ACA Increased Rates of Health Insurance Coverage For Native Americans

MedicalResearch.com Interview with:

Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard T. H. Chan School of Public Health / Brigham & Women's Hospital Boston, MA 02115

Dr. Benjamin D. Sommers

Benjamin D. Sommers, MD, PhD
Assistant Professor of Health Policy & Economics
Harvard T. H. Chan School of Public Health / Brigham & Women’s Hospital
Boston, MA 02115 

Molly E. Frean Data Analyst Department of Health Policy and Management Harvard T.H. Chan School of Public Health Boston, MA 02115

Molly E. Frean

Molly E. Frean
Data Analyst
Department of Health Policy and Management
Harvard T.H. Chan School of Public Health
Boston, MA 02115

MedicalResearch.com: What is the background for this study?

Dr. Sommers: We conducted this study in an effort to see how Native Americans have fared under the Affordable Care Act. In addition to the law’s expansion of coverage via Medicaid and tax credits for the health insurance marketplaces, the law also provided support for Native Americans’ health care specifically through continued funding of the Indian Health Service (IHS). We sought to see how both health insurance coverage patterns and IHS use changed in the first year of the law’s implementation.

MedicalResearch.com: What are the main findings?

Dr. SommersWe found that the law significantly increased general rates of insurance coverage among Native Americans, especially in states that elected to expand Medicaid. We found no evidence to support concerns that gaining Medicaid coverage caused Native Americans to leave IHS – Medicaid coverage appeared to supplement IHS use rather than replace it.

MedicalResearch.com: What should readers take away from your report?

Dr. Sommers: Readers should take away how impactful the ACA has been in helping individuals from all ethnic groups in gaining health insurance. Part of our analysis included looking specifically at Native Americans living in more rural areas on or near reservations. This group experienced even bigger coverage gains than the rest of the Native American population, suggesting that the law is helping close disparities for this group that is particularly at risk due to high poverty rates and high pre-ACA uninsured rates.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Sommers: We think it is important for researchers to continue to follow the impacts of the ACA over time, for Native Americans as well as other populations. Our analysis is limited to the first year following the ACA’s implementation, and we expect the law’s impact to grow over time.   It is also important to go beyond just coverage – we need to better understand how people are using their new insurance coverage and how it is impacting their health care utilization and health outcomes.   

MedicalResearch.com: Is there anything else you would like to add?

Dr. Sommers: Our research joins a growing body of evidence that shows how important the ACA has been for many different populations in the U.S.  Millions more Americans across multiple racial and ethnic groups have gained health insurance under the law and this is a really important policy accomplishment.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Frean M, Shelder S, Rosenthal MB, Sequist TD, Sommers BD. Health Reform and Coverage Changes Among Native Americans. JAMA Intern Med. Published online May 16, 2016. doi:10.1001/jamainternmed.2016.1695.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on May 16, 2016 by Marie Benz MD FAAD