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Refugee Resettlement Patterns and State-Level Health Care Insurance Access in the United States

Published on Apr 1, 2016in American Journal of Public Health5.381
· DOI :10.2105/AJPH.2015.303017
Pooja Agrawal4
Estimated H-index: 4
,
Arjun K. Venkatesh17
Estimated H-index: 17
Sources
Abstract
We sought to evaluate the relationship between state-level implementation of the Patient Protection and Affordable Care Act (ACA) and resettlement patterns among refugees. We linked federal refugee resettlement data to ACA expansion data and found that refugee resettlement rates are not significantly different according to state-level insurance expansion or cost. Forty percent of refugees have resettled to states without Medicaid expansion. The wide state-level variability in implementation of the ACA should be considered by federal agencies seeking to optimize access to health insurance coverage among refugees who have resettled to the United States.
  • References (14)
  • Citations (7)
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References14
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#1Pinar Karaca-Mandic (NBER: National Bureau of Economic Research)H-Index: 17
#2Brent D. Fulton (University of California, Berkeley)H-Index: 10
Last. Richard M. Scheffler (University of California, Berkeley)H-Index: 34
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States have varying degrees of review authority over health insurance carriers’ rates, including prior approval authority over proposed rates and requirements for loss ratios, the proportion of premium revenues spent on medical claims. The Affordable Care Act (ACA) requires carriers in certain categories of health insurance to provide public justification for rate increases of 10 percent or more. We collected data on how states changed their rate review authority and requirements during 2010–13,...
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#1Katherine Yun (UPenn: University of Pennsylvania)H-Index: 12
#2Kelly HebrankH-Index: 1
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The global rise in non-communicable disease (NCD) suggests that US-based refugees are increasingly affected by chronic conditions. However, health services have focused on the detection of infectious disease, with relatively limited data on chronic NCDs. Using data from a retrospective medical record review of a refugee health program in the urban Northeast (n = 180), we examined the prevalence of chronic NCDs and NCD risk factors among adult refugees who had recently arrived in the US, with att...
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#1Meghan D. Morris (UCSD: University of California, San Diego)H-Index: 14
#2Steve T. Popper (UCSD: University of California, San Diego)H-Index: 2
Last. Kimberly C. Brouwer (UCSD: University of California, San Diego)H-Index: 32
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The majority of refugees spend the greater part of their lives in refugee camps before repatriation or resettlement to a host country. Limited resources and stress during residence in refugee camps can lead to a variety of acute and chronic diseases which often persist upon resettlement. However, for most resettled refugees little is known about their health needs beyond a health assessment completed upon entry. We conducted a qualitative pilot-study in San Diego County, the third largest area i...
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#1David M. Blau (UNC: University of North Carolina at Chapel Hill)H-Index: 36
#2Erdal Tekin (GSU: Georgia State University)H-Index: 23
This paper provides an analysis of child care subsidies under welfare reform in the USA. We used data from the 1999 National Survey of America's Families to analyze the determinants of receipt of a child care subsidy and the effects of subsidy receipt on employment, school attendance, unemployment, and welfare participation. Ordinary least-squares estimates that treat subsidy receipt as exogenous show an effect of subsidy receipt on employment of about 13 percentage points. Two-stage least-squar...
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ContextLittle is known about the long-term mental health of trauma-exposed refugees years after permanent resettlement in host countries.ObjectiveTo assess the prevalence, comorbidity, and correlates of psychiatric disorders in the US Cambodian refugee community.Design, Setting, and ParticipantsA cross-sectional, face-to-face interview conducted in Khmer language on a random sample of households from the Cambodian community in Long Beach, Calif, the largest such community in the United States, b...
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Worldwide, there are approximately 13 million refugees and asylum seekers.1 Flight of refugees often occurs in the setting of war, famine, or human rights violations, resulting from a “well-founded fear of being persecuted for reasons of race, religion, nationality, membership in a particular social group, or political opinion.”2 Physicians in host countries increasingly encounter refugees in their practices and, owing to inadequate training, may not fully meet their complex medical needs. Limit...
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Summary Background What are the deleterious effects of mass trauma on the psychological wellbeing of refugees and other war-affected populations? Most epidemiological data are for short-to-medium term effects, leaving the possibility that early psychological reactions could reduce naturally over time. We aimed to assess the long-term effects of trauma on mental health and disability in Vietnamese refugees resettled in Australia. Methods In a population-based study, we identified a community samp...
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#1Gilbert Gonzales (Vandy: Vanderbilt University)H-Index: 9
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Sexual minorities and immigrants face unique challenges to accessing health care in the United States. This study used data on nonelderly adults (n = 100,667) from the 2013–2016 National Health Interview Survey. Unadjusted prevalence estimates and multivariable logistic regression models (with and without interactions between immigration and sexual minority status) were used to compare health insurance coverage and access to care by immigration and sexual minority status. We did not find any dif...
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Social workers, government, and non-governmental organizations in the United States have been inadequately prepared to address the impact of trauma faced by refugees fleeing persecution. Compounding their initial trauma experiences, refugees often undergo further traumatic migration experiences and challenges after resettlement that can have long-lasting effects on their health and mental health. Micro and macro social work practitioners must understand the impact of these experiences in order t...
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