TY - JOUR
T1 - Most uninsured adults could schedule primary care appointments before the ACA, but average price was $160
AU - Saloner, Brendan
AU - Polsky, Daniel
AU - Kenney, Genevieve M.
AU - Hempstead, Katherine
AU - Rhodes, Karin V.
N1 - Publisher Copyright:
© 2015 Project HOPE.
PY - 2015
Y1 - 2015
N2 - Provisions of the Affordable Care Act (ACA) allow millions more Americans to obtain health insurance. However, a sizable number of people remain uninsured because they live in states that have not expanded Medicaid coverage or because they feel that Marketplace coverage is not affordable. Using data from a ten-state telephone survey in which callers posed as patients, we examined prices for primary care visits offered by physician offices to new uninsured patients in 2012-13, prior to ACA insurance expansions. Patients were quoted a mean price of $160. Significantly lower prices for the uninsured were offered by family practice offices compared to general internists, in offices participating in Medicaid managed care plans, and in federally qualified health centers. Prices were also lower for offices in ZIP codes with higher poverty rates. Only 18 percent of uninsured callers were told that they could bring less than the full amount to the visit and arrange to pay the rest later. ACA insurance expansions could greatly decrease out-of-pocket spending for low-income adults seeking primary care. However, benefits of health reform are likely to be greater in states expanding Medicaid eligibility.
AB - Provisions of the Affordable Care Act (ACA) allow millions more Americans to obtain health insurance. However, a sizable number of people remain uninsured because they live in states that have not expanded Medicaid coverage or because they feel that Marketplace coverage is not affordable. Using data from a ten-state telephone survey in which callers posed as patients, we examined prices for primary care visits offered by physician offices to new uninsured patients in 2012-13, prior to ACA insurance expansions. Patients were quoted a mean price of $160. Significantly lower prices for the uninsured were offered by family practice offices compared to general internists, in offices participating in Medicaid managed care plans, and in federally qualified health centers. Prices were also lower for offices in ZIP codes with higher poverty rates. Only 18 percent of uninsured callers were told that they could bring less than the full amount to the visit and arrange to pay the rest later. ACA insurance expansions could greatly decrease out-of-pocket spending for low-income adults seeking primary care. However, benefits of health reform are likely to be greater in states expanding Medicaid eligibility.
UR - http://www.scopus.com/inward/record.url?scp=84929616834&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84929616834&partnerID=8YFLogxK
U2 - 10.1377/hlthaff.2014.1258
DO - 10.1377/hlthaff.2014.1258
M3 - Article
C2 - 25941278
AN - SCOPUS:84929616834
SN - 0278-2715
VL - 34
SP - 773
EP - 780
JO - Health Affairs
JF - Health Affairs
IS - 5
ER -