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Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

Zallman L, Nardin R, Sayah A, McCormick D - Int J Equity Health (2015)

Bottom Line: We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured.We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans.Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

View Article: PubMed Central - PubMed

Affiliation: Cambridge Health Alliance Department of Medicine, 1493 Cambridge St; Macht 420, Cambridge, MA, 02139, USA. lzallman@challiance.org.

ABSTRACT

Introduction: Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments.

Methods: We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured.

Results: We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured.

Conclusions: Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

No MeSH data available.


Related in: MedlinePlus

Satisfaction with and perceived affordability of insurance^. ^ p values are not displayed for non-significant comparisons. *Not applicable to low cost-sharing plans which have no premiums
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Fig2: Satisfaction with and perceived affordability of insurance^. ^ p values are not displayed for non-significant comparisons. *Not applicable to low cost-sharing plans which have no premiums

Mentions: Overall 88 % perceived their insurance as affordable and 93 % were satisfied with their insurance however, these proportions varied by insurance group (Fig. 2). Low CSP recipients were more likely to perceive their insurance was affordable and to be satisfied than both high CSP patients and the commercially insured. High CSP recipients were equally likely to report their insurance was affordable (78 % vs 77 %; p = 0.95) but were more likely to report being worried about affording their insurance premiums than were commercially insured (41 % vs 8 %; p <0.001). There were no differences in satisfaction between high CSP and the commercially insured.Fig. 2


Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

Zallman L, Nardin R, Sayah A, McCormick D - Int J Equity Health (2015)

Satisfaction with and perceived affordability of insurance^. ^ p values are not displayed for non-significant comparisons. *Not applicable to low cost-sharing plans which have no premiums
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4625927&req=5

Fig2: Satisfaction with and perceived affordability of insurance^. ^ p values are not displayed for non-significant comparisons. *Not applicable to low cost-sharing plans which have no premiums
Mentions: Overall 88 % perceived their insurance as affordable and 93 % were satisfied with their insurance however, these proportions varied by insurance group (Fig. 2). Low CSP recipients were more likely to perceive their insurance was affordable and to be satisfied than both high CSP patients and the commercially insured. High CSP recipients were equally likely to report their insurance was affordable (78 % vs 77 %; p = 0.95) but were more likely to report being worried about affording their insurance premiums than were commercially insured (41 % vs 8 %; p <0.001). There were no differences in satisfaction between high CSP and the commercially insured.Fig. 2

Bottom Line: We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured.We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans.Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

View Article: PubMed Central - PubMed

Affiliation: Cambridge Health Alliance Department of Medicine, 1493 Cambridge St; Macht 420, Cambridge, MA, 02139, USA. lzallman@challiance.org.

ABSTRACT

Introduction: Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments.

Methods: We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured.

Results: We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured.

Conclusions: Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

No MeSH data available.


Related in: MedlinePlus