Patterns and Reasons for Being Uninsured Among Sexual Minority Adults Before and After the Affordable Care Act Implementation.

IF 3.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

LGBT health Pub Date : 2024-04-24 DOI:10.1089/lgbt.2023.0166

Zhigang Xie, K. Terrell, Juhan Lee, Ryan Suk, Young-Rock Hong

引用次数: 0

Abstract

Purpose: We aimed to identify the self-reported reasons for being uninsured and sociodemographic factors associated with uninsurance among lesbian, gay, or bisexual (LGB) adults before and after the Affordable Care Act (ACA). Methods: We analyzed the 2013-2018 National Health Interview Survey data using multivariable logistic regression models to estimate the odds of being uninsured and the prevalence of self-reported reasons for not having insurance among LGB adults aged 18-64 years. Results: The study included 2124 LGB adults. The weighted uninsured rate decreased significantly from 19.6% in 2013 to 13.2% in 2017-2018 (odds ratio 0.61; 95% confidence interval 0.47-0.78). The primary reason cited for not having insurance post-ACA was similar to pre-ACA, with cost-related factors being the most commonly reported (31.5%). Conclusion: The overall uninsured rate decreased among LGB adults from 2013 to 2018, whereas disparities across subpopulations remained. Cost-related factors remained significant barriers to obtaining insurance coverage.

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平价医疗法案》实施前后性少数群体成年人无保险的模式和原因。

目的：我们旨在确定在《平价医疗法案》（ACA）实施前后，女同性恋、男同性恋或双性恋（LGB）成年人自我报告的未参保原因以及与未参保相关的社会人口因素。方法：我们使用多变量逻辑回归模型分析了 2013-2018 年全国健康访谈调查数据，以估计 18-64 岁 LGB 成年人中未投保的几率以及自我报告的未投保原因的流行率。研究结果该研究包括 2124 名男女同性恋、双性恋和变性者成年人。加权未投保率从2013年的19.6%大幅降至2017-2018年的13.2%（几率比0.61；95%置信区间0.47-0.78）。ACA后没有保险的主要原因与ACA前相似，成本相关因素是最常见的报告原因（31.5%）。结论：从 2013 年到 2018 年，女同性恋、男同性恋、双性恋和变性者成年人的总体无保险率有所下降，但各亚人群之间的差异依然存在。与费用相关的因素仍然是获得保险的重大障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LGBT health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -

CiteScore

6.60

自引率

6.20%

发文量

期刊介绍： LGBT Health is the premier peer-reviewed journal dedicated to promoting optimal healthcare for millions of sexual and gender minority persons worldwide by focusing specifically on health while maintaining sufficient breadth to encompass the full range of relevant biopsychosocial and health policy issues. This Journal aims to promote greater awareness of the health concerns particular to each sexual minority population, and to improve availability and delivery of culturally appropriate healthcare services. LGBT Health also encourages further research and increased funding in this critical but currently underserved domain. The Journal provides a much-needed authoritative source and international forum in all areas pertinent to LGBT health and healthcare services. Contributions from all continents are solicited including Asia and Africa which are currently underrepresented in sex research.