Prevalence of Pre-existing Conditions Among Community Health Center Patients Before and After the Affordable Care Act

Details

• Journal Article:
  J Am Board Fam Med
• Personal Author:
  Huguet, Nathalie ; Angier, Heather ; Hoopes, Megan J. ; Marino, Miguel ; Heintzman, John ; Schmidt, Teresa ; DeVoe, Jennifer E.
• Description:
  Objective: ; To assess the prevalence of pre-existing conditions for community health center (CHC) patients who gained insurance coverage post-Affordable Care Act (ACA). ; Methods: ; We analyzed electronic health record data from 78,059 patients aged 19 to 64 uninsured at their last visit pre-ACA from 386 CHCs in 19 states. We compared the prevalence and types of pre-existing conditions pre-ACA (2012 to 2013) and post-ACA (2014 to 2015), by insurance status and race/ethnicity. ; Results: ; Pre-ACA, >50% of patients in the cohort had ≥1 Pre-existing condition. Post-ACA, >70% of those who gained insurance coverage had ≥1 condition. Post-ACA, all racial/ethnic subgroups showed an increase in the number of pre-existing conditions, with non-Hispanic Black and Hispanic patients experiencing the largest increases (adjusted prevalence difference, 18.9; 95% CI, 18.2 to 19.6 and 18.3; 95% CI, 17.8 to 18.7, respectively). The most common conditions post-ACA were mental health disorders with the highest prevalence among patients who gained Medicaid (45.6%) and lowest among those who gained private coverage (30.5%). ; Conclusions: ; This study emphasizes the high prevalence of pre-existing conditions among CHC patients and the large increase in the proportion of patients with at least 1 of these diagnoses post-ACA. Given how common these conditions are, repealing pre-existing condition protections could be extremely harmful to millions of patients and would likely exacerbate health care and health disparities.
• Keywords:
  • Chronic Disease
  • Cohort Studies
  • Community Health Centers
  • Electronic Health Records
  • Health Care Reform
  • Health Policy
  • Insurance Coverage
  • Medicaid
  • Medically Uninsured
  • Patient Protection and Affordable Care Act
  More +
• Source:
  J Am Board Fam Med. 32(6):883-889
• DOI:
  http://dx.doi.org/10.3122/jabfm.2019.06.190087
• Pubmed ID:
  31704757
• Pubmed Central ID:
  PMC7001872
• Document Type:
  Text
• Funding:
  U18DP006116/ACL/ACL HHSUnited States/ ; R01 CA204267/CA/NCI NIH HHSUnited States/ ; R01 HL136575/HL/NHLBI NIH HHSUnited States/ ; R01 HS024270/HS/AHRQ HHSUnited States/ ; U18 DP006116/DP/NCCDPHP CDC HHSUnited States/
• Genre:
  Journal Article
• Volume:
  32
• Issue:
  6
• Download URL:
  https://stacks.cdc.gov/view/cdc/84940/cdc_84940_DS1.pdf
• File Type:
  [PDF - 69.45 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:1de1ad21f1d1b9efed83df716bce78489d413f2b70227cb153a939a80b39266cce4f0d26643844eee37e9ff5721291a902e045fe9510b981242ac007ee9ddfe4