Health Insurance Coverage Among Veterans Receiving Care From VA Health Care Facilities

Kevin T. Stroupe; Rachael Martinez; Timothy P. Hogan; Elisa J. Gordon; Beverly Gonzalez; Elizabeth Tarlov; Abigail Silva; Zhiping Huo; Ibuola Kale; Dolores Ippolito; Chad Osteen; Neil Jordan; Dustin D. French; Howard Gordon; Michael J. Fischer; Bridget M. Smith

doi:10.1177/10775587211048661

Health Insurance Coverage Among Veterans Receiving Care From VA Health Care Facilities

Kevin T. Stroupe^*, Rachael Martinez, Timothy P. Hogan, Elisa J. Gordon, Beverly Gonzalez, Elizabeth Tarlov, Abigail Silva, Zhiping Huo, Ibuola Kale, Dolores Ippolito, Chad Osteen, Neil Jordan, Dustin D. French, Howard Gordon, Michael J. Fischer, Bridget M. Smith

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

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)
Pages (from-to)	511-524
Number of pages	14
Journal	Medical Care Research and Review
Volume	79
Issue number	4
DOIs	https://doi.org/10.1177/10775587211048661
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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/10775587211048661

Cite this

Stroupe, K. T., Martinez, R., Hogan, T. P., Gordon, E. J., Gonzalez, B., Tarlov, E., Silva, A., Huo, Z., Kale, I., Ippolito, D., Osteen, C., Jordan, N., French, D. D., Gordon, H., Fischer, M. J., & Smith, B. M. (2022). Health Insurance Coverage Among Veterans Receiving Care From VA Health Care Facilities. Medical Care Research and Review, 79(4), 511-524. https://doi.org/10.1177/10775587211048661

@article{63e5604675a143c7bd38b8864144f161,

title = "Health Insurance Coverage Among Veterans Receiving Care From VA Health Care Facilities",

abstract = "Reasons for acquiring insurance outside Department of Veterans Affairs (VA) health care coverage among VA enrollees are incompletely understood. To assess Veterans{\textquoteright} 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{\textquoteright} health care needs are met through VA or community providers financed through VA.",

keywords = "Affordable Care Act, health policy, insurance, mixed methods, veterans affairs",

author = "Stroupe, {Kevin T.} and Rachael Martinez and Hogan, {Timothy P.} and Gordon, {Elisa J.} and Beverly Gonzalez and Elizabeth Tarlov and Abigail Silva and Zhiping Huo and Ibuola Kale and Dolores Ippolito and Chad Osteen and Neil Jordan and French, {Dustin D.} and Howard Gordon and Fischer, {Michael J.} and Smith, {Bridget M.}",

note = "Funding Information: 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. Publisher Copyright: {\textcopyright} The Author(s) 2021.",

year = "2022",

month = aug,

doi = "10.1177/10775587211048661",

language = "English (US)",

volume = "79",

pages = "511--524",

journal = "Medical Care Research and Review",

issn = "1077-5587",

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Stroupe, KT, Martinez, R, Hogan, TP, Gordon, EJ, Gonzalez, B, Tarlov, E, Silva, A, Huo, Z, Kale, I, Ippolito, D, Osteen, C, Jordan, N , French, DD, Gordon, H, Fischer, MJ & Smith, BM 2022, 'Health Insurance Coverage Among Veterans Receiving Care From VA Health Care Facilities', Medical Care Research and Review, vol. 79, no. 4, pp. 511-524. https://doi.org/10.1177/10775587211048661

TY - JOUR

T1 - Health Insurance Coverage Among Veterans Receiving Care From VA Health Care Facilities

AU - Stroupe, Kevin T.

AU - Martinez, Rachael

AU - Hogan, Timothy P.

AU - Gordon, Elisa J.

AU - Gonzalez, Beverly

AU - Tarlov, Elizabeth

AU - Silva, Abigail

AU - Huo, Zhiping

AU - Kale, Ibuola

AU - Ippolito, Dolores

AU - Osteen, Chad

AU - Jordan, Neil

AU - French, Dustin D.

AU - Gordon, Howard

AU - Fischer, Michael J.

AU - Smith, Bridget M.

N1 - Funding Information: 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. Publisher Copyright: © The Author(s) 2021.

PY - 2022/8

Y1 - 2022/8

N2 - 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.

AB - 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.

KW - Affordable Care Act

KW - health policy

KW - insurance

KW - mixed methods

KW - veterans affairs

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ER -

Health Insurance Coverage Among Veterans Receiving Care From VA Health Care Facilities

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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