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Medicaid expansion

David F Penson
No abstract text is available yet for this article.
May 2017: Journal of Urology
Michael S Cohen, William L Schpero
Recent research has shown that concern about the apprehension and deportation of undocumented immigrants can affect how members of their households who are eligible for public benefits choose to participate in public programs. The extent to which this "chilling effect" broadly affects adults' Medicaid enrollment nationally remains unclear, in part because of the difficulty of isolating undocumented immigrants in survey data. In this study we identified households that likely included undocumented immigrants and then examined whether gains in health care coverage due to the expansion of Medicaid eligibility under the Affordable Care Act (ACA) were dampened for eligible people living in households with mixed immigration status...
March 2018: Health Affairs
Leah E Masselink, Julie Lewis, Clare Coleman, Susan F Wood
CONTEXT: Under the Affordable Care Act (ACA), the number of patients who have health insurance among those receiving family planning and reproductive health services at Title X-funded health centers has grown. However, billing some patients' insurance for services may be difficult because of Title X's extensive confidentiality protections. Little is known about health centers' experiences in addressing these difficulties. METHODS: Eight focus group discussions were conducted with a convenience sample of 54 Title X-funded health center staff members and state program administrators in January and April 2015...
March 5, 2018: Perspectives on Sexual and Reproductive Health
Chien-Jung Lin, Eric Novak, Michael W Rich, Joseph J Billadello
BACKGROUND: Adults with congenital heart disease (ACHD) have traditionally been viewed as an underinsured population. Whether this is true in the Affordable Care Act era is unknown. We determined insurance patterns in ACHD patients compared to the non-ACHD cardiology population in a contemporary cohort. METHODS: All cardiology outpatient visits between July 2016 and February 2017 to a large referral center in the United States were reviewed. The primary payer was categorized as health maintenance organization (HMO), preferred provider organization (PPO), Medicare, Medicaid, self-pay, or other...
February 26, 2018: Congenital Heart Disease
H Angier, N Huguet, M Marino, M Mori, K Winters-Stone, J Shannon, L Raynor, H Holderness, J E DeVoe
Background: Cancer is the second most common cause of mortality in the United States. Cancer screening and prevention services have contributed to improved overall cancer survival rates in the past 40 years. Vulnerable populations (i.e., uninsured, low-income, and racial/ethnic minorities) are disproportionately affected by cancer, receive significantly fewer cancer prevention services, poorer healthcare, and subsequently lower survival rates than insured, white, non-Hispanic populations...
September 2017: Contemporary Clinical Trials Communications
Megan C Roberts, Taylor Murphy, Jennifer L Moss, Christopher W Wheldon, Wayne Psek
OBJECTIVES: To examine how combinations of state policies, rather than single policies, are related to uptake of human papillomavirus (HPV) vaccine. METHODS: Using publicly available records and the literature, we characterized policies for each US state and Washington, DC, in 2015 (n = 51), including (1) Medicaid expansion, (2) policies permitting HPV vaccination in pharmacies, (3) school-entry requirements, (4) classroom sex education mandates, and (5) parental education mandates...
February 22, 2018: American Journal of Public Health
Dahai Yue, Petra W Rasmussen, Ninez A Ponce
OBJECTIVE: To assess racial/ethnic differential impacts of the ACA's Medicaid expansion on low-income, nonelderly adults' access to primary care. DATA SOURCES: Behavioral Risk Factor Surveillance System, State Physicians Workforce Data Book, and Bureau of Labor Statistics, in 2013 and 2015. STUDY DESIGN: Quasi-experimental design with difference-in-differences analyses. Outcomes included health insurance coverage, having personal doctor(s), being unable to see doctors because of cost, and receiving a flu shot...
