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https://www.readbyqxmd.com/read/28102648/2016-rural-enrollment-in-health-insurance-marketplaces-by-state
#1
Abigail R Barker, Kelsey A Huntzberry, Timothy D McBride, Leah M Kemper, Keith J Mueller
Purpose. In this brief, cumulative county-level enrollment in Health Insurance Marketplaces (HIMs) through March 2016 is presented for state HIMs operated as Federally Facilitated Marketplaces (FFMs) and for those operated as Federally Supported State-Based Marketplaces (FS-SBMs). Enrollment rates in metropolitan and non-metropolitan areas of each state, defined as the percentage of “potential market” participants selecting plans, are presented. Monitoring annual enrollment rates provides a gauge of how well state outreach and enrollment efforts are proceeding and helps identify states with strong non-metropolitan enrollment as models for other states to emulate...
2017: Rural Policy Brief
https://www.readbyqxmd.com/read/28069846/medicaid-expansion-and-grant-funding-increases-helped-improve-community-health-center-capacity
#2
Xinxin Han, Qian Luo, Leighton Ku
Through the expansion of Medicaid eligibility and increases in core federal grant funding, the Affordable Care Act (ACA) sought to increase the capacity of community health centers to provide primary care to low-income populations. We examined the effects of the ACA Medicaid expansion and changes in federal grant levels on the centers' numbers of patients, percentages of patients by type of insurance, and numbers of visits from 2012 to 2015. In the period after expansion (2014-15), health centers in expansion states had a 5 percent higher total patient volume, larger shares of Medicaid patients, smaller shares of uninsured patients, and increases in overall visits and mental health visits, compared to centers in nonexpansion states...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069845/at-federally-funded-health-centers-medicaid-expansion-was-associated-with-improved-quality-of-care
#3
Megan B Cole, Omar Galárraga, Ira B Wilson, Brad Wright, Amal N Trivedi
In 2014 many uninsured, low-income nonelderly adults gained access to health insurance in states that expanded Medicaid eligibility under the Affordable Care Act. Federally funded community health centers were likely to be particularly affected by this expansion because many of their patients were uninsured and low income. We used a difference-in-differences approach to compare changes among 1,057 such centers in expansion versus nonexpansion states from 2011 to 2014, in terms of their patients' insurance coverage, the number of patients they served, and the quality of care they provided...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069842/most-newly-insured-people-in-2014-were-long-term-uninsured
#4
Sandra L Decker, Brandy J Lipton
In 2014-after the implementation of most of the Affordable Care Act provisions, including Medicaid expansions in some states and subsidies to purchase Marketplace coverage in all states-adults who had been uninsured for more than three years represented a larger share of the newly insured, compared to adults who had been insured for shorter periods of time.
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28051917/economic-effects-of-medicaid-expansion-in-michigan
#5
John Z Ayanian, Gabriel M Ehrlich, Donald R Grimes, Helen Levy
Under the Affordable Care Act, 31 U.S. states have opted to expand Medicaid coverage to nonelderly adults with annual incomes up to 138% of the federal poverty level (approximately $16,400 for a single adult in 2016). The federal government currently pays the full cost of Medicaid expansion in..
January 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28025774/-they-treat-you-a-different-way-public-insurance-stigma-and-the-challenge-to-quality-health-care
#6
Anna C Martinez-Hume, Allison M Baker, Hannah S Bell, Isabel Montemayor, Kristan Elwell, Linda M Hunt
Under the Affordable Care Act, Medicaid Expansion programs are extending Medicaid eligibility and increasing access to care. However, stigma associated with public insurance coverage may importantly affect the nature and content of the health care beneficiaries receive. In this paper, we examine the health care stigma experiences described by a group of low-income public insurance beneficiaries. They perceive stigma as manifest in poor quality care and negative interpersonal interactions in the health care setting...
December 26, 2016: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/28007801/rhetoric-and-reform-in-waiver-states
#7
Colleen M Grogan, Phillip M Singer, David K Jones
Seven states have used Section 1115 waivers to expand Medicaid as part of the Affordable Care Act (ACA). While each state pursued a unique plan, there are similarities in the types of changes each state desired to make. Equally important to how a state modified their Medicaid programs is how a state talked about Medicaid and reform. We investigate whether the rhetoric that emerged in waiver states is unique, analyze whether the rhetoric is associated with particular waiver reforms, and consider the implications of our findings for the future of Medicaid policy making...
