Amazon Mechanical Turk (MTurk) is a website used to crowdsource tasks, and for a decade it has been used to conduct research within the fields of social science. This paper examines the efficacy of using MTurk to recruit people with disabilities for survey samples, in contrast to the traditional method of working through established relationships with disability organizations. The study finds that each approach can over- and under-represent different groups within the general population and suggests that a combination of both methods may create the most diverse and accurate sample.

As a marginalized group, disabled people face numerous challenges when it comes to political participation in the United States, and the policy views of disabled people have been historically ignored even within the field of health policy research. This study seeks to address this gap using national surveys and interviews to reveal key insights from the disabled population, including the effects of stigma and exclusion on health care quality, opinions regarding the efficacy of the Affordable Care Act, and desires for expansion into a universal system.

This national survey finds that among Americans with autism spectrum disorder (ASD), those that also identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ+) not only have worse experiences with healthcare but worse health overall. LGBTQ+ respondents indicated notably worse physical and mental health compared to those that identify as straight and cisgender, and when seeking help for these problems, their needs were less frequently met by providers, with some individuals being refused service entirely. Through the intersection of ASD and sexual or gender identity, this study reveals the health disparities that minority groups in the United States face and discusses what might be done to address them.

Social isolation has been compared to smoking in terms of risk to public health. Some groups are at particularly high risk for these feelings, including people with disabilities and rural residents. Few studies have considered the potentially compounding effects of disability status and rural residency. To evaluate how reported satisfaction with social participation and perceived isolation relate to the health of rural and urban people with disabilities, and to consider whether number of disabilities, living arrangement, and employment status were.

This article uses recent survey data to compare and contrast American adults with intellectual disability (ID) and/or autism spectrum disorder (ASD) and those with other disabilities with regard to overall health, access to health care, and other aspects of community participation.

On the 2018 National Survey on Health Reform and Disability (NSHRD) and during national telephone interviews in 2019, consumers with disabilities were asked about their experiences with health care services and insurance. At the end of each interview and as the final question on the NSHRD, participants were asked: “What would you tell policymakers about access to health insurance and health care services for people with disabilities?” The quotes provided below are a selection of responses to this question.

CHRIL research is on display April 23 and 24 at the NARRTC conference. We would love to see you and talk about our work and yours. Our slides from our Tuesday morning presentation are available in PDF here. For alternate formats, please contact liz.wood@wsu.edu.

Although health insurance gains are documented, little is known about personal experiences of adults with disabilities in accessing health care after coverage expansions of the Affordable Care Act (ACA) in 2014. We interviewed 22 adults across the U.S. with a variety of disabilities and health insurance types to document remaining barriers to health care after ACA coverage expansions.

In an effort to make information about healthcare, health reform, and people with disabilities more available and accessible, we have developed the following chartbook about the healthcare utilization and expenditures of working-age people with and without disabilities. These results are presented with minimal interpretation and you are welcome to use them with attribution.

While health reform has expanded health insurance coverage for millions of Americans, people with disabilities continue to face numerous barriers to accessing and receiving health care. During the summer of 2017, CHRIL staff at the University of Kansas conducted telephone interviews with a diverse national sample of 22 working-age people with a range of disabilities and coverage types (employer-sponsored, Medicaid, Medicare, marketplace plans and no insurance) to document their experiences with health insurance and obtaining timely access to health care services. During the interviews, participants were asked if they wanted to share any insights or suggestions with policy makers. This brief documents these personal perspectives on barriers to care and suggestions for improving health coverage for Americans with disabilities.

The National Survey on Health Reform and Disability is now closed and all giftcard drawings have been completed. Analyses from this survey will be posted on this website when completed. If you have other questions about the survey itself, please feel free to email healthsurvey@ku.edu. The National Survey on Health Reform & Disability will be fielded again in the Fall of 2019.

Throughout 2017, an online needs assessment survey was administered to nearly 150 CILs. In this survey, CHRIL set out to collect data regarding the CILs funding sources, staff perspectives on the concerns and interests of consumers, the type and frequency of health insurance counseling and enrollment assistance CILs offered, and questions or concerns CIL staff had regarding the health insurance marketplace.

