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Impact of Health Insurance Expansions on Nonelderly Adults With Hypertension
ORIGINAL RESEARCH — Volume 12 — July 2, 2015
PEER REVIEWED
This figure illustrates the disease state transitions in our Markov chain model. Complete transitions are shown only for individuals with a history of myocardial infarction. Insurance status was assumed to affect an individual’s annual probabilities of CVD and 1-year mortality after a CVD event.
Figure 1. Simplified diagram of the Markov process. Abbreviation: CHD, coronary heart disease; CVD, cardiovascular disease; MI, myocardial infarction.
| Scenario and Race/Ethnicity | Age, y | |||
|---|---|---|---|---|
| 25–34 y | 35–44 y | 45–54 y | 55–64 y | |
| Reduction in No. of CVD Events, % | ||||
| Expansion scenario 1 | ||||
| White | 1.17 | 0.86 | 0.45 | 0.31 |
| Black | 2.73 | 1.46 | 0.92 | 0.51 |
| Nonwhite Hispanic | 3.24 | 2.51 | 1.73 | 1.07 |
| Expansion scenario 2 | ||||
| White | 2.40 | 2.02 | 1.05 | 0.54 |
| Black | 5.16 | 3.08 | 1.87 | 0.85 |
| Nonwhite Hispanic | 9.36 | 6.80 | 4.51 | 2.82 |
| Reduction in Total Deaths, % | ||||
| Expansion scenario 1 | ||||
| White | 4.39 | 2.23 | 1.11 | 0.83 |
| Black | 7.59 | 3.60 | 1.70 | 1.43 |
| Nonwhite Hispanic | 7.22 | 3.80 | 1.68 | 0.80 |
| Expansion scenario 2 | ||||
| White | 7.19 | 4.15 | 2.35 | 1.27 |
| Black | 13.23 | 7.12 | 3.70 | 2.23 |
| Nonwhite Hispanic | 19.59 | 10.31 | 4.56 | 2.16 |
Figure 2. Estimated reduction in cardiovascular events and mortality rates under insurance expansions for white, black, and nonwhite Hispanic populations, by age group. These charts illustrate the racial/ethnic-specific effects of insurance coverage expansion by age group. Outcomes are measured by percentage reduction in cardiovascular events and mortality rates. Scenario 1 assumes currently undecided states opting out of Medicaid expansion, and scenario 2 assumes the entire US population is covered by insurance.
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