Coverage Disruptions and Transitions Across the ACA's Medicaid/Marketplace Income Cutoff.
J Gen Intern Med
; 37(14): 3570-3576, 2022 11.
Article
em En
| MEDLINE
| ID: mdl-35277806
ABSTRACT
BACKGROUND:
The Affordable Care Act takes a "patchwork" approach to expanding coverage Medicaid covers individuals with incomes 138% of the federal poverty level (FPL) in expansion states, while subsidized Marketplace insurance is available to those above this income cutoff.OBJECTIVE:
To characterize the magnitude of churning between Medicaid and Marketplace coverage and to examine the impact of the 138% FPL income cutoff on stability of coverage.DESIGN:
We measured the incidence of transitions between Medicaid and Marketplace coverage. Then, we used a differences-in-differences framework to compare insurance churning in Medicaid expansion and non-expansion states, before and after the ACA, among adults with incomes 100-200% of poverty.PARTICIPANTS:
Non-elderly adult respondents of the Medical Expenditure Panel Survey 2010-2018 MAINMEASURES:
The annual proportion of adults who (1) transitioned between Medicaid and Marketplace coverage; (2) experienced any coverage disruption. KEYRESULTS:
One million U.S. adults transitioned between Medicaid and Marketplace coverage annually. The 138% FPL cutoff in expansion states was not associated with an increase in insurance churning among individuals with incomes close to the cutoff.CONCLUSIONS:
Transitions between Medicaid and Marketplace insurance are uncommon-far lower than pre-ACA analyses predicted. The 138% income cutoff does not to contribute significantly to insurance disruptions.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Medicaid
/
Patient Protection and Affordable Care Act
Limite:
Adult
/
Humans
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article