Abstract
Reasons for acquiring insurance outside Department of Veterans Affairs (VA) health care coverage among VA enrollees are incompletely understood. To assess Veterans’ decision-making and acquisition of non-VA health care insurance in the Affordable Care Act era, we used mailed questionnaires and semistructured interviews in a stratified random sample of VA enrollees <65 years in the Midwest. Of the 3,666 survey participants, 32.1% reported non-VA insurance. Frequently reported reasons included wanting coverage for emergency situations or family members. Those without non-VA insurance cited unaffordability as the main obstacle. Analysis of the semistructured interview data revealed similar findings. In multivariable logistic regression analyses, characteristics associated with non-VA insurance included higher income (>$50,000 vs. <$10,000, odds ratio [OR] = 5.95, 95% confidence interval [CI]: 3.45–10.3, p <.001). As financial barriers exist for acquisition of non-VA insurance and hence community care, it is critically important that VA enrollees’ health care needs are met through VA or community providers financed through VA.
Original language | English (US) |
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Pages (from-to) | 511-524 |
Number of pages | 14 |
Journal | Medical Care Research and Review |
Volume | 79 |
Issue number | 4 |
DOIs | |
State | Published - Aug 2022 |
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development Service project IIR 14-069-2.
Keywords
- Affordable Care Act
- health policy
- insurance
- mixed methods
- veterans affairs
ASJC Scopus subject areas
- Health Policy