Social isolation has been compared to smoking in terms of risk to public health. Some
groups are at particularly high risk for these feelings, including people with disabilities and rural residents.
Few studies have considered the potentially compounding effects of disability status and rural
residency. To evaluate how reported satisfaction with social participation and perceived isolation relate
to the health of rural and urban people with disabilities, and to consider whether number of disabilities,
living arrangement, and employment status were. Read more
This article uses recent survey data to compare and contrast American adults with intellectual disability (ID) and/or autism spectrum disorder (ASD) and those with other disabilities with regard to overall health, access to health care, and other aspects of community participation. Read more
On the 2018 National Survey on Health Reform and Disability (NSHRD)1 and during national telephone interviews in 2019, consumers with disabilities were asked about their experiences with health care services and insurance. At the end of each interview and as the final question on the NSHRD, participants were asked: “What would you tell policymakers about access to health insurance and health care services for people with disabilities?” The quotes provided below are a selection of responses to this question. Read more
Although health insurance gains are documented, little is known about personal experiences of adults with disabilities in accessing health care after coverage expansions of the Affordable Care Act (ACA) in 2014. We interviewed 22 adults across the U.S. with a variety of disabilities and health insurance types to document remaining barriers to health care after ACA coverage expansions. Telephone interviews were conducted from May to August 2017. Participants were recruited via disability-related organizations and were demographically and geographically diverse. Content analysis of interview transcripts was used to identify major themes related to accessing health care. Read more
In an effort to make information about healthcare, health reform, and people with disabilities more available and accessible, we have developed the following chartbook about the healthcare utilization and expenditures of working-age people with and without disabilities. These results are presented with minimal interpretation and you are welcome to use them with attribution. Read more
Before the Patient Protection and Affordable Care Act (ACA), many Americans with disabilities were locked into poverty to maintain eligibility for Medicaid coverage. US Medicaid expansion under the ACA allows individuals to qualify for coverage without first going through a disability determination process and declaring an inability to work to obtain Supplemental Security Income. Medicaid expansion coverage also allows for greater income and imposes no asset tests. In this article, we share updates to our previous work documenting greater employment among people with disabilities living in Medicaid expansion states. Read more
While health reform has expanded health insurance coverage for millions of Americans, people with disabilities continue to face numerous barriers to accessing and receiving health care. During the summer of 2017, CHRIL staff at the University of Kansas conducted telephone interviews with a diverse national sample of 22 working-age people with a range of disabilities and coverage types (employer-sponsored, Medicaid, Medicare, marketplace plans and no insurance) to document their experiences with health insurance and obtaining timely access to health care services. During the interviews, participants were asked if they wanted to share any insights or suggestions with policy makers. This brief documents these personal perspectives on barriers to care and suggestions for improving health coverage for Americans with disabilities. Read more
The survey is currently closed. Read more
Throughout 2017, an online needs assessment survey was administered to nearly 150 CILs. In this survey, CHRIL set out to collect data regarding the CILs funding sources, staff perspectives on the concerns and interests of consumers, the type and frequency of health insurance counseling and enrollment assistance CILs offered, and questions or concerns CIL staff had regarding the health insurance marketplace.
The goal of this project is to determine the information, training, and technical assistance needs of CILs as they help consumers access healthcare and obtain or maintain health insurance coverage. The study used an electronic survey designed and administered through SurveyGizmo. Read more
Before the Affordable Care Act (ACA), many people with disabilities were required to live in poverty to maintain their Medicaid eligibility. With Medicaid expansion, they can enter the workforce, increase earnings, and maintain coverage. This study confirmed that people with disabilities were more likely to be employed in the Medicaid expansion states compared with those in non-expansion states (38% vs 32%).
