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. 2019 Sep-Oct;80(5):269-275.
doi: 10.18043/ncm.80.5.269.

Health Status and Access to Care for the North Carolina Medicaid Gap Population

Jennifer C Spencer  1 , Alex K Gertner  2 , Pam J Silberman  3
Affiliations

Health Status and Access to Care for the North Carolina Medicaid Gap Population

Jennifer C Spencer et al. N C Med J. 2019 Sep-Oct.

Abstract

BACKGROUND North Carolina remains one of several states that has not expanded Medicaid eligibility criteria to cover all low-income adults, leading to the so-called Medicaid gap, a population ineligible for Medicaid and too poor for premium subsidies through the federal Health Insurance Marketplace. Our objective was to characterize the health care access and health status of the Medicaid gap population in North Carolina.METHODS We combined annual data from the Behavioral Risk Factor Surveillance Survey (2013-2016). Respondents who were uninsured and earning below 100% of the federal poverty guidelines (FPG) were classified as falling within the Medicaid gap and were compared to insured populations below FPG, representing the traditional Medicaid population, and to individuals above the FPG, regardless of insurance status. We reported health care access, receipt of preventive care, and current health status in unadjusted and demographically adjusted models.RESULTS Compared to either traditional Medicaid or above FPG groups, those in the Medicaid gap were 3 times as likely to have no regular source of care and twice as likely to report delaying needed care due to cost. Individuals in the Medicaid gap were more likely than individuals above FPG to report multiple chronic conditions (22% versus 16%) or a functional disability (35% versus 15%), but less likely than the traditional Medicaid population to do so.CONCLUSION While less likely than the traditional Medicaid population to have complex health needs, we found that individuals in the North Carolina Medicaid gap report numerous health care access barriers and lower use of preventive care.

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Conflict of interest statement

Potential Conflicts of Interest. All authors have no relevant conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Health Care Access for North Carolina Adults (18-64) Note. Data are unadjusted. HIV- Human Immunodeficiency Virus; bars represent 95% confidence intervals *Significantly different from above-poverty + Significantly different from both above-poverty and traditional Medicaid 1 Data only available for 2 years 2 Only includes females, data only available for 2 years
FIGURE 2.
FIGURE 2.
Note. Data are unadjusted. Bars represent 95% confidence intervals *Significantly different from above-poverty # Significantly different from traditional Medicaid + Significantly different from both above-poverty and traditional Medicaid
See this image and copyright information in PMC

References

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