States and Medicaid Expansion

  • State legislatures quarrel over whether to expand Medicaid, By Annie Feidt, May 12, 2015, National Public Radio: “Five years after the Affordable Care Act passed, the law’s provision allowing the expansion of Medicaid coverage to more people is still causing huge fights in state legislatures.  Twenty-four states and the District of Columbia said yes to Medicaid expansion when the law went into effect. Since then, just six more have signed on. States that say yes get billions of additional federal dollars, but many Republican lawmakers are loathe to say yes to the Obama administration…”
  • More managed care, more problems?, By Jordan Shapiro, May 15, 2015, St. Louis Post-Dispatch: “Gov. Jay Nixon recently approved an expansion of Medicaid managed care and now the difficult work begins to shift 200,000 Missourians onto private health plans.  Around the country more and more states are shifting to the managed care model. It differs from traditional Medicaid in that a private corporation receives a flat amount from the state to manage and pay for various aspects of a recipient’s care. Under traditional Medicaid, the state directly reimburses providers for each test and treatment…”

States and Medicaid Expansion

States watching Medicaid standoff between Florida, Obama, By Kelli Kennedy (AP), May 7, 2015, Miami Herald: “The Obama administration rebuffed Florida’s Gov. Rick Scott’s proposal to extend federal funds for hospitals that treat the uninsured, increasing the pressure on states that have refused to expand coverage for low-income people under the president’s health care law.  The decision means Florida’s already acrimonious state budget process will likely become tenser. The standoff also has implications for eight other states, including Texas, which draw billions of dollars from the same pool of hospital funds. And like Florida, several are also refusing to expand Medicaid coverage. Republican leaders in those states are adamant about not expecting any federal money tied to Obama’s Affordable Care Act…”

Medicaid Wellness Incentives

Paying Medicaid enrollees to get healthy: Will it pay off?, By Phil Galewitz, May 4, 2015, St. Louis Post-Dispatch: “When Bruce Hodgins went to the doctor for a checkup in Sioux City, Iowa, he was asked to complete a lengthy survey to gauge his health risks. In return for filling it out, he saved a $10 monthly premium for his Medicaid coverage.  In Las Cruces, N.M., Isabel Juarez had her eyes tested, her teeth cleaned and recorded how many steps she walked with a pedometer. In exchange, she received a $100 gift card from Medicaid to help her buy health care products including mouthwash, vitamins, soap and toothpaste.  Taking a cue from workplace wellness programs, Iowa and New Mexico are among more than a dozen states offering incentives to Medicaid beneficiaries to get them to make healthier decisions — and potentially save money for the state-federal health insurance program for the poor. The stakes are huge because Medicaid enrollees are more likely to engage in unhealthy practices, such as smoking, and are less likely to get preventive care, studies show…”

States and Medicaid Expansion

States find savings through Medicaid expansion, By Michael Ollove, April 29, 2015, Stateline: “Medicaid expansion has given a budget boost to participating states, mostly by allowing them to use federal money instead of state dollars to care for pregnant women, inmates, and people with mental illness, disabilities, HIV/AIDS, and breast and cervical cancer, according to two new reports.  States that levy assessments and fees on health care providers, which have collected higher revenues as a result of expansion, have reaped extra benefits…”

Supplemental Nutrition Assistance Program

  • Health law brings growth in food stamps in some states, By Carla K. Johnson and David Mercer (AP), April 22, 2015, ABC News: “President Barack Obama’s health care law has had a surprising side effect: In some states, it appears to be enticing more Americans to apply for food stamps, even as the economy improves.  New, streamlined application systems built for the health care overhaul are making it easier for people to enroll in government benefit programs, including insurance coverage and food stamps…”
  • Pa. to eliminate asset test for food stamps, By Alfred Lubrano, April 21, 2015, Philadelphia Inquirer: “Pennsylvania will eliminate the asset test for food stamps as of Monday, a spokeswoman for the Department of Human Services announced Tuesday evening. The controversial test, initiated by then-Gov. Tom Corbett in 2012, ties federal food-stamp benefits – now known as the Supplemental Nutrition Assistance Program, or SNAP – to people’s bank accounts and car ownership.  Corbett saw the test as a way to cut down on fraud and waste…”