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The United States is in the midst of a deadly opioid epidemic. About 11.8 million Americans misused prescription opioids in 2016. About 42,249 died from an opioid overdose. Adults with disabilities are much more likely to report constant pain than others. Because of this, they are more likely to use and depend on prescription pain medication. The risk of herion use is higher in adults who use prescription opioids for other than pain relief. It is important to look at misuse of legal and illegal opioids at the same time.
This study looks at working-age adults (18-64) with and without disabilities. It compares the frequency of and treatment of opioid misuse. Read more
According to recent studies, the Affordable Care Act (ACA) improved access to health care and health insurance in the United States. Parts of the law say that insurers must cover people with pre-existing conditions. They also say that insurance must cover mental health services. Under the ACA, some states also chose to expand their Medicaid programs to cover more people.
Our study looked at the impact of the ACA and Medicaid expansion on health insurance coverage, access to health care, and employment for people with mental health conditions.
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Before the Affordable Care Act, people with disabilities had trouble buying private insurance. In 2014, private health insurance marketplaces opened in each state. Now people with pre-existing conditions could purchase private health insurance. Some people also qualified for a subsidy or a tax credit to help them purchase insurance. This report compares how the enrollment process, insurance costs, and coverage available for people with disabilities may have been different from others who enrolled in the marketplaces. Read more
In this article, the authors are commenting on a previously published article and stating that American Community Survey (ACS) disability questions are now used on all federal surveys.
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This article provides information on a state option in the American Health Care Act (AHCA) that allows for high-risk pools in health insurance plans. These plans place persons with preexisting conditions into a pool with others who may have high health care costs. In the past, high-risk pools have not made the cost of insurance affordable or provided adequate coverage to persons with or without preexisting conditions. High-risk pools operated in 35 states before the ACA was passed. At that time, the United States had 47 million uninsured people, 33 million of whom lived in states with high-risk pools. The authors believe that any legislation providing for high-risk pools would be a huge step backward for American health care policy. Read more
Women with disabilities are not as likely to become pregnant as women without disabilities. This study looks at how women with disabilities make decisions about pregnancy. Four focus groups were held with 22 women of child-bearing age. Most of the women wanted to become mothers, but they had concerns about becoming pregnant. Three things affected their decision: 1) how important it was to them to have a child, 2) whether it was possible for them to become pregnant, and 3) the costs of having and raising a child.
The study showed that it is more than the medical issues around having a child that are important to a woman. When they discuss pregnancy with a woman with a disability, health care providers should also talk about social and personal factors. By talking about all her concerns, health care providers can help a woman with a disability to make a decision that is in line with her values and desires.
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The study shows that after passage of the Affordable Care Act (ACA), the number of adults with disabilities who had private health insurance rose slightly, from about 33.9% in 2013 to 36.6% by 2015. However, in 2015, adults with disabilities were still over four times more likely to receive public insurance (54.7%) than those without disabilities (12.5%). The data also shows that adults with disabilities are more likely to delay or not receive medical care due to cost as compared to adults without disabilities. Working-age adults with disabilities also reported more hospital stays and more office visits than adults without disabilities. This also may result in higher out-of-pocket costs and delayed treatment for adults with disabilities.
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This study looked at how much cost affected whether or not people filled their prescriptions. The percentage of all Americans who did not fill a prescription in the previous 12 months because they could not afford it grew from 1999 to 2009 to 8% and then dropped to 5% by 2015. For seniors, however, the number peaked in 2004 at 5% and dropped to 4% after implementation of Medicare Part D in 2006. With implementation of Medicare Part D and the Affordable Care Act, the number of prescriptions unfilled because of cost has declined.
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This study looked at data on blood pressure checks, flu shots, and dental visits in a 12 month period. Results showed that adults with physical limitations were more likely to receive a blood pressure check (92% vs. 70%%) or flu shot (40%% vs. 23%) compared to adults with no limitations. However, people with physical limitations were less likely to have a dental check-up (45% vs. 59%) in comparison to those with no limitation. People who had a regular care provider were more likely to receive services.
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Download plain-language brief.
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