TY - JOUR
T1 - Purged from the Rolls
T2 - A Study of Medicaid Disenrollment in Iowa
AU - Askelson, Natoshia M.
AU - Brady, Patrick
AU - Wright, Brad
AU - Bentler, Suzanne
AU - Momany, Elizabeth T.
AU - Damiano, Peter
N1 - Publisher Copyright:
© Natoshia M. Askelson et al. 2019; Published by Mary Ann Liebert, Inc.
PY - 2019
Y1 - 2019
N2 - Purpose: To describe the impact of disenrollment from Medicaid because of failure to pay premiums as part of Iowa's Medicaid program's personal responsibility component. Methods: We conducted a mixed method study consisting of in-depth interviews with disenrolled members in 2016 and 2017 (n=72) and a survey of disenrolled members in 2017 (n=225). Results: Many disenrollees did not know why they were disenrolled, were unaware of the personal responsibility component or premium requirement, and were confused by the disenrollment process. Disenrollment had negative effects including stress, financial burden, and engaging in behaviors such as skipping medication and postponing medical or dental care. Furthermore, disenrollees were often unable to enroll in health insurance, and for those who did, many reported it was a difficult process. Conclusions: Disenrollment had numerous, negative impacts on members who failed to pay their premiums. There was confusion about program requirements, which might indicate challenges communicating about a complicated program. Policymakers need to consider how to design and implement personal responsibility programs to achieve their desired outcome and reduce confusion and negative consequences.
AB - Purpose: To describe the impact of disenrollment from Medicaid because of failure to pay premiums as part of Iowa's Medicaid program's personal responsibility component. Methods: We conducted a mixed method study consisting of in-depth interviews with disenrolled members in 2016 and 2017 (n=72) and a survey of disenrolled members in 2017 (n=225). Results: Many disenrollees did not know why they were disenrolled, were unaware of the personal responsibility component or premium requirement, and were confused by the disenrollment process. Disenrollment had negative effects including stress, financial burden, and engaging in behaviors such as skipping medication and postponing medical or dental care. Furthermore, disenrollees were often unable to enroll in health insurance, and for those who did, many reported it was a difficult process. Conclusions: Disenrollment had numerous, negative impacts on members who failed to pay their premiums. There was confusion about program requirements, which might indicate challenges communicating about a complicated program. Policymakers need to consider how to design and implement personal responsibility programs to achieve their desired outcome and reduce confusion and negative consequences.
KW - evaluation
KW - health insurance disenrollment
KW - Medicaid
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U2 - 10.1089/heq.2019.0093
DO - 10.1089/heq.2019.0093
M3 - Article
AN - SCOPUS:85079179095
SN - 2473-1242
VL - 3
SP - 637
EP - 643
JO - Health Equity
JF - Health Equity
IS - 1
ER -