Health Insurance and Poverty in Trajectories of Out-of-Pocket Expenditure among Low-Income Middle-Aged Adults

Health Services Research
Eunsun KwonTimothy D McBride

Abstract

To assess the effects of longitudinal patterns of health insurance and poverty on out-of-pocket expenditures among low-income late middle-aged adults. Six waves (2002-2012) of the Health and Retirement Study, in combination with RAND Center for the Study of Aging data, were used. A random coefficient regression analysis was conducted in a multilevel growth curve framework to estimate the impact of health insurance and poverty on out-of-pocket expenditures. At baseline, individuals with private insurance or unstable coverage were more likely to have out-of-pocket expenditures and financial burdens than public insurance holders. Over time, the poor who had no insurance, unstable coverage, or insurance type change had higher out-of-pocket expenditures; private coverage holders had higher odds of financial burden. Unstable insurance coverage had a discernible effect on the long-term, out-of-pocket expenditures among low-income adults. Findings have an important policy implication to protect poor late middle-aged population; as this population enters old age, the high financial burden it faces may exacerbate persistent socioeconomic health disparity among older people with unstable insurance coverage.

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Citations

Jun 5, 2019·International Journal of Environmental Research and Public Health·Ilan KwonGoeun Kwon
Jun 7, 2021·Implementation Science Communications·Eva N WoodwardJoAnn E Kirchner
Aug 29, 2021·Social Science & Medicine·Mohammed Khaled Al-Hanawi
Oct 3, 2021·Current Cardiology Reports·Merilyn S VargheseDhruv S Kazi

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