December 22, 2016: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/28007795/the-future-of-health-care-reform-what-is-driving-enrollment
#8
Timothy H Callaghan, Lawrence R Jacobs
Against a backdrop of ongoing operational challenges, insurance market turbulence, and the ever present pull of partisanship, enrollment in the ACA's programs has soared and significant variations have developed across states in terms of their pace of coverage expansion. Our article explores why ACA enrollment has varied so dramatically across states. We explore the potential influence of party control, presidential cueing, administrative capacity, the reverberating effects of ACA policy decisions, affluence, and unemployment on enrollment...
December 22, 2016: Journal of Health Politics, Policy and Law
https://www.readbyqxmd.com/read/27997244/effect-of-medicaid-expansion-on-workforce-participation-for-people-with-disabilities
#9
Jean P Hall, Adele Shartzer, Noelle K Kurth, Kathleen C Thomas
OBJECTIVES: To use data from the Health Reform Monitoring Survey (HRMS) to examine differences in employment among community-living, working-age adults (aged 18-64 years) with disabilities who live in Medicaid expansion states and nonexpansion states. METHODS: Analyses used difference-in-differences to compare trends in pooled, cross-sectional estimates of employment by state expansion status for 2740 HRMS respondents reporting a disability, adjusting for individual and state characteristics...
February 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/27996379/the-affordable-care-act-and-health-insurance-coverage-for-lesbian-gay-and-bisexual-adults-analysis-of-the-behavioral-risk-factor-surveillance-system
#10
Gilbert Gonzales, Carrie Henning-Smith
PURPOSE: This study compares uninsurance rates for lesbian, gay, and bisexual (LGB) adults by state Medicaid expansion decisions under the Affordable Care Act. METHODS: Data come from nonelderly adults in the 2014 Behavioral Risk Factor Surveillance System. Prevalence estimates and logistic regression models identified LGB adults most likely to be uninsured. RESULTS: Approximately 15.7% of LGB adults lack health insurance, but the uninsurance rate is lower among LGB adults in Medicaid expansion states (12...
December 20, 2016: LGBT Health
https://www.readbyqxmd.com/read/27992930/insurance-expansion-and-hospital-emergency-department-access-evidence-from-the-affordable-care-act
#11
Craig Garthwaite, Tal Gross, Matthew Notowidigdo, John A Graves
Background: Little is known about whether insurance expansion affects the location and type of emergency department (ED) use. Understanding these changes can inform state-level decisions about the Medicaid expansion under the Patient Protection and Affordable Care Act (ACA). Objective: To investigate the effect of the 2014 ACA Medicaid expansion on the location, insurance status, and type of ED visits. Design: Quasi-experimental observational study from 2012 to 2014...
December 20, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27992730/the-affordable-care-act-s-impacts-on-access-to-insurance-and-health-care-for-low-income-populations
#12
Gerald F Kominski, Narissa J Nonzee, Andrea Sorensen
The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states...
December 15, 2016: Annual Review of Public Health
https://www.readbyqxmd.com/read/27992152/the-effect-of-the-affordable-care-act-medicaid-expansion-on-migration
#13
Lucas Goodman
The expansion of Medicaid to low-income nondisabled adults is a key component of the Affordable Care Act's strategy to increase health insurance coverage, but many states have chosen not to take up the expansion. As a result, for many low-income adults, there has been stark variation across states in access to Medicaid since the expansions took effect in 2014. This study investigates whether individuals migrate in order to gain access to these benefits. Using an empirical model in the spirit of a difference-in-differences, this study finds that migration from non-expansion states to expansion states did not increase in 2014 relative to migration in the reverse direction...
2017: Journal of Policy Analysis and Management
https://www.readbyqxmd.com/read/27992151/early-impacts-of-the-affordable-care-act-on-health-insurance-coverage-in-medicaid-expansion-and-non-expansion-states
#14
Charles Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata
The Affordable Care Act (ACA) aimed to achieve nearly universal health insurance coverage in the United States through a combination of insurance market reforms, mandates, subsidies, health insurance exchanges, and Medicaid expansions, most of which took effect in 2014. This paper estimates the causal effects of the ACA on health insurance coverage in 2014 using data from the American Community Survey. We utilize difference-in-difference-in-differences models that exploit cross-sectional variation in the intensity of treatment arising from state participation in the Medicaid expansion and local area pre-ACA uninsured rates...
