Evidence map›Paper›PMID 34845000›Full record

ReviewBMJ global health2021

Compact for care: how the Affordable Care Act marketplaces fell short for a vulnerable population in Hawaii.

Joshua S Ng Kamstra, Teresa Molina, Timothy Halliday

Abstract readReview
In one paragraph

Review in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Obamacare: A bibliometric perspective.Frontiers in public health · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Joshua S Ng KamstraThe Queen's Health Systems, Honolulu, Hawaii, USA josh.ngkamstra@gmail.com.
Teresa MolinaDepartment of Economics, University of Hawai'i at Manoa, Honolulu, Hawaii, USA.
Timothy HallidayDepartment of Economics, University of Hawai'i at Manoa, Honolulu, Hawaii, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The Patient Protection and Affordable Care Act (ACA) was passed in 2010 to expand access to health insurance in the USA and promote innovation in health care delivery. While the law significantly reduced the proportion of uninsured, the market-based protection it provides for poor and vulnerable US residents is an imperfect substitute for government programs such as Medicaid. In 2015, residents of Hawaii from three Compact of Free Association nations (the Federated States of Micronesia, Palau and Marshall Islands) lost their eligibility for the state's Medicaid program and were instructed to enrol in coverage via the ACA marketplace. This transition resulted in worsened access to health care and ultimately increased mortality in this group. We explain these changes via four mechanisms: difficulty communicating the policy change to affected individuals, administrative barriers to coverage under the ACA, increased out of pocket health care costs and short enrolment windows. To achieve universal health coverage in the USA, these challenges must be addressed by policy-makers.

Indexed as

Patient Protection and Affordable Care ActVulnerable PopulationsHawaiiHumansInsurance CoverageInsurance, HealthUnited Stateshealth economicshealth insurancehealth policyhealth services researchhealth systems

Identifiers

PMID34845000
PMCPMC8634008

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.