Miami Herald Series on Medicaid Coverage Gap

Life in Florida without Medicaid expansion, series homepage, Miami Herald: “For two years, Florida legislators have refused to expand Medicaid as envisioned under the Affordable Care Act. Their decision left an estimated 850,000 Floridians without healthcare insurance in the ‘coverage gap.’ Those caught in the gap earn too much to receive Medicaid, but not enough to qualify for subsidies to buy a plan through the federal marketplace. The Miami Herald looks at how these Floridians are coping and what other states are doing to close the gap…”

State Medicaid Costs

  • Alabama Medicaid burden rising more slowly than most states, study shows, By Brendan Kirby, April 23, 2015, Press-Register: “During Alabama’s latest budget crisis, lawmakers often have pointed to out-of-control Medicaid costs as one of the leading culprits. A report released Wednesday by the Pew Charitable Trusts, however, suggests that costs relative to state revenues have been much more manageable in Alabama than most other states over the past decade…”
  • State Medicaid costs grow, By Phil Kabler, April 22, 2015, Charleston Gazette: “Medicaid costs accounted for 11.4 percent of the state’s general revenue budget in 2013, up from 8 percent in 2000, a study released Wednesday by the Pew Charitable Trusts shows. Still, that was below the national average of 16.9 percent in 2013, an average that grew from 12.2 percent in 2000…”

States and Medicaid Coverage

  • Under Obamacare, Medicaid now covers one-fifth of N.J. residents, By Kathleen O’Brien, April 14, 2015, Star-Ledger: “Medicaid, the public health insurance program expanded under the Affordable Care Act, now covers nearly one out of every five New Jersey residents, according to the latest enrollment figures.  More than 420,000 people signed up for insurance since New Jersey allowed more people to into the program, according to Valerie Harr, director of the division of medical assistance and health services for the N.J. Department of Human Services…”
  • Some states pay doctors more to treat Medicaid patients, By Michael Ollove, April 17, 2015, Stateline: “Fifteen states are betting they can convince more doctors to accept the growing number of patients covered by Medicaid with a simple incentive: more money.  The Affordable Care Act gave states federal dollars to raise Medicaid reimbursement rates for primary care services—but only temporarily. The federal spigot ran dry on Jan. 1. Fearing that lowering the rates would exacerbate the shortage of primary care doctors willing to accept patients on Medicaid, the 15 states are dipping into their own coffers to continue to pay the doctors more.  It seems to be working…”

Medicaid Expansion and Mental Health Treatment

Medicaid expansion would have helped 18,400 mentally ill Louisianians in 2014, study says, By Rebecca Catalanello, New Orleans Times-Picayune: “More than 18,400 uninsured Louisianians diagnosed with mental health conditions were denied access to affordable mental health treatment last year — care that would have been available to them if the state’s leaders expanded Medicaid as allowed by federal law, a new study shows. The American Mental Health Counselors Association examined the impact of Medicaid expansion on the mentally ill in the United States and found that more than a half-million uninsured adults were diagnosed with a serious mental health at the beginning of 2014, but did not get treated because they lived in the 24 states that did not expand Medicaid as the Patient Protection and Affordable Care Act allows…”

Medicaid Patients and Access to Care

N.J. doctors least willing to accept Medicaid patients under Obamacare, By Susan K. Livio, March 31, 2015, Star-Ledger: “The Affordable Care Act has provided a path for 420,500 low-income New Jersey residents to gain insurance through the Medicaid program, but a new study says the state ranks last in the nation in doctors willing to treat them.  Just 38.7 percent of New Jersey physicians said they accepted new Medicaid patients in 2013 — far below the national average of nearly 69 percent, according to the most recent data available from the U.S. Centers for Disease Control and Prevention. New Jersey is the only state where fewer than half of the doctors accepted new Medicaid patients. California, at 54.2 percent is second-lowest in the nation…”

