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Background: In response to the Affordable Care Act (ACA) and the expansion of Medicaid, the Denver Sexual Health Clinic (DSHC) saw a dramatic increase in patients seeking STD services with insurance. We sought to better understand the insurance coverage of those visiting the DSHC and their willingness to utilize that insurance at their STD visit.
Methods: Clinic registration sheets were examined for the 4th quarter of 2015 to assess patient insurance status and whether or not they declined to use those benefits during their visit.
Results: Of the 2,771 individuals who filled out the insurance portion of their clinic registration form, 1,828 (66%) indicated they had insurance (38% Medicaid, 31% Private, 28% unspecified, and 2% Medicare). Significant demographic differences were observed between those with insurance and those without. Those with insurance tended to be older (mean age 32 years) with the majority (45%) identifying as White, Non-Hispanic. The mean age of those without insurance was 30 years with the majority (43%) identifying as Hispanic. There were no significant differences in Chlamydia, Gonorrhea, or HIV testing and positivity between the two groups. Of those indicating they had insurance coverage, 23% declined to provide their insurance information at their STD clinic visit. The majority of those declining tended to be male (68%). We saw no significant differences in age, race/ethnicity, or STI testing and positivity between those utilizing their insurance and those who refused to provide insurance information.
Conclusions: Medicaid expansion in Colorado has dramatically changed the landscape of STD Clinics with more individuals seeking care who are covered by insurance. Compared to individuals without coverage, we saw no difference in the rate of STIs for those enrolled in care. In addition, we saw no differences in the risk of STI infection between those utilizing their insurance and those who did not.