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dc.contributor.authorSommers, Benjamin Daniel
dc.contributor.authorMaylone, Bethany Abrams
dc.contributor.authorNguyen, Kevin Hoang
dc.contributor.authorBlendon, Robert J.
dc.contributor.authorEpstein, Arnold M.
dc.date.accessioned2016-02-10T21:55:16Z
dc.date.issued2015
dc.identifier.citationSommers, B. D., B. Maylone, K. H. Nguyen, R. J. Blendon, and A. M. Epstein. 2015. “The Impact Of State Policies On ACA Applications And Enrollment Among Low-Income Adults In Arkansas, Kentucky, And Texas.” Health Affairs 34 (6) (June 1): 1010–1018. doi:10.1377/hlthaff.2015.0215.en_US
dc.identifier.issn0278-2715en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:25156070
dc.description.abstractStates are taking variable approaches to the Affordable Care Act (ACA) Medicaid expansion, Marketplace design, enrollment outreach, and application assistance. We surveyed nearly 3,000 low-income adults in late 2014 to compare experiences in three states with markedly different policies: Kentucky, which expanded Medicaid, created a successful state Marketplace, and supported outreach efforts; Arkansas, which enacted the private option and a federal-state partnership Marketplace, but with legislative limitations on outreach; and Texas, which did not expand Medicaid and passed restrictions on navigators. We found that application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. Limited awareness remains a critical barrier: Fewer than half of adults had heard some or a lot about the coverage expansions. Application assistance from navigators and others was the strongest predictor of enrollment, while Latino applicants were less likely than others to successfully enroll. Twice as many respondents felt that the ACA had helped them as hurt them (although the majority reported no direct impact), and advertising was strongly associated with perceptions of the law. State policy choices appeared to have had major impacts on enrollment experiences among low-income adults and their perceptions of the ACA.en_US
dc.language.isoen_USen_US
dc.publisherHealth Affairs (Project Hope)en_US
dc.relation.isversionofdoi:10.1377/hlthaff.2015.0215en_US
dash.licenseOAP
dc.titleThe Impact Of State Policies On ACA Applications And Enrollment Among Low-Income Adults In Arkansas, Kentucky, And Texasen_US
dc.typeJournal Articleen_US
dc.description.versionAccepted Manuscripten_US
dc.relation.journalHealth Affairsen_US
dash.depositing.authorSommers, Benjamin Daniel
dc.date.available2016-02-10T21:55:16Z
dash.funder.nameCommonwealth Funden_US
dash.funder.nameAgency for Healthcare Research and Quality (AHRQ)en_US
dash.funder.award20140891en_US
dash.funder.awardK02HS021291en_US
dc.identifier.doi10.1377/hlthaff.2015.0215*
dash.contributor.affiliatedNguyen, Kevin
dash.contributor.affiliatedMaylone, Bethany
dash.contributor.affiliatedBlendon, Robert
dash.contributor.affiliatedSommers, Benjamin
dash.contributor.affiliatedEpstein, Arnold


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