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Health insurance status, medical debt, and their impact on access to care in arizona

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  • Herman, P.M.
  • Rissi, J.J.
  • Walsh, M.E.

Abstract

Objectives: We examined the impact of health insurance status on medical debt among Arizona residents and the impact of both of these factors on access to care. Methods: We estimated logistic regression models for medical debt (problems paying and currently paying medical bills) and access to care (medical care and medications delayed or missed because of cost or lack of insurance). Results: Insured status did not predict medical debt after control for health status, income, age, and household characteristics. Insured status (adjusted odds ratio [AOR]=0.32), problems paying medical bills (AOR=4.96), and currently paying off medical bills (AOR=3.04) were all independent predictors of delayed medical care, but only problems paying (AOR=6.16) and currently paying (AOR=3.68) medical bills predicted delayed medications. Inconsistent coverage, however, was a strong predictor of problems paying bills, and both of these factors led to delays in medical care and medications. Conclusions: At least in Arizona, health insurance does not protect individuals from medical debt, and medical debt and lack of insurance coverage both predict reduced access to care. These results may represent a troubling message for US health care in general.

Suggested Citation

  • Herman, P.M. & Rissi, J.J. & Walsh, M.E., 2011. "Health insurance status, medical debt, and their impact on access to care in arizona," American Journal of Public Health, American Public Health Association, vol. 101(8), pages 1437-1443.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2010.300080_3
    DOI: 10.2105/AJPH.2010.300080
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    Cited by:

    1. Jacqueline Warth & Marie-Therese Puth & Ulrike Zier & Niklas Beckmann & Johannes Porz & Judith Tillmann & Klaus Weckbecker & Hans Bosma & Birgitta Weltermann & Eva Münster, 2020. "Patient-physician communication about financial problems: A cross-sectional study among over-indebted individuals," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-14, May.
    2. Benjian Wu & Yi Cui & Yushuo Jiang, 2022. "The Role of Microfinance in China’s Rural Public Health: Evidence from the Anti-Poverty Microcredit Program," IJERPH, MDPI, vol. 19(17), pages 1-22, August.
    3. Sachin J Shah & Harlan M Krumholz & Kimberly J Reid & Saif S Rathore & Aditya Mandawat & John A Spertus & Joseph S Ross, 2012. "Financial Stress and Outcomes after Acute Myocardial Infarction," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-10, October.
    4. Jacqueline Warth & Niklas Beckmann & Marie-Therese Puth & Judith Tillmann & Johannes Porz & Ulrike Zier & Klaus Weckbecker & Birgitta Weltermann & Eva Münster, 2020. "Association between over-indebtedness and antidepressant use: A cross-sectional analysis," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-11, July.
    5. Jiajing Li & Chen Jiao & Stephen Nicholas & Jian Wang & Gong Chen & Jinghua Chang, 2020. "Impact of Medical Debt on the Financial Welfare of Middle- and Low-Income Families across China," IJERPH, MDPI, vol. 17(12), pages 1-13, June.

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