Analyzing patient choices for routine procedures in the United States vs overseas before and after the affordable care act: a case study

2016 ◽  
Vol 5 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Sameer Kumar ◽  
Muer Yang
Keyword(s):  
United States ◽  
Affordable Care Act ◽  
The United States ◽  
Before And After ◽  
The Affordable Care Act ◽  
Routine Procedures

Change in stage of presentation of head and neck cancer in the United States before and after the affordable care act

2020 ◽  
Vol 67 ◽  
pp. 101763
Author(s):  
Neelima Panth ◽  
Justin M. Barnes ◽  
Matthew C. Simpson ◽  
Eric Adjei Boakye ◽  
Rosh K.V. Sethi ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Affordable Care Act ◽  
The United States ◽  
Before And After ◽  
The Affordable Care Act

scholarly journals Health Insurance Coverage before and after the Affordable Care Act in the USA

Sci ◽  
2021 ◽  
Vol 3 (2) ◽  
pp. 25
Author(s):  
Jesse Patrick ◽  
Philip Q. Yang
Keyword(s):  
Health Insurance ◽  
National Health ◽  
Affordable Care Act ◽  
The United States ◽  
Insurance Status ◽  
Health Insurance Status ◽  
Full Implementation ◽  
Before And After ◽  
The Affordable Care Act ◽  
Partial Implementation

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.

The Impact of the Affordable Care Act Medicaid Expansions on the Sources of Health Insurance Coverage of Undergraduate Students in the United States

2021 ◽  
pp. 107755872110158
Author(s):  
Priyanka Anand ◽  
Dora Gicheva
Keyword(s):  
United States ◽  
Health Insurance ◽  
Undergraduate Students ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Medicaid Expansions

This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions—that is, some students substituted their private and employer-sponsored coverage for Medicaid.

Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care

2021 ◽  
pp. 1-9
Author(s):  
Jacob K. Greenberg ◽  
Derek S. Brown ◽  
Margaret A. Olsen ◽  
Wilson Z. Ray
Keyword(s):  
United States ◽  
Spine Surgery ◽  
Surgical Procedures ◽  
Affordable Care Act ◽  
Surgical Care ◽  
The United States ◽  
Medicaid Expansion ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
The Impact

OBJECTIVE The Affordable Care Act expanded Medicaid eligibility in many states, improving access to some forms of elective healthcare in the United States. Whether this effort increased access to elective spine surgical care is unknown. This study’s objective was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. METHODS This study evaluated elective spine surgical procedures performed from 2011 to 2016 and included in the all-payer State Inpatient Databases of 10 states that expanded Medicaid access in 2014, as well as 4 states that did not expand Medicaid access. Adult patients aged 18–64 years who underwent elective spine surgery were included. The authors used a quasi-experimental difference-in-difference design to evaluate the impact of Medicaid expansion on hospital procedure volume and payer mix, independent of time-dependent trends. Subgroup analysis was conducted that stratified results according to cervical fusion, thoracolumbar fusion, and noninstrumented surgery. RESULTS The authors identified 218,648 surgical procedures performed in 10 Medicaid expansion states and 118,693 procedures performed in 4 nonexpansion states. Medicaid expansion was associated with a 17% (95% CI 2%–35%, p = 0.03) increase in mean hospital spine surgical volume and a 23% (95% CI −0.3% to 52%, p = 0.054) increase in Medicaid volume. Privately insured surgical volumes did not change significantly (incidence rate ratio 1.13, 95% CI −5% to 34%, p = 0.18). The increase in Medicaid volume led to a shift in payer mix, with the proportion of Medicaid patients increasing by 6.0 percentage points (95% CI 4.1–7.0, p < 0.001) and the proportion of private payers decreasing by 6.7 percentage points (95% CI 4.5–8.8, p < 0.001). Although the magnitude of effects varied, these trends were similar across procedure subgroups. CONCLUSIONS Medicaid expansion under the Affordable Care Act was associated with an economically and statistically significant increase in spine surgery volume and the proportion of surgical patients with Medicaid insurance, indicating improved access to care.

Conclusion

2020 ◽  
pp. 223-226
Author(s):  
Dan Royles
Keyword(s):  
Climate Change ◽  
United States ◽  
Health Equity ◽  
Affordable Care Act ◽  
The United States ◽  
First Year ◽  
Communities Of Color ◽  
History Of ◽  
The Affordable Care Act ◽  
Hiv Aids

This chapter considers what it means to write the history of a crisis that has not yet ended, and briefly traces connections among the stories told in previous chapters. It connects these stories to the ongoing fight for health equity in the United States, including the author’s involvement in the fight to preserve the Affordable Care Act in the first year of Donald Trump’s presidency. Finally, it compares HIV/AIDS to climate change, as both are existential crises that will disproportionately affect poor communities of color.

scholarly journals PIN71 VACCINATION AND POTENTIAL MISSED OPPORTUNITIES AMONG ADULTS IN THE UNITED STATES DURING THE AFFORDABLE CARE ACT ERA

2019 ◽  
Vol 22 ◽  
pp. S205-S206
Author(s):  
E. Aris ◽  
M. Montourcy ◽  
E. Esterberg ◽  
S.K. Kurosky ◽  
S. Poston ◽  
...  
Keyword(s):  
United States ◽  
Affordable Care Act ◽  
The United States ◽  
Missed Opportunities ◽  
The Affordable Care Act

scholarly journals The adult vaccination landscape in the United States during the Affordable Care Act era: Results from a large retrospective database analysis

Vaccine ◽  
2020 ◽  
Vol 38 (14) ◽  
pp. 2984-2994 ◽  
Author(s):  
Emmanuel Aris ◽  
Marion Montourcy ◽  
Elizabeth Esterberg ◽  
Samantha K. Kurosky ◽  
Sara Poston ◽  
...  
Keyword(s):  
United States ◽  
Affordable Care Act ◽  
The United States ◽  
Database Analysis ◽  
Adult Vaccination ◽  
Retrospective Database Analysis ◽  
The Affordable Care Act ◽  
Retrospective Database

What Is the Affordable Care Act a Case of? Understanding the ACA through the Comparative Method

2020 ◽  
Vol 45 (4) ◽  
pp. 677-691
Author(s):  
Holly Jarman ◽  
Scott L. Greer
Keyword(s):  
United States ◽  
Health Care ◽  
Welfare State ◽  
Affordable Care Act ◽  
Strong Support ◽  
The United States ◽  
The Us ◽  
The Affordable Care Act ◽  
Shed Light ◽  
The Welfare State

Abstract International comparisons of US health care are common but mostly focus on comparing its performance to peers or asking why the United States remains so far from universal coverage. Here the authors ask how other comparative research could shed light on the unusual politics and structure of US health care and how the US experience could bring more to international conversations about health care and the welfare state. After introducing the concept of casing—asking what the Affordable Care Act (ACA) might be a case of—the authors discuss different “casings” of the ACA: complex legislation, path dependency, demos-constraining institutions, deep social cleavages, segmentalism, or the persistence of the welfare state. Each of these pictures of the ACA has strong support in the US-focused literature. Each also cases the ACA as part of a different experience shared with other countries, with different implications for how to analyze it and what we can learn from it. The final section discusses the implications for selecting cases that might shed light on the US experience and that make the United States look less exceptional and more tractable as an object of research.

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