Health Insurance Coverage

Gov’t report: Illinois among 8 states with significant drop in uninsured, Associated Press, February 9, 2016, Chicago Tribune: “Eight states saw a significant drop last year in the number of residents going without health insurance, according to a government report out Tuesday that has implications for the presidential campaign.  All but Florida had accepted a Medicaid expansion that is one of two major pathways to coverage under President Barack Obama’s health care law. The law’s other coverage route is subsidized private insurance, available in all 50 states…”

Medicaid Expansion – Indiana, Ohio

  • Hospitals boosted by Medicaid expansion, By Maureen Groppe, February 1, 2016, Indianapolis Star: “The biggest obstacle a Richmond, Ind., hospital has had in signing up low-income Hoosiers for Indiana’s expanded Medicaid program is convincing them it’s real.  ‘These are people who have never had this type of coverage before,’ said Chris Knight, the chief financial officer and vice president of Reid Health. ‘We have had very touching stories where people just break down and cry when they’re given this coverage.’  As Indiana enters its second year of expanded Medicaid coverage created by the Affordable Care Act, hospitals around the state report it has helped patients gain needed coverage.  But it’s helping hospitals, too.  The amount of unpaid bills Reid Health can’t collect from patients has dropped about 40 percent…”
  • Do Indiana’s poor Medicaid recipients really have skin in the game?, By Maureen Groppe and Shari Rudavsky, February 1, 2016, Indianapolis Star: “When Gov. Mike Pence sought federal permission to run an alternative Medicaid program in Indiana, one aspect was non-negotiable: Participants in the joint federal and state health care program for the poor would have to have ‘skin in the game.’  Even those with no monthly income would have to pay a minimum $1 a month toward their care, if they wanted to stay in the part of the Healthy Indiana Program (HIP 2.0) that offered better benefits and no co-payments…”
  • Medicaid cuts number of uninsured Ohio workers, By Randy Tucker, February 3, 2016, Dayton Daily News: “The number of Ohio workers who were employed but uninsured fell sharply in the first full year of expanded Medicaid coverage under the Affordable Care Act, according to a report released Wednesday by Families USA. On average, the rate of uninsured, mostly low-wage workers, fell by 25 percent in the 26 states that expanded Medicaid in 2014, the non-profit health care advocacy group found. That was about twice the rate of decline in non-expansion states, where the share of uninsured workers was cut by an average of 13 percent, according to the report…”

Health Care and Social Services Screenings

Feds to study health benefits of screening and linking to social services, By Jayne O’Donnell, February 3, 2016, USA Today: “The Obama administration is working to build evidence supporting increased federal and state spending on anti-violence, social service and other programs to improve life in poor neighborhoods and limit the growth in health care costs.  The move comes despite more limited reports done by outside groups and is designed to create a paper trail that makes the need for and efficacy of the programs for Medicare and Medicaid recipients indisputable by showing the cost savings…”

Medicaid Expansion

  • Has Obamacare’s Medicaid expansion reached a tipping point?, By Dan Mangan, January 26, 2016, CNBC: “They like their plans, and they’re likely to keep their plans.  Despite continued Republican efforts to repeal Obamacare, a key component of the law that has given millions of people health coverage — Medicaid expansion — could prove very difficult to undo, experts say. A growing number of states have signed up for that expansion of the government-run program for poor people, or are discussing doing so. Hospitals are becoming accustomed to the money that comes with expansion, and a majority of new enrollees are saying they are happy with their coverage…”
  • Utah lawmakers get creative with Medicaid expansion, By Wendy Leonard, January 24, 2016, Deseret News: “Despite years of discussing the issue without resolution, Utah lawmakers will again take on Medicaid expansion and various plans to implement it for the thousands of Utahns who remain uncovered by health insurance. And, while some lawmakers are taking approaches that have been tried before, others are trying new things — an indication of a potential desire to bring health care benefits closer to Utahns who can’t afford them…”

Medicaid Programs – Ohio, Louisiana

  • Should some Ohio Medicaid recipients have to pay premiums?, By Catherine Candisky, January 18, 2016, Columbus Dispatch: “Tens of thousands of low-income Ohioans could lose Medicaid coverage under a state plan to charge premiums and impose penalties on those who miss the payments, advocates for the poor warn…”
  • Louisiana’s Medicaid expansion enrollment could grow to 450,000, By Kevin Litten, January 22, 2016, New Orleans Times-Picayune: “The Department of Health and Hospitals is now forecasting that Louisiana’s Medicaid rolls could swell to nearly 450,000 people after initially projecting that as many as 300,000 uninsured could be covered under the federally funded program.  The department had originally based its projections based on U.S. Census data that counted about 306,000 people as uninsured. But there is also a population of about 130,000 people who are part of the Take Charge Plus program who are eligible to receive screening and treatment for sexually transmitted infections (STI) and family planning services for men and women even if they aren’t eligible for Medicaid coverage…”

