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首页> 外文期刊>Health affairs >Effects Of The ACA's Health Insurance Marketplaces On The Previously Uninsured: A Quasi-Experimental Analysis
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Effects Of The ACA's Health Insurance Marketplaces On The Previously Uninsured: A Quasi-Experimental Analysis

机译：ACA的健康保险市场对以前无保险的影响：准实验分析

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Descriptive studies have suggested that the Affordable Care Act's (ACA's) health insurance Marketplaces improved access to care. However, no evidence from quasi-experimental studies is available to support these findings. We used longitudinal survey data to compare previously uninsured adults with incomes that made them eligible for subsidized Marketplace coverage (138-400 percent of the federal poverty level) to those who had employer-sponsored insurance before the ACA with incomes in the same range. Among the previously uninsured group, the ACA led to a significant decline in the uninsurance rate, decreased barriers to medical care, increased the use of outpatient services and prescription drugs, and increased diagnoses of hypertension, compared to a control group with stable employer-sponsored insurance. Changes were largest among previously uninsured people with incomes of 138-250 percent of poverty, who were eligible for the ACA's cost-sharing reductions. Our quasi-experimental approach provides rigorous new evidence that the ACA's Marketplaces led to improvements in several important health care outcomes, particularly among low-income adults.
机译：描述性研究表明，经济实惠的护理法案（ACA）的健康保险市场改善了护理机会。然而，没有准实验研究的证据可用于支持这些发现。我们使用了纵向调查数据来比较以前的未知成年人，其中包含有资格获得补贴市场覆盖范围（联邦贫困水平的138-400％）给那些在同一范围内收入的雇主赞助保险的人。在以前没有保险的集团中，ACA导致了无济率的显着下降，对医疗保健的障碍降低，增加了门诊服务和处方药的使用，以及高血压诊断，与具有稳定雇主赞助的对照组相比，高血压诊断保险。在以前没有保险的人中的贫困人数为138-250％的贫困人口中最大的变化是最大的，他们有资格获得ACA的费用分摊削减。我们的准实验方法提供了严格的新证据，即ACA的市场导致了几种重要的医疗保健结果，特别是在低收入成年人之间的改进。

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