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Medicaid Expansion Under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas.

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Title: Medicaid Expansion Under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas.
Authors: Soni, Aparna1, Hendryx, Michael2 hendryx@indiana.edu, Simon, Kosali3
Source: Journal of Rural Health. Spring2017, Vol. 33 Issue 2, p217-226. 10p.
Subject Terms: *Childlessness, *City dwellers, Health insurance, Medicaid, Regression analysis, Rural population, Surveys, Patient Protection & Affordable Care Act
Geographic Terms: United States
Abstract: Purpose To analyze the differential rural-urban impacts of the Affordable Care Act Medicaid expansion on low-income childless adults' health insurance coverage. Methods Using data from the American Community Survey years 2011-2015, we conducted a difference-in-differences regression analysis to test for changes in the probability of low-income childless adults having insurance in states that expanded Medicaid versus states that did not expand, in rural versus urban areas. Analyses employed survey weights, adjusted for covariates, and included a set of falsification tests as well as sensitivity analyses. Findings Medicaid expansion under the Affordable Care Act increased the probability of Medicaid coverage for targeted populations in rural and urban areas, with a significantly greater increase in rural areas ( P < .05), but some of these gains were offset by reductions in individual purchased insurance among rural populations ( P < .01). Falsification tests showed that the insurance increases were specific to low-income childless adults, as expected, and were largely insignificant for other populations. Conclusions The Medicaid expansion increased the probability of having 'any insurance' for the pooled urban and rural low-income populations, and it specifically increased Medicaid coverage more in rural versus urban populations. There was some evidence that the expansion was accompanied by some shifting from individual purchased insurance to Medicaid in rural areas, and there is a need for future work to understand the implications of this shift on expenditures, access to care and utilization. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Rural Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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DbLabel: Education Research Complete
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AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
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  Data: Medicaid Expansion Under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Soni%2C+Aparna%22&quot;&gt;Soni, Aparna&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hendryx%2C+Michael%22&quot;&gt;Hendryx, Michael&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;i&gt; hendryx@indiana.edu&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Simon%2C+Kosali%22&quot;&gt;Simon, Kosali&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Journal+of+Rural+Health%22&quot;&gt;Journal of Rural Health&lt;/searchLink&gt;. Spring2017, Vol. 33 Issue 2, p217-226. 10p.
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  Data: *&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Childlessness%22&quot;&gt;Childlessness&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22City+dwellers%22&quot;&gt;City dwellers&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Health+insurance%22&quot;&gt;Health insurance&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medicaid%22&quot;&gt;Medicaid&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Regression+analysis%22&quot;&gt;Regression analysis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Rural+population%22&quot;&gt;Rural population&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Surveys%22&quot;&gt;Surveys&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Patient+Protection+%26+Affordable+Care+Act%22&quot;&gt;Patient Protection &amp; Affordable Care Act&lt;/searchLink&gt;
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  Data: Purpose To analyze the differential rural-urban impacts of the Affordable Care Act Medicaid expansion on low-income childless adults&#39; health insurance coverage. Methods Using data from the American Community Survey years 2011-2015, we conducted a difference-in-differences regression analysis to test for changes in the probability of low-income childless adults having insurance in states that expanded Medicaid versus states that did not expand, in rural versus urban areas. Analyses employed survey weights, adjusted for covariates, and included a set of falsification tests as well as sensitivity analyses. Findings Medicaid expansion under the Affordable Care Act increased the probability of Medicaid coverage for targeted populations in rural and urban areas, with a significantly greater increase in rural areas ( P &lt; .05), but some of these gains were offset by reductions in individual purchased insurance among rural populations ( P &lt; .01). Falsification tests showed that the insurance increases were specific to low-income childless adults, as expected, and were largely insignificant for other populations. Conclusions The Medicaid expansion increased the probability of having &#39;any insurance&#39; for the pooled urban and rural low-income populations, and it specifically increased Medicaid coverage more in rural versus urban populations. There was some evidence that the expansion was accompanied by some shifting from individual purchased insurance to Medicaid in rural areas, and there is a need for future work to understand the implications of this shift on expenditures, access to care and utilization. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Journal of Rural Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/jrh.12234
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 10
        StartPage: 217
    Subjects:
      – SubjectFull: Childlessness
        Type: general
      – SubjectFull: City dwellers
        Type: general
      – SubjectFull: Health insurance
        Type: general
      – SubjectFull: Medicaid
        Type: general
      – SubjectFull: Regression analysis
        Type: general
      – SubjectFull: Rural population
        Type: general
      – SubjectFull: Surveys
        Type: general
      – SubjectFull: Patient Protection & Affordable Care Act
        Type: general
      – SubjectFull: United States
        Type: general
    Titles:
      – TitleFull: Medicaid Expansion Under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas.
        Type: main
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          Name:
            NameFull: Soni, Aparna
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            NameFull: Hendryx, Michael
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            NameFull: Simon, Kosali
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            – D: 01
              M: 04
              Text: Spring2017
              Type: published
              Y: 2017
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              Value: 0890765X
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              Value: 33
            – Type: issue
              Value: 2
          Titles:
            – TitleFull: Journal of Rural Health
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