Free Clinic Patients' Perceptions and Barriers to Applying for Health Insurance After Implementation of the Affordable Care Act.

Publisher: Springer Country of Publication: Netherlands NLM ID: 7600747 Publication Model: Print Cited Medium: Internet ISSN: 1573-3610 (Electronic) Linking ISSN: 00945145 NLM ISO Abbreviation: J Community Health Subsets: MEDLINE

Publication: Amsterdam : Springer
Original Publication: New York, Human Sciences Press.

Patient Protection and Affordable Care Act*; Health Services Accessibility/*statistics & numerical data ; Insurance Coverage/*statistics & numerical data; Adult ; Black or African American ; Ambulatory Care Facilities ; Eligibility Determination ; Female ; Humans ; Income ; Insurance, Health/statistics & numerical data ; Male ; Medicaid/statistics & numerical data ; Medically Uninsured/statistics & numerical data ; Middle Aged ; Pennsylvania ; Perception ; Poverty ; Surveys and Questionnaires ; United States

Despite implementation of the Affordable Care Act (ACA), many Americans remain uninsured and receive care in free clinics. It is unknown what free clinic attendees in Pennsylvania know about health insurance expansion or what they perceive as barriers in enrolling in health insurance. The objective of this study was to assess the perceptions and experiences of free clinic patients from southwestern Pennsylvania when applying for health insurance after implementation of the ACA. We designed and implemented a survey of patients at three free clinics within Allegheny County, Pennsylvania from September 2016 to February 2017. Our survey included 22-items, 7 sociodemographic questions and 15 questions regarding the patient's health status and their perspectives related to obtaining health insurance. Data was obtained from 203 patient surveys; 110 (55.3%) of the respondents were men and 99 (48.8%) were African American. There were 48 respondents (24.1%) who did not report any income at the time of the study, and of those that did report an income, 92 (46.2%) respondents reported an income below 133% of the federal poverty level. The main barriers patients faced when applying for health insurance were: (1) lack of knowledge about health insurance (n = 127, 58.1%), (2) cost of health coverage (n = 85, 41.9%), (3) lack of resources (n = 83, 40.4%), and (4) lack of enrollment documentation (n = 43, 23.8%). Significant work is needed to better educate patients about their eligibility and options for health insurance. Free clinics can play a key role in eliminating barriers to health insurance enrollment.

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Keywords: Affordable Care Act; Barriers; Free clinics; Medicaid expansion; Uninsured population

Date Created: 20191102 Date Completed: 20210414 Latest Revision: 20221207

20221213

10.1007/s10900-019-00766-y

31673862