Implementing Federal Health Reform in the States: Who Is Included and Excluded and What Are Their Characteristics?

Fried, Brett; Pintor, Jessie Kemmick; Graven, Peter; Blewett, Lynn A.

doi:10.1111/1475-6773.12232

Cited by 9 publications

(12 citation statements)

References 19 publications

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“…The ACA fundamentally restructured the availability of health insurance in the United States. Since its enactment, adults—who are U.S. citizens or authorized residents—may gain health insurance through two newly established pathways (Fried et al 2014). The first is through the Medicaid expansion, which increased Medicaid eligibility to include not just parents but all adults with annual household income levels up to 138 percent of the federal poverty line (FPL) (Wachino, Artiga, and Rudowitz 2014).…”

Section: Decoupling Health Insurance From Historical Linkagesmentioning

confidence: 99%

The Institutional Determinants of Health Insurance: Moving Away from Labor Market, Marriage, and Family Attachments under the ACA

Gutiérrez

2018

Am Sociol Rev

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For more than a century, the American welfare state required working-age adults to access social welfare benefits through their labor market, marriage, and family attachments (Béland and Waddan 2017; Skocpol 1995). These social policy arrangements helped support employed, married, and parenting adults, but offered unemployed, unmarried, and childless adults little protection against key social risks (Hacker 2004). As labor market, marriage, and family outcomes are themselves highly stratified, the provision of social welfare benefits was unequal across gender, race and ethnicity, and education (Quadagno 2005). Recent changes to U.S. healthcare policy prompted by the Patient Protection and Affordable Care Act (ACA), however, provide adults with a new pathway for accessing a key form of social 811112A SRXXX10.

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Section: Decoupling Health Insurance From Historical Linkagesmentioning

confidence: 99%

The Institutional Determinants of Health Insurance: Moving Away from Labor Market, Marriage, and Family Attachments under the ACA

Gutiérrez

2018

Am Sociol Rev

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“…Nativity is another variable that affects health insurance coverage greatly because immigrants are less likely to be insured than the U.S.-born [19]. Fried et al found that immigration status had great impact on health insurance under the ACA, since immigrants potentially account for over 15% of uninsured non-elderly adults [20]. Research has shown that the foreign-born, especially recent immigrants, are on average healthier than the U.S.-born [21].…”

Section: Impact Of Nativitymentioning

confidence: 99%

“…Respondents who are currently married are more likely to have health insurance than those who are not currently married because of possible combined incomes and the need to provide health care coverage for the family [31]. The foreign-born are less likely to have health insurance than the U.S.-born partly because of a lack of resources and partly because of norms of health insurance in the home countries [20,22,23]. Non-U.S. citizens are less likely to have health insurance than U.S. citizens due to their lower degree of assimilation to U.S. culture and society [20].…”

Section: Hypothesesmentioning

confidence: 99%

“…The foreign-born are less likely to have health insurance than the U.S.-born partly because of a lack of resources and partly because of norms of health insurance in the home countries [20,22,23]. Non-U.S. citizens are less likely to have health insurance than U.S. citizens due to their lower degree of assimilation to U.S. culture and society [20]. People with more education are more likely to have health insurance than those with less education since education increases knowledge of the need for health insurance and resources [15].…”

Section: Hypothesesmentioning

confidence: 99%

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Health Insurance Coverage Before and After the Affordable Care Act

Patrick¹,

Yang²

2019

Sci

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The Affordable Care Act (ACA) is at the crossroads. It is important to evaluate the effectiveness of the ACA in order to make rational decisions about the ongoing healthcare reform, but existing research into its effect on health insurance status in the United States is insufficient and descriptive. Using data from the National Health Interview Surveys from 2009 to 2015, this study examines changes in health insurance status and its determinants before the ACA in 2009, during its partial implementation in 2010–2013, and after its full implementation in 2014 and 2015. The results of trend analysis indicate a significant increase in national health insurance rate from 82.2% in 2009 to 89.4% in 2015. Logistic regression analyses confirm the similar impact of age, gender, race, marital status, nativity, citizenship, education, and poverty on health insurance status before and after the ACA. Despite similar effects across years, controlling for other variables, youth aged 26 or below, the foreign-born, Asians, and other races had a greater probability of gaining health insurance after the ACA than before the ACA; however, the odds of obtaining health insurance for Hispanics and the impoverished rose slightly during the partial implementation of the ACA but somewhat declined after the full implementation of the ACA starting in 2014. These findings should be taken into account by the U.S. government in deciding the fate of the ACA.

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“…Medicaid expansion, however, does not apply to all individuals. An estimated 3.5 million non-elderly adults will be excluded from ACA Medicaid expansions and an additional 2 million from health insurance exchanges because of immigration status, as legal permanent residents living in the US for fewer than 5 years and unauthorized immigrants are not eligible for full Medicaid coverage (Fried et al 2014). …”

Section: Introductionmentioning

confidence: 99%

The ACA: Impacts on Health, Access, and Employment

Serakos

Wolfe

2016

Forum for Health Economics and Policy

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On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law. This comprehensive health care reform legislation sought to expand health care coverage to millions of Americans, control health care costs, and improve the overall quality of the health care system. The ACA required that all US citizens and legal residents have qualifying health insurance by 2014. In this paper we give readers a brief overview of the effects of the ACA based on recent research. We then turn our attention to the possibility of using the ACA expansion to answer important underlying questions, such as: To what extent does the holding of insurance lead to improvements in access to care? To what extent does the holding of coverage lead to improvements in health? In mental health? Are there likely general equilibrium effects on labor force participation, hours worked, employment setting, and indeed even the probability of marrying? By necessity, researchers’ ability to answer these questions depends on the availability of data, so we discuss current and potential data sources relevant for answering these questions. We also look to what has been studied about the health reform in Massachusetts and early Medicaid expansions to speculate what we can expect to learn about the effects of the ACA on these outcomes in the future.

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Implementing Federal Health Reform in the States: Who Is Included and Excluded and What Are Their Characteristics?

Abstract: Over 15 percent of income-eligible uninsured nonelderly adults will be potentially excluded from the ACA coverage expansions due to their immigration status. Policy makers must be careful to exclude ineligible nonelderly adults before estimating the impact of the ACA on coverage rates.

Cited by 9 publications

References 19 publications

The Institutional Determinants of Health Insurance: Moving Away from Labor Market, Marriage, and Family Attachments under the ACA

The Institutional Determinants of Health Insurance: Moving Away from Labor Market, Marriage, and Family Attachments under the ACA

Health Insurance Coverage Before and After the Affordable Care Act

The ACA: Impacts on Health, Access, and Employment

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