February 22, 2018: Health Services Research
Nadereh Pourat, Amy Gabriela Bonilla, Maria Elena Young, Michael A Rodriguez, Steven P Wallace
We examined the impact of Medicaid expansion on rates of the remaining uninsured at the federally qualified health center level by race/ethnicity, limited English proficiency, and poverty status of their patients. Results indicated a systematic disadvantage in nonexpansion states for federally qualified health centers with high concentrations of these populations and an advantage in expansion states for federally qualified health centers with fewer limited English proficiency patients. Our findings highlight the importance of maintaining the Affordable Care Act in reducing disparities in coverage and the importance of federal funding to continue services for the remaining uninsured and vulnerable populations in both expansion and nonexpansion states...
April 2018: Family & Community Health
Shih-Chuan Chou, Craig Rothenberg, Alicia Agnoli, Ilse Wiechers, Jason Lott, Jennifer Voorhees, Steven L Bernstein, Arjun K Venkatesh
BACKGROUND: Patients newly insured through coverage expansion under the Affordable Care Act (ACA) may have difficulty obtaining timely primary care follow-up appointments after emergency department (ED) discharge. We evaluated the association between availability of timely follow-up appointment with practice access improvements, including patient-centered medical home (PCMH) designations or extended-hours appointments. METHODS: We performed a secret-shopper audit of primary care practices in greater New Haven, Connecticut...
February 4, 2018: American Journal of Emergency Medicine
Shaun Ossei-Owusu
The United States' health care system is mired in uncertainty. Public opinion on the Patient Protection and Affordable Care Act ("ACA") is undeniably mixed and politicized. The individual mandate, tax subsidies, and Medicaid expansion dominate the discussion. This Article argues that the ACA and reform discourse have given short shrift to a more static problem: the law of emergency care. The Emergency Medical Treatment and Active Labor Act of 1986 ("EMTALA") requires most hospitals to screen patients for emergency medical conditions and provide stabilizing treatment regardless of patients' insurance status or ability to pay...
November 2017: American Journal of Law & Medicine
Nicolas Ajkay, Neal Bhutiani, Bin Huang, Quan Chen, Jeffrey D Howard, Thomas C Tucker, Charles R Scoggins, Kelly M McMasters, Hiram C Polk
BACKGROUND: In January 2014, Kentucky expanded Medicaid coverage to include all individuals and families with incomes up to 33% above the federal poverty line. This study evaluated the early impact of Medicaid expansion on some aspects of the quality of breast cancer care in Kentucky. STUDY DESIGN: The Kentucky Cancer Registry was queried for all women aged 20 to 64 years diagnosed with breast cancer between 2011 and 2016. Demographic, tumor, and treatment characteristics were assessed for each year during this interval...
February 10, 2018: Journal of the American College of Surgeons
Amy J Davidoff, Gery P Guy, Xin Hu, Felisa Gonzales, Xuesong Han, Zhiyuan Zheng, Helen Parsons, Donatus U Ekwueme, Ahmedin Jemal
BACKGROUND: The Affordable Care Act (ACA) improved health care coverage accessibility by expanding Medicaid eligibility, creating insurance Marketplaces, and subsidizing premiums. We examine coverage changes associated with ACA implementation, comparing adults with and without a cancer history. METHODS: We included nonelderly adults from the 2012 to 2015 National Health Interview Survey. Using information on state Medicaid policies (2013), expansion decisions (2015), family structure, income, insurance offers, and current coverage, we assigned adults in all 4 years to mutually exclusive eligibility categories including: Medicaid-eligible pre-ACA; expansion eligible for Medicaid; and Marketplace premium subsidy eligible...
March 2018: Medical Care
Haley A Moss, Laura J Havrilesky, S Yousuf Zafar, Gita Suneja, Junzo Chino
PURPOSE: The Affordable Care Act (ACA) aimed to increase insurance coverage through key provisions such as expansion of Medicaid eligibility and enforcement of an individual mandate. The objective of this study is to examine the impact of the ACA on insurance rates among patients newly diagnosed with colon, lung, or breast cancer. METHODS: Using the SEER database, patients younger than age 65 years diagnosed with colon, lung, or breast cancer between 2008 and 2014 were identified...