Before the Affordable Care Act (ACA), many people with disabilities were required to live in poverty to maintain their Medicaid eligibility. With Medicaid expansion, they can enter the workforce, increase earnings, and maintain coverage. This study confirmed that people with disabilities were more likely to be employed in the Medicaid expansion states compared with those in non-expansion states (38% vs 32%).

The United States is in the midst of a deadly opioid epidemic. About 11.8 million Americans misused prescription opioids in 2016. About 42,249 died from an opioid overdose. Adults with disabilities are much more likely to report constant pain than others. Because of this, they are more likely to use and depend on prescription pain medication. The risk of herion use is higher in adults who use prescription opioids for other than pain relief. It is important to look at misuse of legal and illegal opioids at the same time. This study looks at working-age adults (18-64) with and without disabilities. It compares the frequency of and treatment of opioid misuse.

According to recent studies, the Affordable Care Act (ACA) improved access to health care and health insurance in the United States. Parts of the law say that insurers must cover people with pre-existing conditions. They also say that insurance must cover mental health services. Under the ACA, some states also chose to expand their Medicaid programs to cover more people.

Before the Affordable Care Act, people with disabilities had trouble buying private insurance. In 2014, private health insurance marketplaces opened in each state. Now people with pre-existing conditions could purchase private health insurance. Some people also qualified for a subsidy or a tax credit to help them purchase insurance. This report compares how the enrollment process, insurance costs, and coverage available for people with disabilities may have been different from others who enrolled in the marketplaces.

In this article, the authors are commenting on a previously published article and stating that American Community Survey (ACS) disability questions are now used on all federal surveys.

This article provides information on a state option in the American Health Care Act (AHCA) that allows for high-risk pools in health insurance plans. These plans place persons with preexisting conditions into a pool with others who may have high health care costs. In the past, high-risk pools have not made the cost of insurance affordable or provided adequate coverage to persons with or without preexisting conditions. High-risk pools operated in 35 states before the ACA was passed. At that time, the United States had 47 million uninsured people, 33 million of whom lived in states with high-risk pools. The authors believe that any legislation providing for high-risk pools would be a huge step backward for American health care policy.

Women with disabilities are not as likely to become pregnant as women without disabilities. This study looks at how women with disabilities make decisions about pregnancy. Four focus groups were held with 22 women of child-bearing age. Most of the women wanted to become mothers, but they had concerns about becoming pregnant. Three things affected their decision: 1) how important it was to them to have a child, 2) whether it was possible for them to become pregnant, and 3) the costs of having and raising a child.

The study shows that after passage of the Affordable Care Act (ACA), the number of adults with disabilities who had private health insurance rose slightly, from about 33.9% in 2013 to 36.6% by 2015. However, in 2015, adults with disabilities were still over four times more likely to receive public insurance (54.7%) than those without disabilities (12.5%). The data also shows that adults with disabilities are more likely to delay or not receive medical care due to cost as compared to adults without disabilities. Working-age adults with disabilities also reported more hospital stays and more office visits than adults without disabilities. This also may result in higher out-of-pocket costs and delayed treatment for adults with disabilities.

This study looked at how much cost affected whether or not people filled their prescriptions. The percentage of all Americans who did not fill a prescription in the previous 12 months because they could not afford it grew from 1999 to 2009 to 8% and then dropped to 5% by 2015. For seniors, however, the number peaked in 2004 at 5% and dropped to 4% after implementation of Medicare Part D in 2006. With implementation of Medicare Part D and the Affordable Care Act, the number of prescriptions unfilled because of cost has declined.

This study looked at data on blood pressure checks, flu shots, and dental visits in a 12 month period. Results showed that adults with physical limitations were more likely to receive a blood pressure check (92% vs. 70%%) or flu shot (40%% vs. 23%) compared to adults with no limitations. However, people with physical limitations were less likely to have a dental check-up (45% vs. 59%) in comparison to those with no limitation. People who had a regular care provider were more likely to receive services.

It is estimated that 25.8 million adults aged 40-65 (26.7%) would be interested in paying for a public insurance program to cover PAS benefits. However, interest in PAS insurance varies by age, race, ethnicity, region, income, disability status, and family experience with ADL assistance. Only 1.8% said they would be willing to pay $100 per month or more for coverage. While more than a quarter of the middle-aged adult population said they were interested in PAS insurance, actual participation would be highly dependent on premium rates. The current lack of publicly subsidized insurance for long-term care and personal assistance services remains a serious gap in the disability service system.