Medicaid Expansion and Diabetes Diagnosis

  • With expansion of Medicaid, some states are identifying more new diabetes cases, By Sabrina Tavernise, March 23, 2015, New York Times: “The number of new diabetes cases identified among poor Americans has surged in states that have embraced the Affordable Care Act, but not in those that have not, a new study has found, suggesting that the health care law may be helping thousands of people get earlier treatment for one of this country’s costliest medical conditions.  One in 10 Americans have diabetes, and nearly a third of cases have not been diagnosed. The disease takes a toll if it is caught too late, eventually causing heart attacks, blindness, kidney failure and leg and foot amputations. The Centers for Disease Control and Prevention estimates that the disease accounts for $176 billion in medical costs annually. The poor and minorities are disproportionately affected…”
  • Diabetes study shows benefits of expanded Medicaid under Obamacare, By Noam N. Levey, March 23, 2015, Los Angeles Times: “Low-income patients with diabetes are getting better access to medical care in states that have expanded Medicaid coverage through the Affordable Care Act, suggests a new study that provides one of the first indications of the sweeping law’s health effects.  Residents of other states are at risk of being left behind.  The number of Medicaid patients with newly identified diabetes surged 23% in states that expanded their programs, an option provided by the law, but there was virtually no increase in states that declined to expand coverage, researchers found…”

Medicaid Expansion – Ohio

Ohioans new to Medicaid get care, By Catherine Candisky, March 6, 2015, Columbus Dispatch: “Divorced with four children, Pam Harris had no health insurance — choosing between medications to treat her depression and rheumatoid arthritis or paying utility bills — when she suffered her first stroke two years ago.  After leaving the hospital, the 40-year-old, who lives in Jamestown in Greene County, couldn’t afford follow-up care or physical therapy. Church friends showed her exercises she could do at home.  And after she returned to work with an advocacy group for families with children with behavioral issues, colleagues accompanied her to presentations, stepping in when she couldn’t find the words.   Last fall, Harris suffered a second stroke, but her recovery has been much better. This time, she had health insurance as one of the nearly half-million poor adults who became eligible through Ohio’s expansion of tax-funded Medicaid last year…”

Medicaid Expansion and Safety-Net Hospitals

Economy boosts safety-net hospitals in states not expanding Medicaid, By Phil Galewitz, March 1, 2015, Washington Post: “Hospitals that treat many poor and uninsured patients were expected to face tough financial times in states that did not expand Medicaid under the Affordable Care Act.  That’s because they would get less Medicare and Medicaid funding under the health-care law, while still having to provide high levels of charity care.  But in some of the largest states that did not expand Medicaid, many ‘safety net’ hospitals fared pretty well last year — better than in 2013 in many cases, according to their financial documents…”

Health Insurance Coverage

  • Health law drives down U.S. rate of uninsured adults, survey finds, By Noam N. Levey, February 24, 2015, Los Angeles Times: “America’s uninsured rate plummeted last year, with the improvement driven by states that have fully implemented the Affordable Care Act, a new nationwide Gallup survey indicates.  Led by Arkansas and Kentucky, which both had double-digit declines, seven states saw the percentage of adults without insurance fall by more than 5 percentage points between 2013 and 2014…”
  • Survey: Uninsured rate hit new low in 2014, By Ricardo Alonso-Zaldivar (AP), February 24, 2015, ABC News: “Even as it faces another Supreme Court challenge, President Barack Obama’s health care law has steadily reduced the number of uninsured Americans, according to an extensive survey released Tuesday.  The Gallup-Healthways Well-Being Index found that the share of adults without health insurance dropped to its lowest level in seven years in 2014 as Obama’s overhaul took full effect.  The trend appears likely to continue, since 55 percent of those who remained uninsured told the pollster they plan to get coverage rather than face rising tax penalties…”
  • The stark North-South divide in health insurance, By Aimee Picchi, February 24, 2015, CBS News: “When it comes to health care coverage, America is becoming a land of geographically based haves and have-nots.  States with the lowest uninsured rates are clustered in the Northeast and upper Midwest, while those with the highest rates of uninsured Americans are mostly inSouthern states such as Georgia and Louisiana, according to a new study from Gallup. One reason is that many Southern states opted out of expanding Medicaid coverage under Obamacare…”
  • Medicaid enrollment surges across the U.S., By Kimberly Leonard, February 24, 2015, US News and World Report: “Much of the focus of the health care law in recent months has centered on whether the government could get millions of people to sign up for private health insurance through federal or state exchanges. But the Affordable Care Act also expands health insurance for Americans with the lowest incomes – by giving them greater access to public coverage through Medicaid and the Children’s Health Insurance Program…”
  • Congress is told ruling against health law would impact poor, By Robert Pear, February 24, 2015, New York Times: “The Obama administration told Congress on Tuesday that it had no plans to help low- and moderate-income people if theSupreme Court ruled against the administration and cut off health insurance subsidies for millions of Americans.  Sylvia Mathews Burwell, the secretary of health and human services, said a court decision against the administration would do “massive damage” that could not be undone by executive action.

