The Affordable Care Act, Insurance Coverage, and Health Care Utilization of Previously Incarcerated Young Men: 2008–2015
- 1 May 2017
- journal article
- Published by American Public Health Association in American Journal of Public Health
- Vol. 107 (5), 807-811
- https://doi.org/10.2105/ajph.2017.303703
Abstract
Objectives. To estimate health insurance and health care utilization patterns among previously incarcerated men following implementation of the Affordable Care Act’s (ACA’s) Medicaid expansion and Marketplace plans in 2014. Methods. We performed serial cross-sectional analyses using data from the National Survey of Family Growth between 2008 and 2015. Our sample included men aged 18 to 44 years with (n = 3476) and without (n = 8702) a history of incarceration. Results. Uninsurance declined significantly among previously incarcerated men after ACA implementation (–5.9 percentage points; 95% confidence interval [CI] = −11.5, –0.4), primarily because of an increase in private insurance (6.8 percentage points; 95% CI = 0.1, 13.3). Previously incarcerated men accounted for a large proportion of the remaining uninsured (38.6%) in 2014 to 2015. Following ACA implementation, previously incarcerated men continued to be significantly less likely to report a regular source of primary care and more likely to report emergency department use than were never-incarcerated peers. Conclusions. Health insurance coverage improved among previously incarcerated men following ACA implementation. However, these men account for a substantial proportion of the remaining uninsured. Previously incarcerated men continue to lack primary care and frequently utilize acute care services.Keywords
This publication has 15 references indexed in Scilit:
- Health Insurance Trends and Access to Behavioral Healthcare Among Justice-Involved Individuals—United States, 2008–2014Journal of General Internal Medicine, 2016
- Substance use disorders, psychiatric disorders, and mortality after release from prison: a nationwide longitudinal cohort studyThe Lancet Psychiatry, 2015
- Increased Hospital and Emergency Department Utilization by Individuals with Recent Criminal Justice Involvement: Results of a National SurveyJournal of General Internal Medicine, 2014
- What The Affordable Care Act Means For People With Jail StaysHealth Affairs, 2014
- A High Risk of Hospitalization Following Release From Correctional Facilities in Medicare BeneficiariesJAMA Internal Medicine, 2013
- As Roughly 700,000 Prisoners Are Released Annually, About Half Will Gain Health Coverage And Care Under Federal LawsHealth Affairs, 2012
- Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general populationJournal of Epidemiology and Community Health, 2009
- Psychiatric Disorders and Repeat Incarcerations: The Revolving Prison DoorAmerican Journal of Psychiatry, 2009
- Health and Prisoner Reentry: How Physical, Mental, and Substance Abuse Conditions Shape the Process of ReintegrationPublished by American Psychological Association (APA) ,2008
- Release from Prison — A High Risk of Death for Former InmatesThe New England Journal of Medicine, 2007