title: New Medicaid Enrollees See Health and Social Benefits in Pennsylvania's Expansion.
abstract: Understanding how new Medicaid enrollees are approaching their own health and health care in the shifting health care landscape of the Affordable Care Act has implications for future outreach and enrollment efforts, as well as service planning for this population. The objective of this study was to explore the health care experiences and expectations of new Medicaid expansion beneficiaries in the immediate post-enrollment period. We conducted semistructured, qualitative interviews with a random sample of 40 adults in Philadelphia who had completed an application for Medicaid through a comprehensive benefits organization after January 1, 2015, when the Medicaid expansion in Pennsylvania took effect. We conducted an inductive, applied thematic analysis of interview transcripts. The new Medicaid beneficiaries described especially high levels of pent-up demand for care. Dental care was a far more pressing and motivating concern than medical care. Preventive services were also frequently mentioned. Participants anticipated that insurance would reduce both stress and financial strain and improve their experience in the health care system by raising their social standing. Participants highly valued the support of telephone application counselors in the Medicaid enrollment process to overcome bureaucratic obstacles they had encountered in the past. Dental care and preventive services appear to be high priorities for new Medicaid enrollees. Telephone outreach and enrollment support services can be an effective way to overcome past experiences with administrative barriers.
authors: Crescenz VA Medical Center, Philadelphia, PA, USA University of Pennsylvania, Philadelphia, USA jeffhom@upenn.edu.
authors: Jeffrey K
authors: JK
authors: Hom
authors: University of Pennsylvania, Philadelphia, USA Children's Hospital of Philadelphia, PA, USA.
authors: Charlene
authors: C
authors: Wong
authors: University of Pennsylvania, Philadelphia, USA.
authors: Christian
authors: C
authors: Stillson
authors: University of Colorado, Denver, USA.
authors: Jessica
authors: J
authors: Zha
authors: University of Pennsylvania, Philadelphia, USA.
authors: Carolyn C
authors: CC
authors: Cannuscio
authors: Benefits Data Trust, Philadelphia, PA, USA.
authors: Rachel
authors: R
authors: Cahill
authors: University of Pennsylvania, Philadelphia, USA.
authors: David
authors: D
authors: Grande
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act; D015143:Philadelphia; D011314:Preventive Health Services; D036301:Qualitative Research; D013221:State Health Plans; D014481:United States; D055815:Young Adult
keywords: Medicaid; dental care; health care reform; health insurance; preventive health services