Joint effects of Medicaid eligibility and fees on recession-linked declines in healthcare access and health status

IF 2 3区 医学 Q2 ECONOMICS
Health economics Pub Date : 2024-03-11 DOI:10.1002/hec.4823
Joseph Benitez, Kevin Callison, E. Kathleen Adams
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引用次数: 0

Abstract

Whether Medicaid can function as a safety net to offset health risks created by health insurance coverage losses due to job loss is conditional on (1) the eligibility guidelines shaping the pathway for households to access the program for temporary relief, and (2) Medicaid reimbursement policies affecting the value of the program for both the newly and previously enrolled. We find states with more expansive eligibility guidelines lowered the healthcare access and health risk of coverage loss associated with rising unemployment during the 2007–2009 Great Recession. Rises in cost-related barriers to care associated with unemployment were smallest in states with expansive eligibility guidelines and higher Medicaid-to-Medicare fee ratios. Similarly, states whose Medicaid programs had expansive eligibility guidelines and higher fees saw the smallest recession-linked declines in self-reported good health. Medicaid can work to stabilize access to health care during periods of joblessness. Our findings yield important insights into the alignment of at least two Medicaid policies (i.e., eligibility and payment) shaping Medicaid's viability as a safety net.

医疗补助资格和费用对与经济衰退相关的医疗服务和健康状况下降的共同影响。
医疗补助计划能否发挥安全网的作用,抵消因失业而失去医疗保险所带来的健康风险,取决于:(1)资格指南决定了家庭获得该计划临时救济的途径,以及(2)医疗补助计划的报销政策影响了该计划对新加入者和先前加入者的价值。我们发现,在 2007-2009 年经济大衰退期间,拥有更宽泛资格指南的州降低了与失业率上升相关的医疗保健获得性和失去保险的健康风险。在资格指南宽泛且医疗补助与医疗保险费用比率较高的州,与失业相关的医疗费用障碍上升幅度最小。同样,在那些医疗补助计划资格指南宽泛、费用较高的州,与经济衰退相关的自我健康状况良好人数的下降幅度也最小。医疗补助计划可以在失业期间稳定医疗服务的获得。我们的研究结果对至少两项医疗补助政策(即资格和支付)的协调产生了重要的启示,这两项政策决定了医疗补助作为安全网的可行性。
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来源期刊
Health economics
Health economics 医学-卫生保健
CiteScore
3.60
自引率
4.80%
发文量
177
审稿时长
4-8 weeks
期刊介绍: This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems. Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses. Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.
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