The Affordable Care Act (ACA), passed on March 23rd, 2010, contains widesweeping legislation aimed at reforming the current U.S. healthcare system. The ACA has been lauded by its proponents and deeply criticized by its opponents. The current paper included two experimental studies designed to test if the individual insurance mandate requirement is a specific source of the psychological and behavioral resistance displayed toward the ACA. In study 1 the individual insurance mandate requirement did not produce greater negative attitudes towards the ACA or the current Presidential administration and it did not predict attitudes towards the longevity of the ACA. Democrats were found to have significantly less negative attitudes towards the ACA and towards the longevity of the ACA and Democrats also reported a lower likelihood of the ACA being repealed in comparison to Independents, Republicans or Libertarians. In study 2, the non-significant individual insurance mandate findings from study 1, were replicated in study 2. However, Democrats again were found to have significantly less negative attitudes towards the ACA and towards the longevity of the ACA in comparison to Independents, Republicans and those with no political affiliation. Democrats also indicated that they were less likely to vote for a political candidate who supports the repeal of the ACA in comparison to Independents, Republicans and those with no political affiliation. Implications and future research directions are discussed.

The Little Sisters of the Poor v. Burwell, a 2016 landmark religious liberty case, illustrates the ongoing debate between religious non-profit organizations and the government regarding the contraception mandate of the Affordable Care Act. Although the Little Sisters, in part because of their public relations and political advantages, received a relatively favorable outcome at the Supreme Court, their true successes lie on their impact on conservative politics and on the 2016 election. The Little Sisters became a significant component of political and religious leaders’ strategy to reframe the issue.

Class of 2015 Abstract / Objectives: Characterize all patients in the emergency room diagnosed with anxiety disorders from 11/01/2013 until 5/31/2014 to identify insurance coverage and demographic trends. Methods: Retrospective descriptive study of patients who present to the emergency department between 11/01/2013 – 05/31/2014 and discharged with a primary documented diagnosis of an anxiety disorder. Age, race, and gender were recorded in addition to insurance coverage. Results: 406 visits were reviewed: 212 (52.2%) males and 194 (47.8%) females. Average age per visit: 40.34 (SD=13.388). Race recorded with each visit: 189 (46.6%) white, 146 (36.0%) Hispanic, 42 (10.3%) African American, and 29 (2.2%) other. The most common insurance coverage was Medicaid at 63.3%, while 6.4% of visits had no insurance coverage. There was a significant difference in the distribution in number of ED visits between genders (Mann-Whitney U=17,407.5, p=0.007, sig ≥0.05). A Kruskal-Wallis Test showed a significant difference in the number of ED visits between racial groups X²=43.434, p=0.000 as well as a significant difference between Medicaid and other insurance groups X²=37.778, p=0.021. Conclusions: Men appear to have a higher frequency in anxiety symptoms requiring an ED visit than women do. White patients tend to have a greater frequency in anxiety symptoms followed by Hispanic patients. Medicaid tends to be the most prevalent insurance coverage used.

Expenditures on health are currently an important and growing item of public as well as private budgets in the developed world. This diploma thesis analyzes two different approaches to the function of health insurance on the example of the Czech Republic and the United States of America. The theoretical part will generally characterize access to health care through different theories; there will be also introduced the system of health insurance and the agents on health care market. The specifics of the health care market will be also explained. The analytical part of the work will focus on health insurance systems in the Czech Republic and the United States and their development, with accent on major reforms of recent years. With mutual comparison of the two systems, thesis will examine the shortcomings of public health insurance and private health insurance, including the effectiveness of their removal. Afterwards, the analysis of selected indicators of health care will be provided. The aim of the work is an analysis of the different systems of health insurance in the Czech Republic and the United States with relationship to the recent reforms and evaluation of their mutual effectiveness.

Preventative care services allow patients to be fully equipped with the knowledge, tools, and other resources to help them discover and treat many diseases and illnesses so that the burden of costs will not fall on patients and their families. Since the passage of the Affordable Care of Act (ACA) by President Barack Obama, the requirement for health insurance coverage has not translated to utilization of preventative care services. The purpose of this study is to determine the motivation for African Americans who have insurance coverage and access to care who are not taking advantage of opportunities for screenings and health education. The health belief model was used to determine how belief and modifying factors influence health decisions. The quantitative study required use of a secondary dataset to determine utilization of preventative care services, insurance affordability, future access to care and understanding of the health care law. The study included testing the statistical significance of these factors among African Americans, White Americans, and Hispanic Americans who participated in the Healthy Americas Survey. Using the program SPSS to process data analyzation and organize output, results reveal that African American participants are concerned about the future ability to access and afford care. With a history of distrust amongst African Americans and the health industry, social implications are for administrators and providers to bridge the gap by offering health education to those in their immediate communities and requesting and implementing feedback from those same individuals.

