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CDC finds more health insurance, and more asthma attacks

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The Patient Protection and Affordable Care Act (PPACA) seems to have led to a dramatic improvement in U.S. residents’ access to medical care.

The percentage of U.S. residents of all ages who failed to get care due to cost at some time during the previous 12 months dropped to 4.4 percent during the first three months of 2015.

That’s down from an average of 5.3 percent for all of 2014; down from 5.9 percent for all of 2013; and down from a recent high of 6.9 percent in 2009 and 2010.

The percentage of consumers who reported cost-related care access problems was already starting to fall in 2011, before many PPACA coverage access provisions started to take effect, but improvement accelerated in 2014, when the PPACA exchange program and PPACA Medicaid expansion program came to life, and it accelerated again between 2014 and early 2015.

The U.S. Centers for Disease Control and Prevention (CDC) published the care access data today in an early release of new results from the National Health Interview Survey (NHIS) program.

See also: CDC finds 6.7 million exchange plan enrollees

The Children’s Health Insurance Plan (CHIP) program already provided generous coverage programs for children before 2014, and Medicare provided almost universal coverage access for older adults. Because children and older adults already had ready access to coverage before 2014, PPACA has had the most dramatic access on coverage rates for adults ages 18 to 64.

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The CDC reported in the new NHIS data release that the percentage of people ages 18 to 64 who were uninsured dropped to less than 26 percent in early 2015. That was down from 32 percent in 2014, and down from 40 percent in 2013.

The CDC found that the percentage of people in the 18-64 age group who had either traditional private coverage or PPACA exchange plan private coverage increased to about 70 percent this year, up from 67 percent in 2014, and up from 64 percent in 2013.

Some critics have questioned whether getting Medicaid coverage is necessarily comparable to getting private coverage, in terms of health effects, or whether getting coverage through the new PPACA exchange system has the same effect as getting traditional private coverage.

Tables in the early NHIS results mostly relate to care access indicators, such as access to a regular source of care; slow-to-change variables, such as body weight and use of tobacco; and vaccinations. Use of vaccinations has been increasing, but that may be due to general health promotion programs, the expansion of retail clinics and the PPACA preventive services coverage requirements as well as to the PPACA coverage expansion programs.

One section in the NHIS data release that may relate to the general appropriateness of the care patients are receiving deals with asthma.

The CDC gives the percentage of persons ages 15 to 34 who experienced an asthma episode in the previous 12 months. About 85 percent of the people in that age group are ages 18 to 34.

Earlier this year, 4.3 percent of the NHIS participants in that age group reported experiencing a recent asthma episode. That’s up from 3.6 percent in 2013, up from 4 percent in 2011, and up from 3.1 percent in 2009.

Based on reports from parents and guardians who participated in the NHIS earlier this year, 4.3 percent of the children ages 14 and younger had experienced a recent asthma episode. That was down from 4.5 percent in 2013, down from 5 percent in 2011, and down from 5.5 percent in 2009.

The difference between the asthma episode trends for children and young adults could reflect illnesses or environmental factors that affect young adults more than children, but it could also reflect differences in the nature of the care children and young adults are getting. 

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