The affordable care act and changes in insurance coverage and source of health care among high-risk rural, substance-using, female offenders transitioning to the community

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4 Scopus citations

Abstract

Purpose. This study examines health care coverage and health care among rural, drug-involved female offenders under the Affordable Care Act (ACA) compared with pre-ACA and whether being insured is associated with having a usual source of care. Methods. This study involved random selection, screening, and face-to-face interviews with drug-using women in three rural Appalachian jails. Analyses focused on participants who had completed a three-month follow-up interview after release from jail (N=371). Results. Analyses indicated that women released after ACA implementation were more likely than those released pre-implementation to be insured. A multivariate logistic regression model showed that being insured was significantly related to having a usual health care source during community re-entry. Conclusions. Results demonstrate the benefits of the ACA, signaling important implications for public health in rural communities and the criminal justice system, including targeting underserved groups during incarceration and providing information about and resources for health care enrollment.

Original languageEnglish
Pages (from-to)843-863
Number of pages21
JournalJournal of Health Care for the Poor and Underserved
Volume29
Issue number3
DOIs
StatePublished - Aug 2018

Bibliographical note

Funding Information:
This study was supported by Grants R01DA033866 (PI: Staton) and K02DA035116 (PI: Oser) from the National Institute on Drug Abuse. Opinions expressed are those of the authors and do not represent the position of the National Institute on Drug Abuse or the correctional facilities.

Publisher Copyright:
© Meharry Medical College.

Keywords

  • Health care reform
  • Health services
  • Reentry
  • Rural health
  • Substance abuse
  • Uninsured

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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