Lauren R. Fryling|Peter Mazanec|Robert M. Rodriguez
Barriers to Homeless Persons Acquiring Health Insurance Through the Affordable Care Act
University of California, San Francisco|Georgetown University|University of California, San Francisco
medicaid expansion affordable care act aca intended provide framework increasing health care access vulnerable populations including 12 million experience homelessness year united stateswe sought characterize homeless persons knowledge aca identify barriers aca enrollment determine access various forms communication could used facilitate enrollmentat urban county level trauma center interviewed noncritically ill adults presented emergency department ed daytime hours able provide consent assessed access communication awareness aca insurance status barriers preventing subjects enrolling health insurance compared homeless persons responses concomitantly enrolled housed individualsof 650 enrolled subjects 134 202 homeless homeless subjects likely never heard aca 26 vs 10 aware qualify medicaid common 70 significant 30 barrier enrollment reported uninsured homeless persons homeless subjects unsure qualified medicaid 91 reported income 138 federal poverty level likely qualifying enrollment although 99 housed subjects reported access either phone internet 74 homeless subjects reported accesshomeless persons report less knowledge aca housed counterparts poor understanding aca qualification criteria limited access phone internet edbased outreach education regarding aca eligibility may increase enrollment