Out-of-pocket costs for preventive care persist almost a decade after the Affordable Care Act

被引:11
|
作者
Hoagland, Alex [1 ]
Shafer, Paul [2 ]
机构
[1] Boston Univ, Coll Arts & Sci, Dept Econ, Boston, MA 02215 USA
[2] Boston Univ, Sch Publ Hlth, Dept Hlth Law Policy & Management, Boston, MA USA
关键词
SERVICES;
D O I
10.1016/j.ypmed.2021.106690
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Higher cost-sharing reduces the amount of high-value health care that patients use, such as preventive care. Despite a sharp reduction in out-of-pocket (OOP) costs for preventive care after the implementation of the Affordable Care Act (ACA), patients often still get unexpected bills after receiving preventive services. We examined out-of-pocket costs for preventive care in 2018, almost ten years after the implementation of the ACA. We quantify the excess cost burden on a national scale using a partial identification approach and explore how this burden varies geographically and across preventive services. We found that in addition to premium costs meant to cover preventive care, Americans with employer-sponsored insurance were still charged between $75 million and $219 million in total for services that ought to be free to them ($0.50 to $1.40 per ESI-covered individual and $0.75 to $2.17 per ESI-covered individual using preventive care). However, some enrollees still faced OOP costs for eligible preventive services ranging into the hundreds of dollars. OOP costs are most likely to be incurred for women's services (e.g., contraception) and basic screenings (e.g., diabetes and cholesterol screenings), and by patients in the South or in rural areas.
引用
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页数:11
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