How Has Access to Care for Medi-Cal Enrollees Fared Relative to Employer-Sponsored Insurance 4 Years After the Affordable Care Act Expansion?
J Gen Intern Med
; 37(13): 3338-3345, 2022 10.
Article
en En
| MEDLINE
| ID: mdl-35091914
ABSTRACT
BACKGROUND:
The number of Californians covered by Medi-Cal increased more than 50% between 2013 and 2018, largely due to expansion under the Affordable Care Act (ACA). This rapid expansion of Medicaid rolls prompted concerns that Medi-Cal enrollees would face greater difficulty accessing health care.OBJECTIVE:
Examine whether gaps in access to care between Medi-Cal and employer-sponsored insurance (ESI) present in 2013 (prior to ACA implementation) had changed by 2018 (several years post implementation).DESIGN:
Secondary analysis of data from the 2013 and 2018 California Health Interview Survey. The sample included adults of ages 18-64 insured all year and covered by ESI or Medi-Cal at time of interview. Logistic regressions were used to examine variation across years in the association between access to care and insurance type. MAINMEASURES:
Five access to care outcomes were assessed no usual source of care, not accepted as new patient in past year, insurance not accepted in past year, delayed medical care in past year, and difficulty getting timely appointment. The main predictors of interest were type of insurance (Medi-Cal or ESI) and survey year (2013 or 2018). KEYRESULTS:
The association between insurance type and access to care changed significantly over time for threeoutcomes:
not accepted as new patient in past year (OR = 0.55, 95% CI = 0.32-0.97), delayed medical care in past year (OR = 1.55, 95% CI = 1.06-2.25), and difficulty getting timely appointment (OR = 0.41, 95% CI = 0.23-0.74). Predicted probabilities indicate gaps between Medi-Cal and ESI narrowed for not accepted as new patient in past year and difficulty getting timely appointment, but widened for delayed medical care.CONCLUSIONS:
Despite the rapid expansion in the number of Californians covered by Medi-Cal, most gaps in access to care between Medi-Cal and ESI enrollees improved or did not significantly change between 2013 and 2018.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Medicaid
/
Patient Protection and Affordable Care Act
Tipo de estudio:
Prognostic_studies
Límite:
Adolescent
/
Adult
/
Humans
/
Middle aged
País como asunto:
America do norte
Idioma:
En
Año:
2022
Tipo del documento:
Article