Association of Medicaid expansion with health insurance coverage by marital status and sex

Stimpson, Jim P.; Pintor, Jessie Kemmick; Wilson, Fernando A.

doi:10.1371/journal.pone.0223556

Cited by 8 publications

(9 citation statements)

References 31 publications

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“…Indeed, supplemental analysis that tested the associations between Medicaid expansion and insurance coverage showed that both women and men residing in states that did not expand Medicaid during the study period were more likely to be uninsured. However, restrictions in Medicaid eligibility have been shown to disproportionately affect women's barriers to health care access and subsequent health (Margerison et al 2020;Stimpson, Pintor, and Wilson 2019). We may not have observed such difference because men and women reported similar rates of being insured in the current sample.…”

Section: Summary Of Findings and Connections To Existing Researchmentioning

confidence: 65%

State–Level Sexism and Gender Disparities in Health Care Access and Quality in the United States

et al. 2021

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In this investigation, we examined the associations between state-level structural sexism—a multidimensional index of gender inequities across economic, political, and cultural domains of the gender system—and health care access and quality among women and men in the United States. We linked administrative data gauging state-level gender gaps in pay, employment, poverty, political representation, and policy protections to individual-level data on health care availability, affordability, and quality from the national Consumer Survey of Health Care Access (2014–2019; N = 24,250). Results show that higher state-level sexism is associated with greater inability to access needed health care and more barriers to affording care for women but not for men. Furthermore, contrary to our hypothesis, women residing in states with higher state-level sexism report better quality of care than women in states with lower levels of sexism. These findings implicate state-level sexism in perpetuating gender disparities in health care.

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Section: Summary Of Findings and Connections To Existing Researchmentioning

confidence: 65%

State–Level Sexism and Gender Disparities in Health Care Access and Quality in the United States

et al. 2021

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“…31,32 In addition, married individuals tend to have higher insurance coverage and relatively good financial support from their families compared to unmarried individuals, which improves their adherence to colonoscopy. 29,33 The compliance with colonoscopy was significantly higher among individuals with a preliminary positive result who had a history of polyps, symptoms of hematochezia, or chronic diarrhea. These three risk factors are overt symptoms that individuals can directly perceive and that may cause personal psychological and physical discomfort.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported that individuals usually choose spouses with similar health‐related attitudes and behaviors 30 and that the lifestyles of married individuals are more likely to be healthy and regular 31,32 . In addition, married individuals tend to have higher insurance coverage and relatively good financial support from their families compared to unmarried individuals, which improves their adherence to colonoscopy 29,33 …”

Section: Discussionmentioning

confidence: 99%

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Factors associated with adherence to colonoscopy among individuals who were positive in the preliminary screening for colorectal neoplasms

Wang

et al. 2022

Cancer Medicine

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Objectives This study aimed to investigate the potential factors associated with adherence to colonoscopy among participants who were preliminarily screened positive in a community‐based colorectal cancer screening program in China. Methods This study analyzed data from 1219 out of 6971 community residents who were identified as positive cases by the well‐validated high‐risk factor questionnaire (HRFQ) or fecal immunochemical test (FIT) in the preliminary screening stage for colorectal neoplasms. Patients showing adherence to colonoscopy were defined as those who received positive results in a preliminary screening for colorectal neoplasms and later received a colonoscopy examination as required. The associations of social‐demographic factors, lifestyle behaviors, history of diabetes, body mass index (BMI), and risk factors in the HRFQ with adherence to colonoscopy were evaluated using logistic regression models. Results Among 1219 participants who preliminarily screened positive, the top five risk factors reported by the participants were chronic constipation (25.9%), hematochezia (23.5%), family history of CRC in first‐degree relatives (22.1%), chronic diarrhea (21.8%), and history of polyps (16.6%). Around 14.2% of participants who preliminarily screened positive reported three or more risk factors, and the proportion was 26.2% among participants who were positive according to both HRFQ and FIT. Among all participants who were preliminarily screened positive, the multivariable results showed that those who were married (OR = 1.58, 95% CI: 1.12, 2.25, p = 0.01), had chronic diarrhea (OR = 1.34, 95% CI: 1.00, 1.78, p = 0.047), and had a positive FIT (OR = 1.60, 95% CI: 1.21, 2.10, p < 0.001 for patients who were negative according to HRFQ but positive according to FIT; OR = 2.12, 95% CI: 1.33, 2.78, p = 0.002 for patients who were positive for both HRFQ and FIT) were more likely to adhere to colonoscopy, while participants with a history of cancer (OR: 0.50, 95% CI: 0.31, 0.79, p = 0.003) were less likely to adhere to colonoscopy. The results among participants who were tested positive according to only HRFQ were similar to those among all participants who were tested positive according to HRFQ or FIT. However, among participants who were tested positive according to only FIT, we only found that those who were married (OR = 2.52, 95% CI: 1.08, 5.90, p = 0.033) had a higher odds of adhering to colonoscopy, while those with a history of diabetes (OR = 0.35, 95% CI: 0.13, 0.96, p = 0.042) were less likely to adhere to colonoscopy. Conclusion Our findings provide evidence supporting the development of tailored interventional strategies that aim to improve adherence to colonoscopy for individuals with a high risk of colorectal neoplasms. Both barriers and facilitators associated with adherence to colonoscopy should be considered in supportive systems and health policies. However, further well‐designed prospective studies are warranted to confirm our findings.

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“…young mothers including pregnant women, veterans, people with disabilities, people with obesity, smokers, and immigrants) [ 14 – 20 ], disease conditions (i.e. cancers, AIDS and mental diseases) [ 21 – 30 ], socio-demographics [ 31 , 32 ], and healthcare services (i.e. inpatient, outpatient and preventive services) [ 33 – 36 ], after the policy was implemented.…”

Section: Introductionmentioning

confidence: 99%

Effects of medicaid expansion on poverty disparities in health insurance coverage

Lin

Monnette

Shi

2021

Int J Equity Health

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Background More than 30 states have either expanded Medicaid or are actively considering expansion. The coverage gains from this policy are well documented, however, the impacts of its increasing coverage on poverty disparity are unclear at the national level. Method American Community Survey (2012–2018) was used to examine the effects of Medicaid expansion on poverty disparity in insurance coverage for nonelderly adults in the United States. Differences-in-differences-in-differences design was used to analyze trends in uninsured rates by poverty levels: (1) < 138 %, (2) 138–400 % and (3) > 400 % federal poverty level (FPL). Results Compared with uninsured rates in 2012, uninsured rates in 2018 decreased by 10.75 %, 6.42 %, and 1.11 % for < 138 %, 138–400 %, and > 400 % FPL, respectively. From 2012 to 2018, > 400 % FPL group continuously had the lowest uninsured rate and < 138 % FPL group had the highest uninsured rate. Compared with ≥ 138 % FPL groups, there was a 2.54 % reduction in uninsured risk after Medicaid expansion among < 138 % FPL group in Medicaid expansion states versus control states. After eliminating the impact of the ACA market exchange premium subsidy, 3.18 % decrease was estimated. Conclusion Poverty disparity in uninsured rates improved with Medicaid expansion. However, < 138 % FPL population are still at a higher risk for being uninsured.

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Association of Medicaid expansion with health insurance coverage by marital status and sex

Cited by 8 publications

References 31 publications

State–Level Sexism and Gender Disparities in Health Care Access and Quality in the United States

State–Level Sexism and Gender Disparities in Health Care Access and Quality in the United States

Factors associated with adherence to colonoscopy among individuals who were positive in the preliminary screening for colorectal neoplasms

Effects of medicaid expansion on poverty disparities in health insurance coverage

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