Medicaid expansion Archives - Safety-Net Association of Pennsylvania

ACA May be Improving, Saving Lives

The insurance expansion made possible by the Affordable Care Act may be improving and even saving lives, some studies and anecdotal evidence suggest.

While observers warn that it is difficult to attempt to render a final verdict on the reform law’s insurance expansion and its impact, various studies and observations point to encouraging developments. Among them:

High blood pressure is being detected at a higher rate now among people who bought insurance as a result of the ACA than it was prior to the law’s passage.
Fewer 19-26 year-olds, now permitted to remain on their parents’ health insurance, are choosing not to see a doctor about their asthma because of the cost of seeking care.
Women in Michigan report having an easier time obtaining birth control pills.
Participants in a Michigan program are reporting an increased likelihood of learning they have chronic medical conditions than was the case before they were insured.
People between their mid-50s and mid-60s living in states that expanded their Medicaid programs, and who took advantage of that expansion, had a lower death rate than similar people in non-expansion states.

Pennsylvania is among the 37 states (including the District of Columbia) that took advantage of the Affordable Care Act to expand its Medicaid program.

Learn more about some of the documented and observed benefits of the Affordable Care Act’s improved access to health insurance in the Washington Post article “With the Affordable Care Act’s future in doubt, evidence grows that it saves lives.”

PA Safety Net Admin2019-10-02T15:52:54+00:00October 2nd, 2019|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Medicaid Expansion Helps Pregnant Women and Their Babies

An intuitive assumption now has evidence to support it: Medicaid expansion has improved the health of pregnant women and their babies.

According to a new study from the Georgetown University Health Policy Institute’s Center for Children and Families,

…states that expand Medicaid improve the health of women of childbearing age: increasing access to preventive care, reducing adverse health outcomes before, during and after pregnancies, and reducing maternal mortality rates.

Better health for women of childbearing age also means better health for their infants. States that have expanded Medicaid under the Affordable Care Act saw a 50 percent greater reduction in infant mortality than non-expansion states.

The report notes that the number of uninsured women of childbearing age in Pennsylvania fell 49 percent during the three years after Pennsylvania expanded its Medicaid program. Significant numbers of these newly insured women are served by Pennsylvania safety-net hospitals.

Learn more, including specific health benefits enjoyed by pregnant women and their babies, in the Georgetown study “Medicaid Expansion Fills Gaps in Maternal Health Coverage Leading to Healthier Mothers and Babies.”

PA Safety Net Admin2019-06-03T16:17:14+00:00June 3rd, 2019|Affordable Care Act, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

States Taking Different Paths to Pay for Medicaid Expansion

With the federal share of Medicaid expansion falling to 90 percent next year, states that expanded their Medicaid programs under the Affordable Care Act are now exploring new ways to raise the money to pay for the 10 percent for which they will soon by responsible.

Some are implementing hospital or insurer taxes while others are increasing existing taxes on hospitals and health insurers. New Hampshire is directing part of the proceeds from a liquor tax for this purpose and other states have introduced cigarette taxes. Some are charging premiums to Medicaid beneficiaries and introducing work requirements for their Medicaid population so they can reduce overall enrollment. Many are using money from their general revenues.

This all comes at a time when many states are finding that their budget situations have improved and are better than they have been in years.

Learn more about how states are dealing with this challenge, and whether they are finding that it is worth it, in the Washington Post article “States scramble to head off future Medicaid shortfalls.”

PA Safety Net Admin2019-02-22T06:00:26+00:00February 22nd, 2019|Affordable Care Act, Federal Medicaid issues|Comments Off

Docs Still Less Likely to Treat Medicaid Patients

Medicaid patients continue to be last in line when it comes to finding doctors willing to serve them.

At least that’s the conclusion drawn in a new analysis prepared by the Medicaid and CHIP Payment and Access Commission.

According to a presentation delivered at a MACPAC meeting last week:

Doctors are less likely to accept new Medicaid patients (70.8 percent) than they are patients insured by Medicare (85.3 percent) or private insurers (90 percent), with a much greater differential in acceptance rates among specialists and psychiatrists.
Pediatricians, general surgeons, and ob/gyns have a higher acceptance rate of Medicaid patients than physicians as a whole.
Physicians in states with high managed care penetration rates are less likely (66.7 percent) to accept Medicaid patients than physicians in states with low managed care penetration (78.5 percent).
There is no meaningful differential in acceptance rates among physicians in Medicaid expansion states and states that did not expand their Medicaid programs under the Affordable Care Act.
Physician acceptance rates have not changed since adoption of the Affordable Care Act in either Medicaid expansion nor non-Medicaid expansion states.
The higher the ratio of Medicaid-to-Medicare physician payments in an individual state, the more likely that physicians in those states will accept Medicaid patients. The difference is especially great among general practitioners and ob/gyns.

Learn more from the MACPAC presentation “Physician Acceptance of New Medicaid Patients.”

PA Safety Net Admin2019-01-31T06:00:14+00:00January 31st, 2019|Uncategorized|Comments Off

MACPAC Meets

The non-partisan legislative branch agency that advises Congress, the administration, and the states on Medicaid and CHIP-related issues met recently in Washington, D.C.
The following is the Medicaid and CHIP Payment and Access Commission’s own summary of its meeting.

The December 2017 meeting of the Medicaid and CHIP Payment and Access Commission began with a brief update on the State Children’s Health Insurance Program (CHIP). Although federal funding for the CHIP expired at the end of September, legislation to renew funding was still pending in Congress. The Commission then heard from a panel discussing state tools to manage drug utilization and spending in Medicaid. Panelists included Renee Williams, director of clinical pharmacy services for TennCare; Doug Brown, Magellan Rx Management’s vice president for Medicaid drug rebate management; and John Coster, director of the Center for Medicaid and CHIP Services Division of Pharmacy at the Centers for Medicare & Medicaid Services. At the final morning session, Commissioners reviewed a draft March 2018 report chapter on streamlining Medicaid managed care authorities. The Commission voted to approve recommendations to Congress, but deferred action on a third recommendation for further discussion at its upcoming January 2018 meeting.