Introduction: The US Health Care and Social Services sector (North American Industrial Classification System 'sector 62') has become an extremely important component of the nation's economy, employing approximately 18 million workers and generating almost $753 billion in annual payrolls. At the county level, the health care and social services sector is typically the largest or second largest employer. Hospital employment is often the largest component of the sector's total employment. Hospital employment is particularly important to non-metropolitan or rural communities. A high quality healthcare sector serves to promote economic development and attract new businesses and to provide stability in economic downturns. The purpose of this study was to examine the intensity of hospital employment in rural counties relative to the nation as a whole using location quotients and to draw conclusions regarding how potential changes in Medicare and Medicaid might affect rural populations. Methods: Estimates for county-level hospital employment are not commonly available. Estimates of county-level hospital employment were therefore generated for all counties in the USA the Census Bureau's County Business Pattern Data for 2010. These estimates were used to generate location quotients for each county which were combined with demographic data to generate a profile of factors that are related to the magnitude of location quotients. The results were then used to draw inferences regarding the possible impact of the Patient Protection and Affordable Care Act 2010 (ACA) and the possible imposition of aspects of the Budget Control Act 2011 (BCA). Results: Although a very high percentage of rural counties contain medically underserved areas, an examination of location quotients indicates that the percentage of the county workforce employed by hospitals in the most rural counties tends to be higher than for the nation as a whole, a counterintuitive finding. Further, when location quotients are regressed upon data related to poverty, county demographics, and the percentage of the population insured, a relationship between the proportion of the population over 65 years, the percentage of the population living in poverty, the percentage of the population without insurance and county density was found. Conclusion: The results of the analysis suggest that hospital employment in rural communities is higher than would be expected in the absence of programs that provide external funding to support hospital hiring. The most important public programs providing this support are Medicare and Medicaid. Social Security is another source of federal funding important for rural populations. Sequestration and other cuts in funding could impact rural communities significantly. This can be even worse in states that fail to expand Medicaid and in states that fail to increase Medicaid reimbursements for services important in rural communities.

Introduction: The US Health Care and Social Services sector (North American Industrial Classification System 'sector 62') has become an extremely important component of the nation's economy, employing approximately 18 million workers and generating almost $753 billion in annual payrolls. At the county level, the health care and social services sector is typically the largest or second largest employer. Hospital employment is often the largest component of the sector's total employment. Hospital employment is particularly important to non-metropolitan or rural communities. A high quality healthcare sector serves to promote economic development and attract new businesses and to provide stability in economic downturns. The purpose of this study was to examine the intensity of hospital employment in rural counties relative to the nation as a whole using location quotients and to draw conclusions regarding how potential changes in Medicare and Medicaid might affect rural populations. Methods: Estimates for county-level hospital employment are not commonly available. Estimates of county-level hospital employment were therefore generated for all counties in the USA the Census Bureau's County Business Pattern Data for 2010. These estimates were used to generate location quotients for each county which were combined with demographic data to generate a profile of factors that are related to the magnitude of location quotients. The results were then used to draw inferences regarding the possible impact of the Patient Protection and Affordable Care Act 2010 (ACA) and the possible imposition of aspects of the Budget Control Act 2011 (BCA). Results: Although a very high percentage of rural counties contain medically underserved areas, an examination of location quotients indicates that the percentage of the county workforce employed by hospitals in the most rural counties tends to be higher than for the nation as a whole, a counterintuitive finding. Further, when location quotients are regressed upon data related to poverty, county demographics, and the percentage of the population insured, a relationship between the proportion of the population over 65 years, the percentage of the population living in poverty, the percentage of the population without insurance and county density was found. Conclusion: The results of the analysis suggest that hospital employment in rural communities is higher than would be expected in the absence of programs that provide external funding to support hospital hiring. The most important public programs providing this support are Medicare and Medicaid. Social Security is another source of federal funding important for rural populations. Sequestration and other cuts in funding could impact rural communities significantly. This can be even worse in states that fail to expand Medicaid and in states that fail to increase Medicaid reimbursements for services important in rural communities.

No description available.

Affordable Care Act (ACA) was passed and implemented to expand insurance coverage, reduce health care cost, and improve the quality of care. The purpose of this dissertation study was to investigate whether the ACA insurance expansion correlates with the number of visits made to emergency departments (EDs). The quasi-experimental design interrupted time series was utilized in the analysis. The ED visits were compared using MANOVA to determine the relationship between ED visits and ACA and canonical correlation analysis to assess the strength of the relationship and the extent to which independent variables could predict the dependent variable. The hypothesis was that the ACA will reduce the uninsured, increase the insured, and reduce the ED visits. The relationship between number of ED visits and the ACA will present whether the uninsured patients contributed significantly to the ED overcrowding. Analysis of secondary data from four EDs (H1, H2, H3, and H4) in the Chicago area showed that 484,742 visits were made, and 2,801 were excluded due to unknown payer type. Medicaid patients recorded the largest number of visits (181,226) while the uninsured patients recorded the least number of visits (56,572). The ED visits decreased by 6% from 2012 to 2013 (pre-ACA) and increased by 4% from 2013 to 2105 (post-ACA). The ACA implementation increased the people with insurance who visited the EDs by 11%. The results demonstrated a strong relationship between ACA and ED visits. The correlation of the variables (hospital and year) and ED visits demonstrated that the hospital could explain 97% of the Medicaid visits and 87% of uninsured while the year could predict 82.6% of the uninsured visits and 52.5% of Medicaid visits.

The U.S. Department of Health and Human Services has declared the misuse of opioid prescription drugs as a public health emergency. The Affordable Care Act’s Medicaid expansion expanded the number of people with insurance and increased the demand for services related to substance abuse treatment. In the first part of this study, the researcher examines whether the Medicaid expansion reduced the likelihood of treatment delay. The second part of this study explores whether the length of stay for opioid use disorder treatment is significantly different in states that adopted Medicaid expansion versus states that did not. In both studies, the researcher analyzes administrative data from the Substance Abuse and Mental Health Services Administration to discover any treatment delays associated with the opioid treatments for the states that adopted the expansion versus the states that did not, and to determine whether there was a difference in the length of stay in the states that adopted the Medicaid versus the states that did not. A difference-in-difference approach is used in both studies to compare the states which adopted an optional Medicaid expansion to those non-adoption states. The evidence suggests that demand for opioid treatment services increased in expansion states as there is a decreased probability of obtaining treatment on the first day for initial requests for outpatient treatment. In addition, evidence suggests that Medicaid expansion increased the likelihood of staying longer in outpatient facilities, but not inpatient facilities. / Business Administration/Risk Management and Insurance