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Medicaid expansion

Veronica X Vela, Elizabeth W Patton, Darshak Sanghavi, Susan F Wood, Peter Shin, Sara Rosenbaum
CONTEXT: Long-acting reversible contraception (LARC) is the most effective reversible method to prevent unplanned pregnancies. Variability in state-level policies and the high cost of LARC could create substantial inconsistencies in Medicaid coverage, despite federal guidance aimed at enhancing broad access. This study surveyed state Medicaid payment policies and outreach activities related to LARC to explore the scope of services covered. METHODS: Using publicly available information, we performed a content analysis of state Medicaid family planning and LARC payment policies...
January 9, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Katherine Diaz Vickery, Peter Bodurtha, Tyler N A Winkelman, Courtney Hougham, Ross Owen, Mark S Legler, Erik Erickson, Matthew M Davis
Childless adults in the Medicaid expansion population have complex social and behavioral needs. This study compared the cross-sector involvement of Medicaid expansion enrollees who were high health care utilizers to that of other expansion enrollees in Hennepin County, Minnesota. We examined forty-six months of annualized utilization and cost data for expansion-eligible residents with at least twelve months of enrollment (N = 70,134) across health care, housing, criminal justice, and human service sectors...
January 2018: Health Affairs
Richard C Lindrooth, Marcelo C Perraillon, Rose Y Hardy, Gregory J Tung
Decisions by states about whether to expand Medicaid under the Affordable Care Act (ACA) have implications for hospitals' financial health. We hypothesized that Medicaid expansion of eligibility for childless adults prevents hospital closures because increased Medicaid coverage for previously uninsured people reduces uncompensated care expenditures and strengthens hospitals' financial position. We tested this hypothesis using data for the period 2008-16 on hospital closures and financial performance. We found that the ACA's Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of uninsured adults before Medicaid expansion...
January 2018: Health Affairs
Peter Cunningham, Yaou Sheng
BACKGROUND: Expansions of health insurance coverage tend to increase hospital emergency department (ED) utilization and inpatient admissions. However, provisions in the Affordable Care Act that expanded primary care supply were intended in part to offset the potential for increased hospital utilization. OBJECTIVES: To examine the association between health insurance coverage, primary care supply, and ED and inpatient utilization, and to assess how both factors contributed to trends in utilization in California between 2012 and 2015...
January 2, 2018: Medical Care
Laura R Wherry
OBJECTIVE: To evaluate impacts of state Medicaid expansions for low-income parents on the health insurance coverage, pregnancy intention, and use of prenatal care among mothers who became pregnant. DATA SOURCES/STUDY SETTING: Person-level data for women with a live birth from the 1997-2012 Pregnancy Risk Assessment Monitoring System. DATA COLLECTION/EXTRACTION METHODS: The sample was restricted to women who were already parents using information on previous live births and combined with information on state Medicaid policies for low-income parents...
December 28, 2017: Health Services Research
Emily M Johnston, Andrea E Strahan, Peter Joski, Anne L Dunlop, E Kathleen Adams
INTRODUCTION: We use data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2012 to 2015 to estimate the effects of the Affordable Care Act's (ACA) Medicaid expansions on insurance coverage and access to care for low-income women of reproductive age (19-44). METHODS: We use two-way fixed effects difference-in-differences models to estimate the effects of Medicaid expansions on low-income (<100% of the Federal Poverty Level) women of reproductive age...
December 20, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Brendan Saloner
No abstract text is available yet for this article.
December 22, 2017: Journal of General Internal Medicine
Amal N Trivedi, Benjamin D Sommers
No abstract text is available yet for this article.
December 14, 2017: Clinical Journal of the American Society of Nephrology: CJASN
Susan L Hayes, Sarah R Collins, David C Radley, Douglas McCarthy
Issue: Given uncertainty about the future of the Affordable Care Act, it is useful to examine the progress in coverage and access made under the law. Goal: Compare state trends in access to affordable health care between 2013 and 2016. Methods: Analysis of recent data from the U.S. Census Bureau and the Behavioral Risk Factor Surveillance System. Findings and Conclusions: Between 2013 and 2016, the uninsured rate for adults ages 19 to 64 declined in all states and the District of Columbia, and fell by at least 5 percentage points in 47 states...
December 1, 2017: Issue Brief of the Commonwealth Fund
Emily J Decker, Katherine A Ahrens, Christina I Fowler, Marion Carter, Loretta Gavin, Susan Moskosky
BACKGROUND: The federal Title X Family Planning Program supports the delivery of family planning services and related preventive care to 4 million individuals annually in the United States. The implementation of the 2010 Affordable Care Act's (ACA's) Medicaid expansion and provisions expanding access to health insurance, which took effect in January 2014, resulted in higher rates of health insurance coverage in the U.S. population; the ACA's impact on individuals served by the Title X program has not yet been evaluated...
December 13, 2017: Journal of Women's Health
Allen Dobson, Joan E DaVanzo, Randy Haught, Luu Phap-Hoa
Issue: Safety-net hospitals play a vital role in delivering health care to Medicaid enrollees, the uninsured, and other vulnerable patients. By reducing the number of uninsured Americans, the Affordable Care Act (ACA) was also expected to lower these hospitals’ significant uncompensated care costs and shore up their financial stability. Goal: To examine how the ACA’s Medicaid expansion affected the financial status of safety-net hospitals in states that expanded Medicaid and in states that did not...