In the afternoon, MACPAC staff previewed highlights from the December 2017 MACStats: Medicaid and CHIP Data Book. MACStats pulls together Medicaid and CHIP data from multiple sources that often can be difficult to find. The collection is published annually and individual tables are updated throughout the year. The Commission then reviewed the draft March report chapter on telemedicine in Medicaid, and later in the day the Commission returned to the topic of prescription drugs, to explore potential recommendations on the Medicaid drug rebate program.

The final December sessions covered MACPAC’s annual analysis of disproportionate share hospital payments (a required element of its March reports), and findings from interviews with four states to better understand how they are implementing Section 1115 Medicaid-expansion waivers.

The following presentations, many with supporting documents, were offered during the MACPAC meeting:

PA Safety Net Admin2017-12-19T06:00:26+00:00December 19th, 2017|Federal Medicaid issues|Comments Off

To Require Work or Not to Require Work

That is the question policy-makers are asking as they consider imposing work requirements on healthy Medicaid participants.
In recent years a number of states have attempted to establish such a requirement, only to have their requests to do so rejected by regulators in Washington, and a clause permitting states to establish such a requirement was included last month in the eventually sidetracked American Health Care Act. Even now, a Kentucky Medicaid waiver application under consideration by the Centers for Medicare & Medicaid Services includes a work requirement.
Does the lack of a work requirement encourage people in Medicaid expansion states to withdraw from the workforce?
Is a work requirement a way to raise the income of beneficiaries just enough to cost them their Medicaid eligibility?
Are there jobs available for beneficiaries if such a requirement were to be imposed?
And aren’t many able-bodied Medicaid beneficiaries already working?
This issue is of particular interest to Pennsylvania safety-net hospitals because they serve such large numbers of Medicaid patients.
The Urban Institute looks at these and other Medicaid work-related issues in the new paper “Rationale for Medicaid work requirements not supported by evidence.” Find that paper here.

PA Safety Net Admin2017-04-05T06:00:54+00:00April 5th, 2017|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

Perspective on Medicaid

A new report looks at how Medicaid has affected the health and health care of people throughout the country.
The Commonwealth Fund report “Understanding the Value of Medicaid” examines the impact of the Affordable Care Act’s expansion of Medicaid and notes that the program currently serves 73 million children, seniors, low-income working adults, and people with disabilities.
It also examines how Medicaid expansion has enhanced access to care and even given some people medical benefits comparable to those offered by private insurance.
Finally, the report notes that safety-net hospitals that serve especially large numbers of low-income patients now serve fewer uninsured patients and are better able to invest in new staff, clinics, and equipment, thereby enhancing the quality of care they deliver.
For a closer look at the impact Medicaid has on the American health care system, see this Commonwealth Fund report.

PA Safety Net Admin2016-10-14T06:00:35+00:00October 14th, 2016|Pennsylvania safety-net hospitals|Comments Off

Who’s Still Uninsured?

Hispanics.
Young people between the ages of 19 and 34.
Men.
Low-income people, especially those living in states that have not expanded their Medicaid programs.
People in the South – again, especially those living in states that have not expanded their Medicaid programs.
Those who work for small companies.
The uninsured rate in the U.S., 20 percent before the Affordable Care Act took effect, is now 13 percent.
Learn more about how the Affordable Care Act has changed the rate at which different groups of Americans are insured in this Commonwealth Fund survey.

PA Safety Net Admin2016-08-29T06:00:54+00:00August 29th, 2016|Affordable Care Act|Comments Off

Medicaid Expansion Producing Benefits for Safety-Net Providers

Seeing fewer uninsured patients, safety-net hospitals in states that have expanded their Medicaid programs as provided for under the Affordable Care Act are finding themselves able to use money previously caring for the uninsured for things like more and better primary and behavioral health services, more staff, new or improved health centers and clinics, and better equipment.
This conclusion is drawn in a new study from the Georgetown University Health Policy Institute based on interviews with leaders of eleven hospital systems and federally qualified health centers (FQHCs) in seven states: four that expanded their Medicaid programs and three that did not.
While Pennsylvania was not one of the states included in the study, it is one of more than 30 states that has expanded its Medicaid program.
To learn more about what the study revealed, go here to read Beyond the Reduction in Uncompensated Care: Medicaid Expansion is Having a Positive Impact on Safety Hospitals and Clinics.

PA Safety Net Admin2016-06-21T06:00:03+00:00June 21st, 2016|Affordable Care Act, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Increases in Medicaid Enrollment Should Slow

Growth in Medicaid enrollment, significant this year and last, should slacken in 2016, according a new Kaiser Family Foundation report.
That growth – 8.3 percent in 2014 and 13.8 percent in 2015 – should fall to approximately four percent next year. The upswing is the result of Medicaid expansion authorized by the Affordable Care Act and most of the growth was in states that expanded their Medicaid programs, although in 2015 every state experienced an increase in Medicaid enrollment.
Growth in Medicaid spending, too, is expected to decline, from 14.3 percent in 2014 and 13.9 percent in 2015 to a projected 6.9 percent in 2016.
To learn more about how, where, and why Medicaid enrollment and spending continue to grow, see this CQ HealthBeat report presented by the Commonwealth Fund.

PA Safety Net Admin2015-10-22T06:00:01+00:00October 22nd, 2015|Affordable Care Act|Comments Off

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