Health Insurance Coverage – Kentucky

Kentucky’s newly insured worry about their health under next governor, By Amy Goldstein, November 9, 2015, Washington Post: “Amid the coal fields of eastern Kentucky, a small clinic that is part of the Big Sandy Health Care network furnishes daily proof of this state’s full embrace of the Affordable Care Act. It was here that Mindy Fleming handed a wad of tissues to Tiffany Coleman when she arrived, sleepless and frantic, with no health insurance and a daughter suffering a 103-degree fever and mysterious pain. ‘It will be all right,’ Fleming assured her, and it was. An hour later, Coleman had a WellCare card that paid for hospital tests, which found that 4-year-old Alexsis had an unusual bladder problem.  Such one-by-one life changes are the ground-level stakes ushered in by the election last week of businessman Matt Bevin as Kentucky’s next governor. The second Republican elected to the office in 48 years, he wrapped his campaign around a pledge to dismantle Kynect, the state’s response to the federal health-care law. If he follows through, the Bluegrass State would go from being perhaps the nation’s premier ACA success story to the first to undo the law’s results, razing a state insurance exchange and reversing its considerable expansion of Medicaid…”

Medicaid Coverage Gap – Missouri

Failure to expand Medicaid impacts thousands in Ozarks, By Jon Swedien, Springfield News-Leader: “Looking back over the past year, Terri McCulloch said she was like one of the living dead. The 52-year-old said a thyroid condition had rendered her sick and unable to work. And in the wake of a recent divorce, she was left scrambling for a new place to live and without the health insurance…”

Health Insurance and Low-Income Employees

Many low-income workers say ‘no’ to health insurance, By Stacy Cowley, October 19, 2015, New York Times: “When Billy Sewell began offering health insurance this year to 600 service workers at the Golden Corral restaurants that he owns, he wondered nervously how many would buy it. Adding hundreds of employees to his plan would cost him more than $1 million — a hit he wasn’t sure his low-margin business could afford. His actual costs, though, turned out to be far smaller than he had feared. So far, only two people have signed up. ‘We offered, and they didn’t take it,’ he said.  Evidence is growing that his experience is not unusual…”

State Medicaid Spending and Enrollment

  • Medicaid costs rise, report says, but not more than most states expected, By Abby Goodnaugh, October 15, 2015, New York Times: “Spending on Medicaid rose nearly 14 percent on average in the last fiscal year, a report has found, largely because of a tide of newly eligible enrollees in the 29 states that had expanded the program by then to cover millions more low-income adults. But for most of those states, the per-member, per-month cost of the new enrollees was not higher — in a few cases, in fact, it was lower — than expected, according to the report, released Thursday by the Kaiser Family Foundation. And almost all of the additional spending was covered by federal funds, which are paying the entire cost of expanding Medicaid through 2016 and at least 90 percent thereafter…”
  • Survey: Big growth in Medicaid enrollees in expansion states, By Christina A. Cassidy (AP), October 15, 2015, Washington Post: “States that opted to expand Medicaid under the Affordable Care Act saw enrollment increase on average by 18 percent during the first full year of expansion, according to a report released Thursday. That will soon have an effect on state budgets, with expansion states to pay a portion of costs to cover the new enrollees beginning in 2017. Currently, the federal government is covering the expanded population at 100 percent. States will eventually pay 10 percent of costs by 2020…”
  • Study: Nearly half of Iowa’s uninsured are eligible for Medicaid, By Ed Tibbetts, October 15, 2015, Quad-City Times: “A new study says nearly half of Iowa’s non-elderly uninsured are eligible for Medicaid, one of the highest rates in the nation. The Kaiser Family Foundation this week released a state-by-state analysis, which said 188,000 non-elderly are uninsured in Iowa, and 47 percent of them are eligible for Medicaid, the program that is run jointly by the federal government and the states to provide coverage for the low-income and disabled people…”

