Table A3.
Multivariable Interaction Regression Results of Health Care Financial Strain, Access and Utilization by FPL, Ages 27-64 (N = 111°485).
Financial strain
|
Access
|
Utilization
|
|||||||
|---|---|---|---|---|---|---|---|---|---|
| Couldn’t afford prescription medication in past 12 months due to cost | Delayed care due to cost in past 12 months | Didn’t get needed care due to cost in past 12 months | Problems paying medical bills in past 12 months | Worried about paying medical bills in past 12 months | Currently uninsured | Waited too long in physician’s office in past 12 months | ≥1 physician visit in past 12 months | ≥1 ED visit in past 12 months | |
| Pre-ACA | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| Post-ACA (2014-2016) |
−0.005** | −0.006* | −0.003 | −0.010*** | −0.026*** | −0.011*** | −0.006** | 0.002 | −0.006 |
| (−0.01 to −0.00) | (−0.01 to −0.001) | (−0.01 to 0.00) | (−0.02 to −0.01) | (−0.04 to −0.02) | (−0.01 to −0.01) | (−0.01 to −0.00) | (−0.01 to 0.01) | (−0.01 to 0.00) | |
| Post-ACA × 0%-124% | −0.047*** | −0.065*** | −0.058*** | −0.045*** | −0.048*** | −0.111*** | −0.004 | 0.020** | 0.018* |
| (−0.06 to −0.03) | (−0.08 to −0.05) | (−0.07 to −0.04) | (−0.06 to −0.03) | (−0.07 to −0.03) | (−0.13 to −0.10) | (−0.01 to 0.00) | (0.01 to 0.04) | (0.00 to 0.03) | |
| Post-ACA × 125%-199% | −0.045*** | −0.068*** | −0.0455*** | −0.070*** | −0.047*** | −0.137*** | 0.002 | 0.0264** | 0.018* |
| (−0.06 to −0.03) | (−0.08 to −0.05) | (−0.06 to −0.03) | (−0.09 to −0.05) | (−0.07 to −0.03) | (−0.15 to −0.12) | (−0.01 to 0.01) | (0.01 to 0.04) | (0.002 to 0.034) | |
| Post-ACA × 200%-299% | −0.021*** | −0.026*** | −0.023*** | −0.028*** | −0.016 | −0.064*** | 0.007 | 0.011 | −0.009 |
| (−0.03 to −0.01) | (−0.04 to −0.01) | (−0.03 to −0.01) | (−0.04 to −0.01) | (−0.04 to 0.00) | (−0.08 to −0.05) | (−0.00 to 0.02) | (−0.00 to 0.03) | (−0.02 to 0.01) | |
| Post-ACA × 300%-399% | −0.011* | −0.004 | −0.015** | −0.011 | −0.003 | −0.019** | −0.00 | −0.002 | 0.005 |
| (−0.02 to −0.00) | (−0.02 to 0.01) | (−0.02 to −0.01) | (−0.03 to 0.00) | (−0.03 to 0.02) | (−0.03 to −0.01) | (−0.01 to 0.01) | (−0.02 to 0.01) | (−0.01 to 0.02) | |
| Post-ACA × 400% and up | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| FPL | |||||||||
| 0%-124% | 0.149*** | 0.165*** | 0.169*** | 0.180*** | 0.189*** | 0.302*** | 0.013*** | −0.135*** | 0.078*** |
| (0.14 to 0.16) | (0.15 to 0.18) | (0.16 to 0.18) | (0.17 to 0.19) | (0.17 to 0.21) | (0.29 to 0.32) | (0.01 to 0.02) | (−0.15 to −0.12) | (0.07 to 0.09) | |
| 125%-199% | 0.127*** | 0.190*** | 0.164*** | 0.228*** | 0.258*** | 0.295*** | 0.003 | −0.129*** | 0.030*** |
| (0.12 to 0.14) | (0.18 to 0.20) | (0.15 to 0.17) | (0.21 to 0.24) | (0.24 to 0.27) | (0.28 to 0.31) | (−0.00 to 0.01) | (−0.143 to −0.116) | (0.02 to 0.04) | |
| 200%-299% | 0.070*** | 0.115*** | 0.089*** | 0.155*** | 0.196*** | 0.160*** | −0.006* | −0.085*** | 0.009 |
| (0.06 to 0.08) | (0.11 to 0.13) | (0.08 to 0.10) | (0.14 to 0.17) | (0.18 to 0.21) | (0.15 to 0.17) | (−0.01 to −0.00) | (−0.09 to −0.07) | (−0.00 to 0.02) | |
| 300%-399% | 0.032*** | 0.054*** | 0.042*** | 0.084*** | 0.138*** | 0.0596*** | −0.003 | −0.037*** | −0.007 |
| (0.02 to 0.04) | (0.05 to 0.06) | (0.04 to 0.05) | (0.07 to 0.09) | (0.12 to 0.15) | (0.05 to 0.07) | (−0.01 to 0.00) | (−0.05 to −0.03) | (−0.02 to 0.00) | |
| 400% and up | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| Wald test of interactions (F-statistic) |
171.69*** | 200.39*** | 256.08*** | 269.52*** | 232.72*** | 423.01*** | 6.25*** | 87.13*** | 45.22*** |
Source. NHIS 2011-2016.
Note. All models are adjusted for sex, age, race/ethnicity, income, education, citizenship status, self-reported health, interview language, functional limitations, marital status, family structure, and US Census Region. All regression results are presented as regression coefficients with 95% confidence intervals. FPL = Federal Poverty Level; ED = emergency department; ACA = Patient Protection and Affordable Care Act; NHIS = National Health Interview Survey.*P < .05. **P < .01. ***P < .001.