Medicaid Expansion – Kentucky

Study: Ky Medicaid expansion showing benefits, By Chris Kenning, February 13, 2015, Louisville Courier-Journal: “One year after it was enacted, Kentucky’s Medicaid expansion is benefiting patients and health care providers — and is expected to generate jobs and economic growth that will more than offset $1.1 billion in state costs through 2021, according to a state study released Thursday. The expansion, which enrolled 375,000 people in the health care program for the poor and disabled last year, is now projected to create 40,000 jobs and add $30 billion to the economy in the next six years — more than initially predicted…”

States and Medicaid Expansion

Complicated politics of Medicaid expansion are playing out state by state, By Abby Goodnough, February 10, 2015, New York Times: “In Pennsylvania, Gov. Tom Wolf, a newly elected Democrat, is scrapping his Republican predecessor’s conservative approach to expanding Medicaid under the Affordable Care Act. Mr. Wolf said this week that he would instead pursue a straightforward expansion of the government health insurance program for the poor, no longer charging premiums or limiting benefits for some enrollees. In Tennessee and Wyoming, however, bills to extend Medicaid to far more low-income residents under the law were quashed by Republican legislators last week, despite having the support of the states’ Republican governors. Opponents in both states said that, among other things, they did not believe the federal government would keep its promise of paying at least 90 percent of the cost of expanding the program. It currently pays the full cost, but the law reduces the federal share to 90 percent — a permanent obligation, it says — by 2020…”

State Medicaid Programs

  • Some Iowans will face premiums for Medicaid expansion, By Catherine Lucey, February 1, 2015, Des Moines Register: “As Iowa’s modified Medicaid expansion hits the one-year anniversary mark, some enrollees will be asked to pay small monthly premiums because they have not yet completed a required physical exam and health questionnaire. For Gov. Terry Branstad, setting these health requirements was a key provision for expanding Medicaid in Iowa using funding from President Barack Obama’s health care overhaul. The state received federal approval to make modifications to the traditional Medicaid terms, including setting health requirements and charging contributions…”
  • US’s 1st program using federal funds to buy private insurance for poor survives in Arkansas, By Andrew DeMillo (AP), February 5, 2015, Minneapolis-St. Paul Star Tribune: “Arkansas’ first-in-the-nation program using federal funds to buy private health insurance for the poor will survive another year after the Legislature reauthorized the program Thursday, despite an influx of new Republican lawmakers elected on a vow to kill the hybrid Medicaid expansion. The Arkansas House voted 82-16 to reauthorize funding through June 2016 for the ‘private option’ plan, which was crafted two years ago as an alternative to expanding Medicaid under the federal health law. Arkansas was the first state to win federal approval for such an approach, touted as a compromise for Republican-leaning states…”
  • Medicaid could dump 500,000 Ohioans in 6 months, By Catherine Candisky, February 6, 2015, Columbus Dispatch: “The state will send out letters to 107,000 Medicaid recipients today telling them that their health-care benefits will be terminated on Feb. 28 for failure to verify their income. ‘They should consider this as a final notice,’ said Sam Rossi, spokesman for the Ohio Department of Medicaid. ‘There is personal responsibility. You need to report income for a program like Medicaid.’ An additional 140,000 recipients will receive termination notices next week, with 100,000 scheduled for March. The Ohio Job and Family Services Association and advocates for the poor have urged state officials to delay terminating benefits because fewer than half of those sent renewal notifications in December have responded, and many never received them…”
  • Few lawmakers supported Haslam’s Insure Tennessee, By Dave Boucher, February 4, 2015, The Tennessean: “In 21 months, Gov. Bill Haslam and his administration spent countless hours crafting a health care plan they thought could thread the political needle: satisfy Democrats in Washington, D.C., Republicans in Tennessee and help the working poor. It took considerably less time for the plan to unravel in the General Assembly. After a little more than two days, a few state Senators officially killed Haslam’s plan to provide 280,000 low-income Tennesseans with federally funded health care…”
  • Governor’s panel again urges Medicaid expansion in Idaho, By Bill Dentzer, February 6, 2015, Idaho Statesman: “Members of the governor-appointed group that developed options for expanding Medicaid to cover Idaho’s poorest adults told lawmakers Thursday that opposition to the expansion has blocked money that taxpayers are due under federal health care reform. The panel’s alternative funding plan provides greater accountability, saves money and gives the state more control over how funds are spent, they said. The federal government already has approved similar alternative plans in other states where Medicaid expansion has been politically or ideologically unpopular…”