2017: Journal of Policy Analysis and Management
https://www.readbyqxmd.com/read/27957740/impact-of-enroll-america-on-the-number-of-individuals-covered-through-the-federally-facilitated-marketplace
#15
Sean Orzol, Lauren Hula
OBJECTIVE: To assess the impact of Enroll America's field outreach activities on the number of individuals enrolled in Marketplace coverage during the first open enrollment period. DATA SOURCES/STUDY SETTING: Marketplace enrollment for the initial open enrollment period linked with data on Enroll America's field activities and baseline local-area demographic, economic, and health services characteristics. STUDY DESIGN: We used a quasi-experimental design, comparing Marketplace enrollment during the first open enrollment period in local areas drawn from Enroll America field states to a comparison group of local areas drawn from states that were not served by Enroll America's field effort, but that otherwise match up well with Enroll America states...
December 12, 2016: Health Services Research
https://www.readbyqxmd.com/read/27932786/state-medicaid-expansion-tobacco-cessation-coverage-and-number-of-adult-smokers-enrolled-in-expansion-coverage-united-states-2016
#16
Anne DiGiulio, Meredith Haddix, Zach Jump, Stephen Babb, Anna Schecter, Kisha-Ann S Williams, Kat Asman, Brian S Armour
In 2015, 27.8% of adult Medicaid enrollees were current cigarette smokers, compared with 11.1% of adults with private health insurance, placing Medicaid enrollees at increased risk for smoking-related disease and death (1). In addition, smoking-related diseases are a major contributor to Medicaid costs, accounting for about 15% (>$39 billion) of annual Medicaid spending during 2006-2010 (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications are effective treatments for helping tobacco users quit (3)...
December 9, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27920318/survey-highlights-differences-in-medicaid-coverage-for-substance-use-treatment-and-opioid-use-disorder-medications
#17
Colleen M Grogan, Christina Andrews, Amanda Abraham, Keith Humphreys, Harold A Pollack, Bikki Tran Smith, Peter D Friedmann
The Affordable Care Act requires state Medicaid programs to cover substance use disorder treatment for their Medicaid expansion population but allows states to decide which individual services are reimbursable. To examine how states have defined substance use disorder benefit packages, we used data from 2013-14 that we collected as part of an ongoing nationwide survey of state Medicaid programs. Our findings highlight important state-level differences in coverage for substance use disorder treatment and opioid use disorder medications across the United States...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920315/after-medicaid-expansion-in-kentucky-use-of-hospital-emergency-departments-for-dental-conditions-increased
#18
Natalia Chalmers, Jane Grover, Rob Compton
Access to oral health care is a critical need for the adult Medicaid population. Following the 2014 expansion of Medicaid eligibility in Kentucky, millions of adults became eligible to receive dental benefits. We examined the impact of the expansion on adult Medicaid enrollees' use of hospital emergency departments (EDs) for conditions related to dental or oral health in the period 2010-14. Based on our analysis of data for Kentucky from the State Emergency Department Databases, we found that the rate of discharges for these conditions from the ED increased significantly, from 1,833 per 100,000 population in 2013 to 5,635 in 2014...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920313/previous-medicaid-expansion-may-have-had-lasting-positive-effects-on-oral-health-of-non-hispanic-black-children
#19
Brandy J Lipton, Laura R Wherry, Sarah Miller, Genevieve M Kenney, Sandra Decker
Healthy tooth development starts early in life, beginning even before birth. We present new evidence suggesting that a historic public health insurance expansion for pregnant women and children in the United States in the 1980s and 1990s may have had long-lasting effects on the oral health of the children gaining eligibility. We estimated the relationship between adult oral health and the extent of state public health insurance eligibility for pregnant women, infants, and children throughout childhood separately for non-Hispanic whites, non-Hispanic blacks, and Hispanics...
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27906931/repeal-and-replace-of-affordable-care-a-complex-but-not-an-impossible-task
#20
Laxmaiah Manchikanti, Joshua A Hirsch
The Affordable Care Act (ACA), signature legislation of President Obama, was arguably the most consequential and comprehensive health care reform since Medicare was introduced as part of President Lyndon B. Johnson's great society. It has been claimed that many of the law's reforms are now so integrated in the health system that full repeal would be impractical, while others including President Elect Trump have rejected that idea and called for full repeal and replacement claiming ACA law cannot be fixed. A tsunami of increasing regulatory burden over the past 8 years, the current health care milieu has moved independent practitioners towards hospital employment in great numbers...
November 2016: Pain Physician
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