Nonelderly adults who are uninsured or use public coverage are more likely to report they experienced unfair treatment when receiving health care, according to a report published on Tuesday by the Urban Institute.
The group found that 9.6 percent of uninsured adults and 7.4 percent of publicly insured adults reported experiencing unfair treatment because of their coverage type, more than five times as likely as the 1.3 percent of privately insured adults who reported such treatment.
“Experiences of unfair treatment in health care settings have been associated with unmet health needs that can result in poorer health care quality and contribute to health inequities,” the group wrote. “Understanding who is experiencing unfair treatment and why is necessary so that policymakers and payers can implement effective policies to prevent such treatment.”
The Urban Institute cited lower Medicaid payments to health care providers compared to those made by private insurance companies as a potential cause, suggesting that an increase in Medicaid payments could reduce the disparity.
But the group also noted that uninsured and publicly insured adults indicated higher rates of unfair treatment for reasons outside of their coverage type, including income, disability status, race and sexual orientation.
“The higher rates of unfair treatment experienced by publicly insured and uninsured adults could have many causes, including providers’ and office staff members’ biases, payment and administrative barriers in Medicaid and affordability issues facing uninsured people,” the group wrote in the report.
Nearly 82 million people were insured through Medicaid as of May, federal data shows. About two-thirds of nonelderly adults use private insurance.
The Urban Institute also found that adults with public insurance were more likely than those insured privately to report having an unmet health need due to an insurance-related hassle, like difficulty finding a doctor that will accept their coverage.
Roughly 16 percent of publicly insured adults reported such an issue in the past year, compared to 11 percent among adults with private insurance.
“These patterns suggest that, on average, adults experience greater hassles associated with having Medicaid coverage relative to private insurance, which, in turn, could be interpreted by patients as unfair treatment,” the report states.