Health Insurance Coverage

Medicaid, CHIP add 10.1 million since insurance marketplaces opened, By Tony Pugh, February 2, 2015, Fresno Bee: “More than 10.1 million people have enrolled in Medicaid and the Children’s Health Insurance Program in the first 14 months since marketplace enrollment began, the Obama administration reported Monday. That’s a 17.5 percent increase over the average monthly enrollment of both programs just before marketplace health insurance became available in October 2013…”

Medicaid Expansion – Indiana

  • Gov. Pence gets federal OK for Medicaid alternative, By Shari Rudavsky and Maureen Groppe, January 27, 2015, Indianapolis Star: “After months of wrangling between Gov. Mike Pence and the Obama administration, Indiana won approval to expand its own brand of Medicaid that injects personal responsibility into the healthcare program for the poor. About 350,000 low-income Hoosiers who lack insurance could benefit from the program, whose approved expansion was announced Tuesday, the day enrollment began. Coverage could start as early as Feb. 1. Pence said the Healthy Indiana Plan 2.0, a revamped version of a program started by then-Gov. Mitch Daniels, goes beyond standard Medicaid expansion by requiring that participants contribute to the cost of their care…”
  • Indiana will allow entry to Medicaid for a price, By Abby Goodnough, January 27, 2015, New York Times: “After a lengthy back-and-forth, the Obama administration has agreed to let Gov. Mike Pence of Indiana, a Republican, expand Medicaid on his own terms, including some that have not been allowed before under federal rules. The plan will extend coverage to an additional 350,000 Indiana residents with incomes of up to 138 percent of the federal poverty level — about $16,100 for a single person and $27,310 for a family of three — starting next month. As in the 27 other states that have expanded Medicaid under the Affordable Care Act, the federal government will cover the entire cost through this year and at least 90 percent in future years. But Mr. Pence, like several Republican governors before him, insisted on adding a conservative twist to the expansion, mostly by requiring beneficiaries to pay something toward their coverage…”

Medicaid Expansion – Kentucky

Kentucky examines Medicaid expansion’s effects, By Chris Kenning and Laura Ungar, January 26, 2015, Louisville Courier-Journal: “One year after Kentucky enacted expanded Medicaid under Obamacare, the health care program for the poor and disabled has grown to serve nearly 1.2 million residents — a quarter of Kentucky’s population. Now, consultants are finalizing a report examining the expansion’s impact on the state’s health care system — and its bottom line — in a review that advocates say will carry important implications and is being watched by other states still considering an expansion. The study, set for release by the Cabinet for Health and Family Services in the coming weeks, will explore how the change has affected areas such as provider reimbursements and uncompensated care; whether it’s beginning to create more jobs or tax revenue; and its future enrollment outlook…”