Variability of assister availability in health insurance marketplace in the U.S.

Background: The Affordable Care Act (ACA) established the health insurance marketplaces to provide people the opportunity to obtain healthcare coverage. Assisters have worked with people who may have difficulty understanding the new system and selecting the right plan. This study aims to describe th...

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Publicado en:BMC Health Services Research Vol. 18; no. 1
Autores principales: Han, Jayoung, Ko, Dongwoo
Formato: research Journal Article
Publicado: BioMed Central 6/19/2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 6/19/2018
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      pub: BioMed Central
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        atl: Variability of assister availability in health insurance marketplace in the U.S.
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          Han, Jayoung
          Ko, Dongwoo
        affil: Pharmacy Practice, School of Pharmacy and Health Sciences Fairleigh Dickinson University 230 Park Avenue, M-SP1-01 07932 Florham Park NJ USA
      sug:
        subj:
          Patient Protection and Affordable Care Act
          Health Insurance Exchanges
          Social Behavior
          Resource Databases
          Female
          Insurance Coverage
          Poverty
          Human
          Adult
          United States
          Male
          Medically Uninsured
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Arthritis Impact Measurement Scales
          Adult: 19-44 years
          Female
          Male
      ab: Background: The Affordable Care Act (ACA) established the health insurance marketplaces to provide people the opportunity to obtain healthcare coverage. Assisters have worked with people who may have difficulty understanding the new system and selecting the right plan. This study aims to describe the local availability of assister programs, and examine the factors influencing assister provision.Methods: The 2016 Small Area Health Insurance Estimates data and a database of assister programs constructed using healthcare.gov were analyzed at the county level. Bivariate analysis by assister provision was performed to determine the differences between the two groups, and the hierarchical generalized linear model was used to examine the factors predicting assister availability.Results: The study analyzed 2260 counties nested within 35 states. Assister availability largely varied across counties and states. About half of the counties did not provide assisters at all, and the assister provision rate at state level ranged between 19 - 100%. Counties in metropolitan areas were more likely to provide assister programs than rural areas, and so were counties with higher adult uninsured rate or higher uninsured rate among the people with incomes between 138 - 400% of federal poverty level (FPL).Conclusions: Despite the important role of in-person assistance in plan enrollment, no previous study has examined the local variability of assister program. Our study found a large geographical variation in assister availability, raising concerns about the disparity in access to assister service.
      pubtype: Academic Journal
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        research
        Journal Article
      ougenre: Article
    language: English
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