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Abstract
BackgroundIn recent years, policymakers have sought to reduce health disparities between the insured and uninsured through a federal health insurance expansion policy; however, disparities continue to persist among the insured population. One potential explanation is that the use of healthcare services varies by the type of health insurance coverage due to differences in the design of coverage. The aim of this study is to examine whether health insurance coverage type is associated with the structure and use of healthcare services.MethodsThe nationally representative Medical Expenditure Panel Survey and multinomial logistic regression are used to estimate the effects of different types of health coverage on the combinations of routine and emergency care sought and received.ResultsThe multinomial logistic regression analysis for the overall sample revealed privately insured respondents reported higher use of routine care only p < 0.01 and lower use of emergency room care only (− 2.13%; p < 0.01) than the uninsured. The publicly insured reported similar trends for use of routine care only (17.93%; p < 0.01) as the privately insured, as compared to the uninsured. Both the privately and publicly insured reported higher use of a mixture of care; however, publicly insured were more likely to use a mixture of care (8.57%, p < 0.01).ConclusionThe results show that health insurance is associated with higher use of the physician services, but does not promote the use of cost-effective schedules of care among the publicly insured.
Highlights
The Social Security Act Amendments (Pub L N. 89–97), passed in 1965, were designed to address the low rates of insurance among financially vulnerable households not receiving coverage from an employer by creating the Medicare insurance program for older adults over 65 and the Medicaid insurance program for low income mothers and children
(Pub L N. 111–148) reduced the uninsured rate across the population by allowing states to expand Medicaid to include low-income adults, providing premium subsidies to help improve the affordability of private health plans, and imposing an individual mandate requiring all persons not receiving government or employer-based insurance to retain coverage
Researchers in the US have documented that insurance status plays an important role in individual health, as the uninsured are the least likely to use preventative medical services, are the most likely to encounter financial barriers to access care, and report the highest rates of preventable hospitalizations [1,2,3,4,5,6,7]; less is known about how use of care varies by health insurance coverage type
Summary
In later years, coverage expansions have widened to include the remainder of the uninsured population using both a public and private mechanism. 111–148) reduced the uninsured rate across the population by allowing states to expand Medicaid to include low-income adults, providing premium subsidies to help improve the affordability of private health plans, and imposing an individual mandate requiring all persons not receiving government or employer-based insurance to retain coverage. Researchers in the US have documented that insurance status plays an important role in individual health, as the uninsured are the least likely to use preventative medical services, are the most likely to encounter financial barriers to access care, and report the highest rates of preventable hospitalizations [1,2,3,4,5,6,7]; less is known about how use of care varies by health insurance coverage type (e.g., no insurance, public insurance, private insurance). The aim of this study is to examine whether health insurance coverage type is associated with the structure and use of healthcare services
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