Inequalities in Young Adult Health Insurance Coverage Post-federal Health Reform

Wisk, Lauren E.; Sharma, Niraj

doi:10.1007/s11606-018-4723-0

Cited by 17 publications

(30 citation statements)

References 35 publications

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“…Consistent with these studies, we found that the ACA was associated with an increase in HPV vaccine completion among females; however, our results show that both privatelyand publicly-insured females benefited from the policyincreasing vaccine completion by 4.3 and 5.7 percentage points, respectively. Although Lipton and Decker found no effect of the ACA on self-reported awareness of the HPV vaccine [15], increased insurance coverage and access to providers as a result of the ACA [23][24][25] may have resulted in an increased awareness of vaccination among providers for all young women. This is one of the first studies to evaluate the 2014 ACA-related health insurance reforms on HPV vaccine completion.…”

Section: Discussionmentioning

confidence: 99%

Associations between insurance-related affordable care act policy changes with HPV vaccine completion

et al. 2021

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Background Although all 11- or 12-year-olds in the US were recommended to receive a 3-dose series of the human papillomavirus (HPV) vaccine within a 12-month period prior to 2016, rates of completion of the HPV vaccine series remained suboptimal. The effects of the Affordable Care Act (ACA), including private insurance coverage with no cost-sharing and health insurance expansions, on HPV vaccine completion are largely unknown. The aim of this study was to examine the associations between the ACA’s 2010 provisions and 2014 insurance expansions with HPV vaccine completion by sex and health insurance type. Methods Using 2009–2015 public and private health insurance claims from Maine, New Hampshire, and Massachusetts, we identified 9-to-26-year-olds who had at least one HPV vaccine dose. We conducted a logistic regression model to examine the associations between the ACA policy changes with HPV vaccine completion (defined as receiving a 3-dose series within 12 months from the date of initiation) as well as interactions by sex and health insurance type. Results Over the study period, among females and males who initiated the HPV vaccine, 27.6 and 28.0%, respectively, completed the series within 12 months. Among females, the 2010 ACA provision was associated with a 4.3 percentage point increases in HPV vaccine completion for the privately-insured (0.043; 95% CI: 0.036–0.061) and a 5.7 percentage point increase for Medicaid enrollees (0.057; 95% CI: 0.032–0.081). The 2014 health insurance expansions were associated with a 9.4 percentage point increase in vaccine completion for females with private insurance (0.094; 95% CI: 0.082–0.107) and a 8.5 percentage point increase for Medicaid enrollees (0.085; 95% CI: 0.068–0.102). Among males, the 2014 ACA reforms were associated with a 5.1 percentage point increase in HPV vaccine completion for the privately-insured (0.051; 95% CI: 0.039–0.063) and a 3.4 percentage point increase for Medicaid enrollees (0.034; 95% CI: 0.017–0.050). In a sensitivity analysis, findings were similar with HPV vaccine completion within 18 months. Conclusions Despite low HPV vaccine completion overall, both sets of ACA provisions were associated with increases in completion among females and males. Our results suggest that expanding Medicaid across the remaining states could increase HPV vaccine completion among publicly-insured youth and prevent HPV-related cancers.

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Section: Discussionmentioning

confidence: 99%

Associations between insurance-related affordable care act policy changes with HPV vaccine completion

et al. 2021

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“…[1][2][3] Also, despite increases in coverage, large portions of this cohort remain uninsured or underinsured, putting them at greater risk for delayed treatment. 4 American young adults make up a large part of emergency visits in the United States. 5 Of these, injuries account for more than a third of the visits.…”

