ABSTRACT
Some policy makers are proposing Medicaid work or community engagement requirements. Using national data, we found that 13.9 percent of new, nonelderly adult Medicaid beneficiaries in 2015-16 had experienced a decline in health before enrollment, and a similar percentage had had jobs that ended before they enrolled. These findings highlight the need for careful design of work requirement policies.
Subject(s)
Employment , Health Status , Medicaid , Databases, Factual , Humans , Medicaid/statistics & numerical data , Surveys and Questionnaires , United StatesABSTRACT
Over the past decade, employers have increasingly turned to high-deductible health plans (HDHPs) to limit health insurance premium growth. We used data from private-sector establishments for 2006 and 2016 from the Medical Expenditure Panel Survey-Insurance Component to examine trends in HDHP enrollment and heterogeneity in HDHPs by firm size. We studied insurance plan offerings along the following dimensions: whether employers fund accounts to help defray employees' out-of-pocket health care spending, the availability of non-HDHP plan choices, and single and family deductible levels. We extend the literature by examining these characteristics by detailed firm-size categories and by including all plans with deductibles that met or exceeded Internal Revenue Service thresholds to be qualified for health savings accounts. We found that in 2016, 78.0 percent of HDHP enrollees in the smallest firms (those with fewer than 25 employees) lacked an employer-funded account, compared to 35.2 percent in the largest firms (those with 1,000 or more employees). Overall, HDHP enrollees in the largest firms had significant advantages relative to workers in smaller firms along all of the dimensions examined.
Subject(s)
Deductibles and Coinsurance/trends , Health Benefit Plans, Employee/trends , Deductibles and Coinsurance/statistics & numerical data , Health Benefit Plans, Employee/statistics & numerical data , United StatesABSTRACT
Using longitudinal data from the Medical Expenditure Panel Survey-Household Component (MEPS-HC), we found that nonelderly respondents in 2014-15, following implementation of ACA coverage provisions, experienced shorter periods of being uninsured than did respondents in 2012-13 and 2013-14. This was particularly true for people with preexisting (or "high-risk-pool") health conditions.
Subject(s)
Health Expenditures , Insurance Coverage/statistics & numerical data , Medically Uninsured/statistics & numerical data , Patient Protection and Affordable Care Act/legislation & jurisprudence , Adult , Age Factors , Databases, Factual , Female , Health Care Reform , Humans , Incidence , Longitudinal Studies , Male , Middle Aged , Quality Control , Retrospective Studies , Time Factors , United States , Young AdultABSTRACT
New data for 2014-15 from the Medical Expenditure Panel Survey-Insurance Component longitudinal survey show substantial churn in insurance offers by small employers (those with fifty or fewer workers), with 14.6 percent of employers that offered insurance in 2014 having dropped it in 2015 and 5.5 percent of those that did not offer it adding coverage.
Subject(s)
Employment/statistics & numerical data , Health Benefit Plans, Employee/statistics & numerical data , Insurance, Health/economics , Health Services Accessibility/statistics & numerical data , Humans , Insurance Coverage/statistics & numerical data , Medically Uninsured/statistics & numerical data , United StatesABSTRACT
We used data from the Medical Expenditure Panel Survey-Household Component to examine coverage transitions for nonelderly US adults. We found that 71.5 percent of Marketplace enrollees in 2014 had some period of uninsurance before enrollment. In Medicaid expansion states, 17.4 percent of adults who were uninsured throughout 2013 gained Medicaid coverage in 2014, compared with only 5.6 percent in those states between 2012 and 2013.
Subject(s)
Health Insurance Exchanges/statistics & numerical data , Insurance Coverage/statistics & numerical data , Insurance, Health/statistics & numerical data , Adult , Humans , Longitudinal Studies , Medicaid/statistics & numerical data , Medically Uninsured/statistics & numerical data , Middle Aged , Patient Protection and Affordable Care Act/legislation & jurisprudence , Surveys and Questionnaires , United StatesABSTRACT
Newly available longitudinal survey data show that people who lacked health insurance in 2013 and gained coverage through Medicaid or the Marketplaces in 2014 were far more likely to obtain a usual source of care and receive preventive care services than their counterparts who remained uninsured in 2014.
Subject(s)
Health Services Accessibility/statistics & numerical data , Insurance Coverage/statistics & numerical data , Insurance, Health/statistics & numerical data , Medicaid/statistics & numerical data , Adult , Health Care Surveys , Humans , Longitudinal Studies , Medically Uninsured/statistics & numerical data , Middle Aged , Patient Protection and Affordable Care Act/legislation & jurisprudence , United StatesABSTRACT
We consider a compelling research question raised by the growing prevalence of overweight among adolescents: do overweight adolescents incur greater health care expenditures than adolescents of normal weight? To address this question, we use data from the Medical Expenditure Panel Survey (MEPS) and estimate a two-part, generalized linear model (GLM) of health spending. Considering separate models by gender, we find that overweight females incur $790 more in annual expenditures than those of normal weight but we find no expenditure differences by bodyweight for males. We find that mental health spending is associated with part of the disparity in expenditures for adolescent females but establishing causality between mental health problems and weight-related health expenditure differences is challenging.
Subject(s)
Health Expenditures/trends , Overweight/economics , Overweight/epidemiology , Adolescent , Body Mass Index , Child , Female , Humans , Male , Nutrition Surveys , United States/epidemiology , Young AdultABSTRACT
Using data from the Medical Expenditure Panel Surveys for 1997 and 2005, spanning the eight-year period after enactment of the State Children's Health Insurance Program (SCHIP), we examine whether the composition of insurance coverage has changed for working families. Public coverage has played an increasingly important role for working families with children. For families without access to job-based insurance, roughly two-thirds of single-parent and over half of two-parent families with children had at least one family member covered by public insurance in 2005. Among families with access to job-based insurance, nearly half of minority single-parent families had at least one family member with public coverage.