February 2018: Journal of Oncology Practice
Sara B McMenamin, Sara W Yoeun, Helen A Halpin
INTRODUCTION: Four sections of the Affordable Care Act address the expansion of Medicaid coverage for recommended smoking-cessation treatments for: (1) pregnant women (Section 4107), (2) all enrollees through a financial incentive (1% Federal Medical Assistance Percentage increase) to offer comprehensive coverage (Section 4106), (3) all enrollees through Medicaid formulary requirements (Section 2502), and (4) Medicaid expansion enrollees (Section 2001). The purpose of this study is to document changes in Medicaid coverage for smoking-cessation treatments since the passage of the Affordable Care Act and to assess how implementation has differentially affected Medicaid coverage policies for: pregnant women, enrollees in traditional Medicaid, and Medicaid expansion enrollees...
February 9, 2018: American Journal of Preventive Medicine
Judith Pauwels, Amanda Weidner
BACKGROUND AND OBJECTIVES: Numerous organizations are calling for the expansion of graduate medical education (GME) positions nationally. Developing new residency programs and expanding existing programs can only happen if financial resources are available to pay for the expenses of training beyond what can be generated in direct clinical income by the residents and faculty in the program. The goal of this study was to evaluate trended data regarding the finances of family medicine residency programs to identify what financial resources are needed to sustain graduate medical education programs...
February 2018: Family Medicine
Richard W Valachovic
Good oral health affects academic performance, employability and annual earnings, military readiness, overall health care costs, and general health status and well-being. The Affordable Care Act (ACA) has enhanced the ability of many Americans to receive dental care through the expansion of Medicaid and the inclusion of pediatric oral health as one of the ten "essential health benefits." Almost all of the proposals presented by Congress and the Administration to modify the ACA call for changes to Medicaid that would cut back funding and/or give states more control over programs...
February 6, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Cirila Estela Vasquez Guzman
No abstract text is available yet for this article.
February 2018: Health Affairs
Fumiko Chino, Gita Suneja, Haley Moss, S Yousuf Zafar, Laura Havrilesky, Junzo Chino
PURPOSE: To compare insurance status in cancer patients receiving radiation before and after Medicaid expansion under the Patient Protection and Affordable Care Act (ACA), in both expanded and non-expanded states. METHODS AND MATERIALS: Newly diagnosed cancer patients aged 18 to 64 years who received radiation from 2011 to 2014 were compiled from the Surveillance, Epidemiology, and End Results database. Patients with a prior cancer diagnosis or unknown insurance status were excluded...
December 13, 2017: International Journal of Radiation Oncology, Biology, Physics
Lorraine T Dean, Madeline C Montgomery, Julia Raifman, Amy Nunn, Thomas Bertrand, Alexi Almonte, Philip A Chan
INTRODUCTION: Sexually transmitted diseases continue to increase in the U.S. There is a growing need for financially viable models to ensure the longevity of safety-net sexually transmitted disease clinics, which provide testing and treatment to high-risk populations. This micro-costing analysis estimated the number of visits required to balance cost and revenue of a sexually transmitted disease clinic in a Medicaid expansion state. METHODS: In 2017, actual and projected cost and revenues were estimated from the Rhode Island sexually transmitted disease clinic in 2015...
January 31, 2018: American Journal of Preventive Medicine
Sean M O'Neill, Stanley K Frencher, Melinda Maggard-Gibbons
Although geographic variation in health care services is well established, relatively less is known about ambulatory surgical procedures in California. Thus, we sought to describe statewide trends according to geographic and institutional factors. Using the California Office of State Health Planning and Development Ambulatory Surgery and Hospital Utilization datasets, overall and per-capita procedure rates by county and institution were calculated and compared across 2012 to 2014. There was substantial variation in services provided at the county level (Range: 49-382,142 cases/county)...
October 1, 2017: American Surgeon
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