Reasons Why Individuals Remain Uninsured Under the Affordable Care Act: Experiences of Patients at a Student-Run Free Clinic in Michigan, a Medicaid Expansion State

Since the enactment of the Affordable Care Act (ACA), many people remain uninsured. While studies have examined this population, few have explored patients’ experiences seeking insurance. To elucidate these individuals’ perspectives, we surveyed patients (n = 80) at the University of Michigan Studen...

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Bibliographic Details
Published in:	Journal of community health 2016-04, Vol.41 (2), p.417-423
Main Authors:	Desmond, Brian S., Laux, Molly A., Levin, Carolyn C., Huang, Jiaxin, Williams, Brent C.
Format:	Article
Language:	eng
Subjects:	Adult Aged Ambulatory Care Facilities Barriers Community and Environmental Psychology Counties Eligibility Ethics Female Health care expenditures Health care policy Health disparities Health insurance Health insurance exchanges Health Promotion and Disease Prevention Humans Insurance Coverage Insurance, Health Internal Medicine Male Medicaid Medicaid - legislation & jurisprudence Medically Uninsured Medicine Medicine & Public Health Michigan Middle Aged ORIGINAL PAPER Patient Protection and Affordable Care Act - legislation & jurisprudence Patients Primary Health Care Public Health Reforms Student Run Clinic Surveys and Questionnaires Tax credits United States Young Adult
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Summary:	Since the enactment of the Affordable Care Act (ACA), many people remain uninsured. While studies have examined this population, few have explored patients’ experiences seeking insurance. To elucidate these individuals’ perspectives, we surveyed patients (n = 80) at the University of Michigan Student-Run Free Clinic concerning their activity accessing insurance. Over half of respondents had sought insurance in the past 6 months; 57 % of respondents qualified for Medicaid by self-reported income (≤ 138 % FPL) and all but one were eligible for tax credits on the Health Insurance Marketplace. However, only 35 % of apparently Medicaid-eligible respondents had recently applied. There was no significant difference in the rate of applying for those above the income cutoff (p = 0.901). Perceived expense of plans and belief of ineligibility for Medicaid discouraged respondents from actively seeking insurance. Personalized outreach emphasizing new Medicaid eligibility requirements and tax credits may be needed to facilitate Medicaid enrollment for some uninsured persons under the ACA.
ISSN:	0094-5145 1573-3610