November 1, 2017: Issue Brief of the Commonwealth Fund
Chima D Ndumele, William L Schpero, Amal N Trivedi
OBJECTIVE: To assess the effect of the 2014 Medicaid expansion on Medicaid managed care plan quality. DATA SOURCES: Three composite measures of plan-level quality constructed from the Health Care Effectiveness Data and Information Set. STUDY SETTING: One hundred and sixty-three plans in 27 Medicaid expansion states and 100 plans in 14 nonexpansion states. STUDY DESIGN: Quasi-experimental difference-in-differences (DID) analysis, comparing quality before (2011-13) and after (2014-15) Medicaid expansion in states that elected to expand Medicaid eligibility and those that did not...
December 12, 2017: Health Services Research
Colleen M Grogan, Sunggeun Ethan Park
Policy Points: More than half of Americans are connected to the Medicaid program-either through their own coverage or that of a family member or close friend-and are significantly more likely to view Medicaid as important and to support increases in spending, even among conservatives. This finding helps explain why Affordable Care Act repeal efforts faced (and will continue to face) strong public backlash. Policymakers should be aware that although renaming programs within Medicaid may have increased enrollment take-up, this destigmatization effort might have also increased program confusion and reduced support for Medicaid even among enrollees who say the program is important to them...
December 2017: Milbank Quarterly
Jade Marcus Jenkins
BACKGROUND: Rates of child insurance coverage have increased due to expansions in public programs, but many eligible children remain uninsured. Uninsured children are less likely to receive preventative care, which leads to poorer health and achievement in the long term. This study is an evaluation of a school-based health insurance outreach initiative, "Healthy and Ready to Learn," aiming to identify and enroll uninsured kindergarteners in areas of high economic need in 16 counties in North Carolina...
January 2018: Journal of School Health
Micah Hartman, Anne B Martin, Nathan Espinosa, Aaron Catlin, The National Health Expenditure Accounts Team
Total nominal US health care spending increased 4.3 percent and reached $3.3 trillion in 2016. Per capita spending on health care increased by $354, reaching $10,348. The share of gross domestic product devoted to health care spending was 17.9 percent in 2016, up from 17.7 percent in 2015. Health spending growth decelerated in 2016 following faster growth in 2014 and 2015 associated with coverage expansions under the Affordable Care Act (ACA) and strong retail prescription drug spending growth. In 2016 the slowdown was broadly based, as spending for the largest categories by payer and by service decelerated...
December 6, 2017: Health Affairs
Shashi N Kapadia, Philip J Jeng, Bruce R Schackman, Yuhua Bao
Medicaid program criteria for accessing hepatitis C treatment are changing. Using Medicaid drug utilization data from 2014-6, we found that programs that have relaxed their criteria have seen significant increases in treatment utilization compared to those that have not. States with Medicaid expansions also had marked increases in utilization.
December 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Oluseyi Aliu, Aviram M Giladi, Kevin C Chung
BACKGROUND: Expanding eligibility will increase the demand for surgical services within Medicaid but little is known of the response to such increase in demand. We examined how much of the increased demand for breast reconstruction was met after expansion of Medicaid eligibility. METHODS: We used New York state databases from 1998 to 2006 and a population of non-elderly adults (19-64) who underwent breast cancer treatment and reconstructive procedures. We used an Interrupted Time-Series design to examine the association between Medicaid expansion in 2001 and changes in the percentages of treatment and reconstructive procedures covered by Medicaid...
November 28, 2017: American Journal of Surgery
Katherine Baicker, Heidi L Allen, Bill J Wright, Amy N Finkelstein
Oregon's 2008 Medicaid expansion significantly increased the use of prescription medications in 2009-10.
December 2017: Health Affairs
Thomas M Selden, Brandy J Lipton, Sandra L Decker
Affordable Care Act (ACA) provisions implemented in 2014 provide a valuable case study regarding the merits of using public versus subsidized private insurance to help low-income people obtain and finance health care. In particular, nonelderly adults with incomes of 100-138 percent of the federal poverty level gained Medicaid eligibility if they lived in states that implemented the ACA's Medicaid expansion, whereas those in nonexpansion states became eligible for subsidized Marketplace coverage. Using data for 2008-15 from the National Health Interview Survey, we found that as of 2015, adults with family incomes in this range had experienced large declines in uninsurance rates in both expansion and nonexpansion states (the adjusted declines were 22 percentage points and 18 percentage points, respectively)...
December 2017: Health Affairs
Alice Chen, Anthony T Lo Sasso, Michael R Richards
Medicaid and the Child Health Insurance Programs (CHIP) are key sources of coverage for U.S. children. Established in 1997, CHIP allocated $40 billion of federal funds across the first 10 years but continued support required reauthorization. After 2 failed attempts in Congress, CHIP was finally reauthorized and significantly expanded in 2009. Although much is known about the demand-side policy effects, much less is understood about the policy's impact on providers. In this paper, we leverage a unique physician dataset to examine if and how pediatricians responded to the expansion of the public insurance program...
December 1, 2017: Health Economics
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