People with disabilities rely on timely, affordable access to quality healthcare in order to manage their health. Our research evaluates whether the American health system - before and during reform - can meet this need.
On the 2018 National Survey on Health Reform and Disability (NSHRD)1 and during national telephone interviews in 2019, consumers with disabilities were asked about their experiences with health care services and insurance. At the end of each interview and as the final question on the NSHRD, participants were asked: “What would you tell policymakers about access to health insurance and health care services for people with disabilities?” The quotes provided below are a selection of responses to this question.
Although health insurance gains are documented, little is known about personal experiences of adults with disabilities in accessing health care after coverage expansions of the Affordable Care Act (ACA) in 2014. We interviewed 22 adults across the U.S. with a variety of disabilities and health insurance types to document remaining barriers to health care after ACA coverage expansions. Telephone interviews were conducted from May to August 2017. Participants were recruited via disability-related organizations and were demographically and geographically diverse. Content analysis of interview transcripts was used to identify major themes related to accessing health care.
Before the Patient Protection and Affordable Care Act (ACA), many Americans with disabilities were locked into poverty to maintain eligibility for Medicaid coverage. US Medicaid expansion under the ACA allows individuals to qualify for coverage without first going through a disability determination process and declaring an inability to work to obtain Supplemental Security Income. Medicaid expansion coverage also allows for greater income and imposes no asset tests. In this article, we share updates to our previous work documenting greater employment among people with disabilities living in Medicaid expansion states.
While health reform has expanded health insurance coverage for millions of Americans, people with disabilities continue to face numerous barriers to accessing and receiving health care. During the summer of 2017, CHRIL staff at the University of Kansas conducted telephone interviews with a diverse national sample of 22 working-age people with a range of disabilities and coverage types (employer-sponsored, Medicaid, Medicare, marketplace plans and no insurance) to document their experiences with health insurance and obtaining timely access to health care services. During the interviews, participants were asked if they wanted to share any insights or suggestions with policy makers. This brief documents these personal perspectives on barriers to care and suggestions for improving health coverage for Americans with disabilities.
The United States is in the midst of a deadly opioid epidemic. About 11.8 million Americans misused prescription opioids in 2016. About 42,249 died from an opioid overdose. Adults with disabilities are much more likely to report constant pain than others. Because of this, they are more likely to use and depend on prescription pain medication. The risk of herion use is higher in adults who use prescription opioids for other than pain relief. It is important to look at misuse of legal and illegal opioids at the same time.
This study looks at working-age adults (18-64) with and without disabilities. It compares the frequency of and treatment of opioid misuse.
According to recent studies, the Affordable Care Act (ACA) improved access to health care and health insurance in the United States. Parts of the law say that insurers must cover people with pre-existing conditions. They also say that insurance must cover mental health services. Under the ACA, some states also chose to expand their Medicaid programs to cover more people.
Our study looked at the impact of the ACA and Medicaid expansion on health insurance coverage, access to health care, and employment for people with mental health conditions.
Women with disabilities are not as likely to become pregnant as women without disabilities. This study looks at how women with disabilities make decisions about pregnancy. Four focus groups were held with 22 women of child-bearing age. Most of the women wanted to become mothers, but they had concerns about becoming pregnant. Three things affected their decision: 1) how important it was to them to have a child, 2) whether it was possible for them to become pregnant, and 3) the costs of having and raising a child.
The study showed that it is more than the medical issues around having a child that are important to a woman. When they discuss pregnancy with a woman with a disability, health care providers should also talk about social and personal factors. By talking about all her concerns, health care providers can help a woman with a disability to make a decision that is in line with her values and desires.
This study looked at how much cost affected whether or not people filled their prescriptions. The percentage of all Americans who did not fill a prescription in the previous 12 months because they could not afford it grew from 1999 to 2009 to 8% and then dropped to 5% by 2015. For seniors, however, the number peaked in 2004 at 5% and dropped to 4% after implementation of Medicare Part D in 2006. With implementation of Medicare Part D and the Affordable Care Act, the number of prescriptions unfilled because of cost has declined.
This study looked at data on blood pressure checks, flu shots, and dental visits in a 12 month period. Results showed that adults with physical limitations were more likely to receive a blood pressure check (92% vs. 70%%) or flu shot (40%% vs. 23%) compared to adults with no limitations. However, people with physical limitations were less likely to have a dental check-up (45% vs. 59%) in comparison to those with no limitation. People who had a regular care provider were more likely to receive services.
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