实施自动医疗补助资格更新与计划参与度的提高无关

Daniel B Nelson, Phillip M Singer, Vicki Fung
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引用次数: 0

摘要

让更多符合条件的个人参与医疗补助计划对于改善低收入人群获得医疗服务的机会至关重要。登记和更新资格的行政负担是参与的主要障碍。为减轻这些负担,《平价医疗法案》要求各州采用自动续保流程,利用现有数据库验证持续资格。到 2019 年,几乎所有的州都采用了自动续保,但人们对这一政策如何影响医疗补助参与率知之甚少。利用 2015-2019 年美国社区调查,我们发现各州非残疾、非老年成人和儿童的参与率差异很大,平均分别为 70.8% 和 90.7%。在符合医疗补助资格的成年人中,年轻成年人、男性、未婚人士、无子女家庭以及生活在非扩展州的成年人的参与率低于同类人群。各州采用自动续保的情况随时间而变化,但参与率与采用情况无关。这一发现可能反映了当前自动续保流程的局限性或资格续保流程之外的参保障碍,随着更多的州扩大医疗补助计划,以及大流行病时期的参保保护措施到期,解决这些问题将非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementing automated Medicaid eligibility renewals was not associated with higher levels of program participation
Increasing participation in Medicaid among eligible individuals is critical for improving access to care among low-income populations. The administrative burdens of enrolling and renewing eligibility are a major barrier to participation. To reduce these burdens, the Affordable Care Act required states to adopt automated renewal processes that use available databases to verify ongoing eligibility. By 2019, nearly all states adopted automated renewals, but little is known about how this policy affected Medicaid participation rates. Using the 2015-2019 American Community Survey, we found that participation rates among non-disabled, non-elderly adults and children varied widely by state with an average of 70.8% and 90.7%, respectively. Among Medicaid-eligible adults, participation was lower among younger adults, males, unmarried individuals, childless households, and those living in non-expansion states compared with their counterparts. State adoption of automated renewals varied over time, but participation rates were not associated with adoption. This finding could reflect limitations to current automated renewal processes or barriers to participation outside of the eligibility renewal process, which will be important to address as additional states expand Medicaid and pandemic-era protections on enrollment expire.
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