Official websites use .gov
Secure .gov websites use HTTPS
Is ACA coverage affordable for low-income people?: perspectives from individuals in six cities
Is ACA coverage affordable for low-income people?: perspectives from individuals in six cities
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Tolbert, Jennifer, author
Rudowitz, Robin, author
Majerol, Melissa, author - Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
Kaiser Commission on Medicaid and the Uninsured, issuing body. - Publication:
- Menlo Park, CA : Henry J. Kaiser Family Foundation, April 2016
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Insurance Coverage -- economics
Insurance, Health -- economics
Medicaid -- economics
Poverty
United States
United States. - Genre(s):
- Technical Report
- Abstract:
- Millions of people have gained access to health insurance coverage under the Affordable Care Act (ACA) through Medicaid and the Marketplaces. While research shows that coverage improves access to care and promotes financial stability, issues around access and affordability remain, and are more acute for the low-income population. To learn more about how low-income individuals have fared with their new coverage, we conducted nine focus groups (three groups with Medicaid enrollees and six groups with low-income Marketplace enrollees) in six states (California, Florida, Maryland, Missouri, Ohio, and Virginia). Many participants were struggling financially and reported substantial debt (including medical debt). Many had ongoing physical and mental health needs and were accessing health services to treat those conditions. Following are key themes from the groups: (1) New coverage did not change underlying financial struggles and hardship due to medical debt incurred prior to gaining coverage. Many participants were stretched financially, had limited capacity to absorb unexpected costs, and struggled with finding secure employment in their area. (2) Medicaid stands up well for the lowest income participants in terms of ease of enrollment, out-of-pocket costs and affordability, and ability to find providers and access care. A small number of participants reported trouble affording care that wasn't covered (particularly for vision or dental) and difficulty finding some providers, including mental health providers. (3) Largely due to premium tax credits in the Marketplace, premiums were generally affordable, but out-of-pocket costs weighed heavily on Marketplace participants, especially those with high deductible plans. Many reported being overwhelmed by plan choices. Some were able to make trade-offs to purchase higher cost plans with lower deductibles to meet anticipated care needs, but not everyone was able to afford higher premiums. (4) The fear of unknown costs was a constant worry for many Marketplace participants. Many got bills for services they thought were covered, such as screenings, colonoscopies and mammograms when issues were discovered and treated. These bills caused many to avoid getting needed care. Marketplace participants also reported trouble affording care that wasn't covered by their plan, notably vision and some dental services. (5) Most participants had accessed care and were positive overall about new ACA coverage through Medicaid and the Marketplace. They were grateful that coverage was available to them, particularly those who had been previously ineligible for Medicaid or barred from private coverage due to pre-existing conditions. However, many Marketplace participants wanted coverage to be more affordable.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (13 pages, 1 unnumbered page)).
- NLM Unique ID:
- 101684750 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101684750