Medicaid Expansion – Arkansas, Pennsylvania

  • Arkansas governor wants to keep Medicaid expansion, but with changes, By Abby Goodnough, August 19, 2015, New York Times: “Gov. Asa Hutchinson of Arkansas on Wednesday told an advisory group weighing the future of the state’s alternative Medicaid expansion that he favored keeping it — but only if the federal government allowed changes that seemed intended to appeal to conservative legislators who continue to oppose the program. Mr. Hutchinson, a Republican who took office in January, created the advisory group to recommend whether to change or replace the state’s ‘private option’ version of Medicaid expansion. The program’s fate will ultimately be decided by the Republican-controlled legislature, which is likely to meet in a special session this year to vote on it…”
  • Pennsylvania’s Medicaid expansion simplifies enrollment, By Adam Smeltz, August 20, 2015, Pittsburgh Post-Gazette: “Low-income families who might have waited months for medical assistance last winter are enrolling within weeks under Pennsylvania’s Medicaid expansion, sailing through simplified applications that help them see doctors faster. ‘People are able to get the care and treatment they need much sooner. Folks are able to get preventive care much sooner,’ said Antoinette Kraus, state director at the nonprofit Pennsylvania Health Access Network, which urged policymakers to broaden traditional Medicaid. Still, critics remain cautious whether the expanded program could overburden the state budget…”

Medicaid and Dental Care

Dental care for Medicaid patients is expanding, but a study says that won’t reduce ER visits, By Robert Gebeloff, August 6, 2015, Washington Post: “A lack of dental care for low-income Americans has long put stress on hospital emergency rooms, a new study has found, bring hundreds of thousands of patients in to ERs for minor dental problems. The study, published this week in Health Affairs, found that in 2010, somewhere around 2 percent of all ER visits was dedicated to avoidable these patients, posing questions about how best to deliver dental care to poor people. Authors of the study argue, however, that an expansion of dental care under Medicaid alone won’t fix the problem. Patients relying on the federal program would still face limited access to dentists who are willing to take them…”

Medicaid and Preventive Care – Kentucky

Preventive care rises among Kentucky Medicaid patients, By Laura Ungar, August 5, 2015, Louisville Courier-Journal: “Kentuckians on Medicaid were far more likely to get cancer screenings, physicals and dental check-ups after the state expanded the government program for the poor and disabled through the Affordable Care Act, new state data shows…”

ACA and Safety Net Hospitals

Some public hospitals win, others lose with Obamacare, Reuters, July 23, 2015, NBC News: “A year and a half after the Affordable Care Act brought widespread reforms to the U.S. healthcare system, Chicago’s Cook County Health & Hospitals System has made its first profit in 180 years.  Seven hundred miles south, the fortunes of Atlanta’s primary public hospital, Grady Health System, haven’t improved, and it remains as dependent as ever on philanthropy and county funding to stay afloat.  The disparity between the two ‘safety net’ hospitals, both of which serve a disproportionate share of their communities’ poorest patients, illustrates a growing divide nationwide…”

Medicaid Expansion – Illinois

In Illinois, Medicaid expansion sign-ups double predictions, By Carla K. Johnson (AP), July 20, 2015, St. Louis Post-Dispatch: “Illinois is among a dozen states where the number of new enrollees surpassed projections for the expansion of Medicaid under President Barack Obama’s health law. While the surge in sign-ups lifts the number of insured people, it has also stoked worries about the future cost to taxpayers.  Illinois and Cook County eventually will have to bear 10 percent of the cost of expanding the safety-net insurance program for the poor. The federal government agreed to pay all costs for the expansion through 2016, but it will begin lowering its share in 2017.  More than twice as many Illinois residents have enrolled under the expansion than was projected by former Democratic Gov. Pat Quinn’s administration. It expected 298,000 people to sign up in 2015, but 623,000 newly eligible Illinoisans enrolled by the end of June. Sign-ups have outstripped forecasts in at least a dozen states, according to a new analysis by The Associated Press…”

States and Medicaid Expansion

On Medicaid expansion, a question of math and politics, By Christine Vestal, July 8, 2015, Stateline: “With its ruling in King v. Burwell last month, the U.S. Supreme Court likely settled the question of whether President Barack Obama’s signature Affordable Care Act will survive. Whether and when the health law will be fully implemented in all 50 states is a different question.  ‘With the King decision behind us, the drumbeats for Medicaid expansion are increasing,’ said Matt Salo, executive director of the National Association of Medicaid Directors. ‘There is movement in every state. They’ll get there. Maybe not today and maybe not this year, but they’ll get there soon.’  That’s the hope of health care industry groups and legions of consumer advocates. Major business organizations and local and county governments are also onboard. Following the high court’s decision, President Obama vowed to do all he can to persuade states to opt in before he leaves office in 18 months. But in the mostly Southern and Midwestern states that have rejected expansion, opposition shows little sign of abating…”