Section: Introductionmentioning

confidence: 99%

Facial Fractures in Young Adults: A National Retrospective Study

Povolotskiy

Youssef

Kaye

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: “Young adulthood” is a term used to define individuals falling within the 18- to 22-year-old age range. Injuries account for more than a third of emergency department visits in this population. A particular area of concern is accidents that lead to injuries of the facial bones because they can have long-term functional, aesthetic, and psychosocial impacts. As many as 30 million young adults participate in some sort of sport in the United States per year, and facial injuries from these activities are not uncommon and thus require further exploration. Methods: The National Electronic Injury Surveillance System was used to conduct a retrospective review to explore patterns of maxillofacial fractures in young adult patients between the ages of 18 and 22 years from 2004 through 2017. The data analyzed yielded information about patient demographics, diagnoses, and associated products. Results: A total of 3486 emergency department visits were included in the study. The most common facial fractures were nasal fractures (64.4%), mandible fractures (12.3%), and orbital fractures (6.1%). The most common causes of fractures were sports (55.48%), fixed structures (6.39%), and stairs or steps (5.60%). The top 3 sports associated with facial fractures were basketball (25.4%), baseball (11.6%), and football (10.4%). Conclusions: For young adult individuals, some sort of sporting activity is common outside of the National Collegiate Athletic Association. The overwhelming majority of facial fractures in this population were caused by sports, and the authors believe this issue warrants further exploration and discussion. According to the Centers for Disease Control and Prevention, an estimated 8.6 million sports- and recreation-related injuries occurred per year between 2011 and 2014. Despite ever growing research and guidelines into sports injury incidence and prevention, it is clear that sports are the cause of a large portion of maxillofacial fractures in the United States.

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“…Results from Lipton et al's study highlight that while the some policies may help improve insurance coverage, they may not be as effective in reducing disparities among subgroups-evident from differences in coverage rates after the implementation of the Dependent Coverage provision. McMorrow et al (2015), Wisk and Sharma (2019) also found that the 2014 Medicaid and Marketplace policies mitigated many of the disparities in health insurance coverage among socioeconomic groups. The researchers employed public-use data from the 2000-2016 NHIS to investigate inequalities in insurance coverage, insurance coverage type, and reason for being uninsured pre and post ACA policies (Wisk & Sharma, 2019).…”

Section: Review Of the Literature Medicaid Expansion And Young Adult ...mentioning

confidence: 96%

“…Thirty-seven states to date including the District of Columbia opted to expand Medicaid eligibility to their residents. A few recent studies have evaluated the effect of Medicaid expansion on the young adult population, focusing on health insurance coverage and health care access for all young adults (Griffith, 2019;Lipton et al, 2019;McMorrow et al, 2015;Wisk & Sharma, 2019). No research to date to the author's knowledge, however, has examined the policy's effect on the health and non-health outcomes of low-income young adults.…”

Section: Chapter 2: the Impact Of The Aca's Medicaid Expansion On The...mentioning

confidence: 99%

“…The four studies to date examining the effect of the 2014 Medicaid eligibility expansion on the outcomes of young adults found Medicaid expansion not only improved health insurance coverage and health care access among young adults (Griffith, 2019;Lipton et al, 2019;McMorrow et al, 2015;Wisk & Sharma, 2019), but was also more effective than the Dependent Coverage provision in narrowing existing socioeconomic (McMorrow et al, 2015;Wisk & Sharma, 2019) and racial/ethnic (Lipton et al, 2019) disparities. All four studies, however, do not isolate the effect of Medicaid expansion policy on the outcomes of low-income childless young adults-the subpopulation among young adults who belonged to this policy intervention's target population.…”

Section: Review Of the Literature Medicaid Expansion And Young Adult ...mentioning

confidence: 99%

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Three essays on the impact of public policies on the health and educational outcomes of young adults

Hamilton¹

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Young adulthood is a critical time in the life course when access to resources and opportunities help determine later in life outcomes. To contribute to the research on young adults, this dissertation uses restricted health and education data, as well as quasiexperimental and descriptive analyses to evaluate how two public polices improve outcomes for young adults. The first essay focuses on effects on young adults' health outcomes, while the second and third chapters focus on impacts to educational outcomes and opportunities. Together, these chapters highlight the important role public policies can play in improving outcomes for disadvantaged groups.

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Inequalities in Young Adult Health Insurance Coverage Post-federal Health Reform

Cited by 17 publications

References 35 publications

Associations between insurance-related affordable care act policy changes with HPV vaccine completion

Associations between insurance-related affordable care act policy changes with HPV vaccine completion

Facial Fractures in Young Adults: A National Retrospective Study

Three essays on the impact of public policies on the health and educational outcomes of young adults

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