Comparing weighted data on proportions of uninsured adults living in Tennessee households in 1993 and 1998 provides insight into changes in health status, utilization of medical care services and access to care after introducing TennCare, the Medicaid waiver program, in 1994. Results of two random digit dial telephone surveys of approximately 8,000 and 11,000 adults in 1993 and 1998, respectively, show that the prevalence of being uninsured has decreased 43% (from 14% to 8%) over the five-year period. Differences are slightly more pronounced when looking at certain subgroups of the population. The prevalence of lack of insurance declined approximately 44% among non-whites, 46% for low-income (less than $25,000 per household) Tennesseeans living in rural areas, and 48% for low-income men. While the prevalence of reported poor or fair health and disability remained stable over time, more people on TennCare in 1998 had regular sources of health care than did those on Medicaid in 1993. At the same time, utilization of emergency room services declined among people on TennCare in 1998 compared to those on Medicaid in 1993, but remained stable among the uninsured over time. However, among both the uninsured and TennCare recipients in 1998, health care access declined sharply compared to 1993. These changes will be further explored and documented by age, sex, race and metropolitan residence. Multivariate analysis will be used to assess time trends. Results have important implications for determining the success of TennCare and similar Medicaid waiver programs in eliminating disparities in health care access.
Learning Objectives: 1. Explore and document changes in the prevalence of being uninsured by age, sex, race and metropolitan residence. 2. Identify key predictors of change in lack of health insurance over time. 3. Assess the applicability of findings to evaluation of Medicaid waiver programs like TennCare
Keywords: Access to Health Care, Insurance-Related Barriers
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.