Health Insurance Coverage in the US

Fewer poor uninsured after health law, study finds, By Sabrina Tavernise, June 23, 2015, New York Times: “The share of poor Americans who were uninsured declined substantially in 2014, according to the first full year of federal data since the Affordable Care Act extended coverage to millions of Americans last year. The drop was largely in line with earlier findings by private polling companies such as Gallup, but was significant because of its source — the National Health Interview Survey, a long-running federal survey considered to be a gold standard by researchers. The findings are being released on Tuesday…”

State Medicaid Program – Indiana

Indiana’s poor get Medicaid — by paying, By Noam N. Levey, June 15, 2015, Chicago Tribune: “Linda Joyner, at 64, just got health coverage. Uninsured for years, the former waitress signed up for Medicaid after Indiana expanded its program through the Affordable Care Act. But unlike millions of low-income Americans who’ve enrolled in the government plan since last year, Joyner is paying for her coverage. Indiana, which has a conservative Republican governor and legislature, is pioneering an experiment that requires low-income patients to contribute monthly to a special health account. Joyner chips in $12.33…”

Medicaid and Dental Care

Adult dental coverage expanding slowly in Medicaid, By Christine Vestal, June 10, 2015, Stateline: “At the Interfaith Dental Center in Crown Heights, Brooklyn, people with dental pain can walk into a ground floor office off Bedford Avenue and get treated without an appointment. They might have to wait in a packed waiting room. But if they’re in the door by 5 p.m., a dentist will see them.  Residents in this low- to middle-income neighborhood likely don’t realize how lucky they are. The majority of Americans have to travel miles to see a dentist who takes their insurance, particularly if they’re covered by Medicaid. Many dental patients with private insurance cannot afford to pay their share of the bill. Federal law requires state Medicaid programs to include dental care for children, and the Affordable Care Act extended that requirement to private insurers. But the federal health law did little for adults: While premium tax credits were made available to help low-income people purchase health insurance, the subsidies cannot be used to purchase dental coverage except as an add-on to health coverage. No new dental benefit requirements were included for adults covered by Medicaid…”

States and Medicaid Expansion

  • In wake of federal reform, Minnesota’s Medicaid enrollment surges to 1 million, By Glenn Howatt, May 31, 2015, Minneapolis Star Tribune: “Minnesota’s Medicaid rolls have soared past the 1 million mark for the first time, driven by two years of explosive growth in government insurance programs in the wake of federal health reform.  The enrollment surge — one of the largest in the country and the biggest for the state in 35 years — helped push Minnesota’s uninsured rate down to about 5 percent and has enabled more low-income families to receive regular medical care, doctors say. But it also means that Medicaid and its sister program, MinnesotaCare for the working poor, now rank among the state’s largest health insurers, which could place long-run strains on the state budget. Fully one in five Minnesotans now receive health insurance from public programs, up from one in 10 just five years ago…”
  • Louisiana Legislature OKs potential Medicaid expansion, By Marsha Shuler, June 2, 2015, Baton Rouge Advocate: “The Louisiana Senate gave final approval Monday to a measure that would allow the next governor to expand Medicaid. The Senate voted 31-8 for a House-passed resolution establishing a funding source to cover the state’s contribution for the government health insurance expansion…”

Rules for Private Medicaid Plans

  • ‘Milestone’ rules would limit profits, score quality for Medicaid plans, By Jay Hancock, May 27, 2015, St. Louis Post-Dispatch: “Sweeping proposals disclosed Tuesday would create profit guidelines for private Medicaid plans as well as new standards for the plans’ doctor and hospital networks and rules to coordinate Medicaid insurance more closely with other coverage.  ‘We are taking steps to align how these programs work,’ said Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services, which proposed the rules.  Privatized Medicaid has grown rapidly as budget-pinched states have responded to commercial insurers’ promise to deliver care for a fixed price. Most beneficiaries of Medicaid — state programs for the poor run partly with federal dollars — now get care through contracted insurers…”
  • Pennsylvania moves to keep pace with increase in Medicaid, By Bill Toland, May 29, 2015, Pittsburgh Post-Gazette: “With Medicaid enrollment growing nationally and in Pennsylvania, the federal government is proposing new oversight of privately administered Medicaid plans, tightening profit guidelines for insurers and keeping a closer eye on doctor availability for patients.  Participation in Medicaid, the state-run health insurance plan for the poor and disabled, has grown by about 10 million in the U.S. over the last 18 months, an increase driven by federal subsidies and the broad income-based eligibility expansion included in the 2010 Affordable Care Act…”