Financial Literacy and Consumer Choice of Health Insurance: Evidence from Low-Income Populations in the United States

2013 ◽  
Author(s):  
Sebastian Bauhoff ◽  
Katherine Grace Carman ◽  
Amelie C. Wuppermann
Getting By ◽  
2019 ◽  
pp. 329-428
Author(s):  
Helen Hershkoff ◽  
Stephen Loffredo

This chapter addresses the issue of health care for low-income people. The United States, virtually alone among developed nations, does not offer universal access to health care, leaving many millions of individuals without health insurance or other means of obtaining necessary medical services. In 2010, Congress enacted the landmark Patient Protection and Affordable Care Act (ACA)—popularly known as “Obamacare”—marking an important but incomplete response to the nation’s health care crisis. This chapter examines the ACA in detail, including its impact on Medicaid and Medicare, the major government health programs in the United States, its creation of Health Insurance Exchanges and tax credits to help low-income households obtain private health coverage, and the reform of private health insurance markets through a patient’s bill of rights, which, among other measures, prohibits insurance companies from refusing coverage for preexisting medical conditions. Perhaps the most critical aspect of the ACA was its expansion of Medicaid to cover virtually all low-income citizens (and certain immigrants) who do not qualify for other health coverage. Although several states opted out of the ACA’s Medicaid expansion, the Medicaid program nevertheless remains the largest single provider of health coverage in the United States. This chapter also provides a detailed description of Medicaid, its eligibility criteria and scope of coverage; the Child Health Insurance Program (CHIP), a government-funded health insurance program for children in households with too much income to qualify for Medicaid; and Medicare, the federal health insurance program for aged, blind, and disabled individuals.


2015 ◽  
Vol 37 (1) ◽  
pp. 40-45
Author(s):  
Georgia Beilmann ◽  
Ying-Jen Lin ◽  
Sabrina Perlman ◽  
Kimberly Ross ◽  
Michael Cavanaugh ◽  
...  

Health care in the United States is undergoing a radical restructuring, mandated in the Affordable Care Act (ACA), designed to improve access to care and increase the efficiency of our health care system. Key features include a revamped health insurance market and increased reliance on electronic technologies for buying insurance and tracking patient care. One goal of these changes is to reduce the unequal burden of disease carried by low-income racial/ethnic minorities. However, the long history of racial/ethnic health disparities in the United States raises concern for how diverse populations will be affected by these innovations. Applied anthropologists are well equipped to produce knowledge and insight to inform how changes are enacted and to maximize positive impact for vulnerable populations. Employing a holistic framework and an in-depth data collection strategy, anthropologists are especially adept at uncovering the insider's perspective. This adds important insight and nuance to understandings of how the ACA's health care innovations affect specific groups.


2012 ◽  
Vol 37 (1) ◽  
pp. 113-116 ◽  
Author(s):  
HB Waldman ◽  
D Cannella ◽  
SP Perlman

The proportion and numbers of children living in low income families and without health insurance continues to increase. The magnitude of these problems is considered at localized levels in terms of the impact on the use of dental services.


1974 ◽  
Vol 4 (4) ◽  
pp. 583-598 ◽  
Author(s):  
Thomas Bodenheimer ◽  
Steven Cummings ◽  
Elizabeth Harding

The private health insurance industry in the United States began as a money-collection mechanism for hospitals and doctors, and has evolved into an important profit-making sector of the economy. Blue Cross is dominated by hospital representatives and serves to channel money into the nation's hospitals. Physicians control Blue Shield and are its principal beneficiaries. And commercial insurance companies are closely linked to banks and industrial corporations through the country's large financial empires. Some effects of this elite control over the health insurance industry have been inadequate and distorted insurance coverage, discrimination against the elderly, the sick, and the poor, and rapidly rising medical costs. In addition, the control of Medicare and Medicaid by private insurance institutions has contributed to the enormous inflation produced by these programs. Though governments, consumers, and even the insurance industry itself are beginning to apply controls to the unprecedented medical inflation of the late 1960s, these controls tend to limit access to health care, especially for low-income people. Unless insurance companies are barred from the health care field and a public financing mechanism based on progressive taxation is introduced, health care will never be an equal right for everyone in the United States.


2017 ◽  
Vol 31 (4) ◽  
pp. 3-22 ◽  
Author(s):  
Jonathan Gruber

The United States has seen a sea change in the way that publicly financed health insurance coverage is provided to low-income, elderly, and disabled enrollees. When programs such as Medicare and Medicaid were introduced in the 1960s, the government directly reimbursed medical providers for the care that they provided, through a classic “single payer system.” Since the mid-1980s, however, there has been an evolution towards a model where the government subsidizes enrollees who choose among privately provided insurance options. In the United States, privatized delivery of public health insurance appears to be here to stay, with debates now focused on how much to expand its reach. Yet such privatized delivery raises a variety of thorny issues. Will choice among private insurance options lead to adverse selection and market failures in privatized insurance markets? Can individuals choose appropriately over a wide range of expensive and confusing plan options? Will a privatized approach deliver the promised increases in delivery efficiency claimed by advocates? What policy mechanisms have been used, or might be used, to address these issues? A growing literature in health economics has begun to make headway on these questions. In this essay, I discuss that literature and the lessons for both economics more generally and health care policymakers more specifically.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.


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