coverage. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | MARY ANN LIEBERT, INC | - |
dc.relation.isPartOf | POPULATION HEALTH MANAGEMENT | - |
dc.subject | INSURANCE-COVERAGE | - |
dc.subject | PREVENTIVE SERVICES | - |
dc.subject | YOUNG-ADULTS | - |
dc.subject | ACT | - |
dc.subject | US | - |
dc.subject | IMPACTS | - |
dc.subject | MATTER | - |
dc.subject | COSTS | - |
dc.title | The Effects of State Medicaid Expansion on Low-Income Individuals' Access to Health Care: Multilevel Modeling | - |
dc.type | Article | - |
dc.identifier.doi | 10.1089/pop.2017.0104 | - |
dc.type.rims | ART | - |
dc.identifier.bibliographicCitation | POPULATION HEALTH MANAGEMENT, v.21, no.3, pp.235 - 244 | - |
dc.description.journalClass | 1 | - |
dc.identifier.wosid | 000434262000012 | - |
dc.identifier.scopusid | 2-s2.0-85048162574 | - |
dc.citation.endPage | 244 | - |
dc.citation.number | 3 | - |
dc.citation.startPage | 235 | - |
dc.citation.title | POPULATION HEALTH MANAGEMENT | - |
dc.citation.volume | 21 | - |
dc.contributor.affiliatedAuthor | Lee, Sungkyu | - |
dc.type.docType | Article | - |
dc.description.isOpenAccess | N | - |
dc.subject.keywordAuthor | Affordable Care Act | - |
dc.subject.keywordAuthor | Medicaid expansion | - |
dc.subject.keywordAuthor | uninsured | - |
dc.subject.keywordAuthor | access to health care | - |
dc.subject.keywordPlus | INSURANCE-COVERAGE | - |
dc.subject.keywordPlus | PREVENTIVE SERVICES | - |
dc.subject.keywordPlus | YOUNG-ADULTS | - |
dc.subject.keywordPlus | ACT | - |
dc.subject.keywordPlus | US | - |
dc.subject.keywordPlus | IMPACTS | - |
dc.subject.keywordPlus | MATTER | - |
dc.subject.keywordPlus | COSTS | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
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