In:
Public Health Nursing, Wiley, Vol. 38, No. 5 ( 2021-09), p. 720-729
Abstract:
The study examined the impact that the Medicaid expansion in Illinois had upon insurance rates, access to medical care, dental care, pharmaceuticals, and mental‐health counseling between rural and urban counties. Design and Sample A serial cross‐sectional design was used to assess the health perceptions of adults living in Illinois. Measures Survey data were collected in 2012 ( n = 6,149) before the Medicaid expansion in Illinois and in 2015 ( n = 3,532) after the expansion from rural ( n = 4) and urban counties ( n = 4). Intervention Medicaid expansion reduced the uninsured rate in both rural (16.39%–4.87%) and urban counties (17.05%–5.2%) and improved self‐reported health. It also increased access to all types of healthcare, with the biggest increase in dental coverage. Results Path analysis indicated that the Medicaid expansion β = −1.03 ( p 〈 .01) and poor versus not poor β = −1.50 ( p 〈 .01) were a significant predictor to no healthcare access. Rural verses urban location was not significant ( β = 0.04); however, race/ethnicity was significantly different ( p 〈 .01). Conclusion Findings suggest that although the expansion has increased access to care overall, those who are the most vulnerable are still not benefiting equally from the expansion. Therefore, strategies to assist high‐risk adults in enrolling and using their Medicaid coverage need to developed and implemented.
Type of Medium:
Online Resource
ISSN:
0737-1209
,
1525-1446
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2010328-1
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