Your browser doesn't support javascript.
Health Insurance Disruptions and Care Access and Affordability in the U.S.
Yabroff, K Robin; Zhao, Jingxuan; Halpern, Michael T; Fedewa, Stacey A; Han, Xuesong; Nogueira, Leticia M; Zheng, Zhiyuan; Jemal, Ahmedin.
  • Yabroff KR; Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia. Electronic address: robin.yabroff@cancer.org.
  • Zhao J; Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia.
  • Halpern MT; Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland.
  • Fedewa SA; Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia.
  • Han X; Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia.
  • Nogueira LM; Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia.
  • Zheng Z; Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia.
  • Jemal A; Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia.
Am J Prev Med ; 61(1): 3-12, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1240149
ABSTRACT

INTRODUCTION:

Health insurance is associated with better care in the U.S., but little is known about the associations of coverage disruptions (i.e., periods without insurance) with care access, receipt, and affordability.

METHODS:

Adults aged 18-64 years with current private (n=124,746), public (n=30,932), or no (n=31,802) insurance coverage were identified from the 2011-2018 National Health Interview Survey. Data were analyzed in 2020. Separate multivariable logistic regressions evaluated the associations of having coverage disruptions or being uninsured with care access, receipt, and affordability.

RESULTS:

Overall, 5.0% of currently insured adults with private and 10.7% with public insurance reported a coverage disruption in the previous year, representing nearly 9.1 million adults in 2018. Among currently uninsured, 24.9% reported coverage loss within the previous year, representing nearly 8.1 million adults in 2018. Among adults with current private or current public coverage, disruptions were associated with lower receipt of all preventive services (AOR=0.42, 95% CI=0.37, 0.46 and AOR=0.48, 95% CI=0.40, 0.58, respectively), with forgoing any needed care because of cost (AOR=4.79, 95% CI=4.44, 5.17 and AOR=4.28, 95% CI=3.86, 4.75), and with medication nonadherence because of cost (AOR=3.55, 95% CI=3.13, 4.03 and AOR=4.09, 95% CI=3.43, 4.88) compared with that among adults with continuous coverage (p<0.05). Longer disruptions among currently insured adults were significantly associated with worse care access, receipt, and affordability, with dose-response patterns. Currently uninsured adults, especially those with longer uninsured periods, reported significantly worse care access, receipt, and affordability than currently insured adults with coverage disruptions or continuous coverage.

CONCLUSIONS:

Findings highlight the importance of continuous insurance coverage; disruptions owing to the COVID-19 pandemic will likely have adverse consequences for care access and affordability.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Experimental Studies / Observational study Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Am J Prev Med Journal subject: Public Health Year: 2021 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Experimental Studies / Observational study Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Am J Prev Med Journal subject: Public Health Year: 2021 Document Type: Article