Health Insurance in the United States: 2015

  • Uninsurance rate drops to the lowest level since before the Great Recession, By Amy Goldstein, September 13, 2016, Washington Post: “About 4 million Americans gained health insurance last year, decreasing the nation’s uninsured rate to 9.1 percent, the lowest level since before the Great Recession, according to new federal figures.  The figures, released Tuesday from a large annual Census Bureau survey, show that the gains were driven primarily by an expansion of coverage among people buying individual policies, rather than getting health benefits through a job. This includes, but is not limited to, the kind of coverage sold on the insurance exchanges that began in 2014 under the Affordable Care Act…”
  • The striking difference between states that expanded Medicaid and the ones that didn’t, By Carolyn Y. Johnson, September 13, 2016, Washington Post: “The number of Americans without health insurance declined to 9.1 percent last year, according to federal data released Tuesday. A set of maps released by the Census Bureau suggests an obvious way to decrease the uninsured rate even more: expand Medicaid in the 19 states that haven’t…”

Health Insurance Coverage

  • The states with the biggest Obamacare struggles spent years undermining the law, By Noam N. Levy, September 7, 2016, Los Angeles Times: “As insurers exit Obamacare marketplaces across the country, critics of the Affordable Care Act have redoubled claims that the health law isn’t working.  Yet these same critics, many of them Republican politicians in red states, took steps over the last several years to undermine the 2010 law and fuel the current turmoil in their insurance markets…”
  • Obamacare pushes nation’s health uninsured rate to record low 8.6 percent, By Dan Mangan, September 7, 2016, CNBC: “Low enough for you yet?  The rate of Americans who lack health insurance has hit a record low — again — as a result of Obamacare.  In the first quarter of 2016, there were 8.6 percent of Americans — or about 27.3 million people — who were uninsured, the first time in history that the nation’s uninsured rate fell below 9 percent…”

States and Medicaid Expansion

  • How expanding Medicaid can lower insurance premiums for all, By Margot Sanger-Katz, August 25, 2016, New York Times: “The Obama administration for years has been pleading with states to expand their Medicaid programs and offer health coverage to low-income people. Now it has a further argument in its favor: Expansion of Medicaid could lower insurance prices for everyone else.  A new study published by in-house researchers at the Department of Health and Human Services compared places that have expanded their Medicaid programs as part of Obamacare with neighboring places that have not. They found that, in 2015, insurance in the marketplace for middle-income people cost less in the places that had expanded Medicaid…”
  • Controversial parts of Medicaid plan remain, By Tom Loftus and Deborah Yetter, August 25, 2016, Louisville Courier-Journal: “Gov. Matt Bevin’s administration unveiled its long-awaited plan to reshape the state’s Medicaid program Wednesday, and while it restores some benefits Bevin proposed be cut two months ago, it retains the most controversial components of the governor’s approach to overhauling the federal-state health plan for low-income and disabled Kentuckians.  Taking aim at the Medicaid expansion launched by his predecessor, Democrat Steve Beshear, under the federal Affordable Care Act, Bevin, a Republican, has said he wants to create a different program that includes more cost-sharing by consumers, encourages more personal responsibility, and brings the state’s soaring costs of Medicaid under control…”

Health Insurance Coverage – California

More Californians are insured in 2016, but many still worry about medical costs, By Soumya Karlamangla, August 18, 2016, Los Angeles Times: “Nearly three-quarters of Californians who didn’t have health coverage before the Affordable Care Act are now insured, yet many are still concerned about their medical expenses, according to a report released Thursday. A Kaiser Family Foundation survey tracking the state’s uninsured population found that 72% of those without insurance in 2013 had a health plan in 2016…”

Access to Health Care

  • Study of Philly neighborhoods finds big disparities in health-care access by race, By Don Sapatkin, August 9, 2016, Philadelphia Inquirer: “Philadelphia has plenty of primary-care providers overall, but there is far less access to care in communities with the highest concentrations of African American residents, according to a new study.  While the general findings were not a surprise – highly segregated black (and, to a lesser extent, Hispanic) areas were known to have fewer medical practitioners – the difference was bigger than the researchers had expected…”
  • Obamacare is helping more poor patients get to the doctor even as political battles continue, By Noam N. Levey, August 8, 2016, Los Angeles Times: “Even as the Affordable Care Act remains a political flash point, new research shows it is dramatically improving poor patients’ access to medical care in states that have used the law to expand their Medicaid safety net. After just two years of expanded coverage, patients in expansion states are going to the doctor more frequently and having less trouble paying for it.  At the same time, the experience in those states suggests better access will ultimately improve patients’ health, as patients get more regular checkups and seek care for chronic illnesses such diabetes and heart disease…”
  • Obamacare appears to be making people healthier, By Margot Sanger-Katz, August 9, 2016, New York Times: “Obamacare has provided health insurance to some 20 million people. But are they any better off?  This has been the central question as we’ve been watching the complex and expensive health law unfurl. We knew the law was giving people coverage, but information about whether it’s protecting people from debt or helping them become more healthy has been slower to emerge…”

Medicaid Expansion

Obamacare’s Medicaid expansion leading to health insurance boom in some states, By Dan Mangan, July 20, 2016, CNBC: “The U.S. Supreme Court decision that upheld most of Obamacare also rejected the section of the Affordable Care Act that would have compelled states to expand eligibility in their Medicaid programs to nearly all poor adults.  That part of the ruling received far less public attention — but it’s that part that likely has had the biggest impact on states over the past four years…”

Medicaid Expansion – Louisiana

  • Louisiana, the U.S. incarceration capital, prepares for expanded Medicaid, By Jayne O’Donnell, June 28, 2016, USA Today: “Here in the state that imprisons more of its citizens per capita than any other, the long-awaited July 1 launch of expanded Medicaid coverage will give those leaving prison a chance to at least continue what many describe as spotty treatment for the conditions that plagued them while behind bars. These include Dolfinette Martin, who has been out of prison for four years with no health coverage or medications to control her bipolar disorder, and Maryam Henderson-Uloho, who spent more than 12 years in prison, and who says she and other inmates seldom sought medical treatment because prison officials would write them up for ‘malingering’ when they did…”
  • Louisiana Medicaid expansion and the promise of economic security, By Kevin Litten, June 30, 3016, New Orleans Times-Picayune: “There was a dignity in getting up to go to work each day, even if it was a low-wage janitorial job. Marigny resident Katherine White had been brought up with working class values: What you have is what you worked for, and friends and family were there to support you if you fell short.  But because White didn’t have health insurance that would cover regular doctor visits and prescriptions to treat her persistent high blood pressure, she fell into a gap. That same gap has affected thousands of New Orleans area residents, plunging many of them into situations that threaten their ability to earn regular wages to support themselves and their families…”
  • A rush to ERs in Louisiana Medicaid expansion? Clinics hope to fill that need, By Kevin Litten, July 1, 3016, New Orleans Times-Picayune: “In most of the 30 states that expanded Medicaid eligibility before Louisiana, emergency rooms often experienced a surge in traffic when tens of thousands of patients were made eligible for the federally subsidized health insurance.  But in New Orleans and the surrounding area, it’s the network of health clinics established in the years after Hurricane Katrina that is expected to absorb many of the new patients. In many ways, the New Orleans area is uniquely positioned to begin treating the estimated 60,000 people who become eligible for Medicaid on Friday (July 1)…”

States and Medicaid Expansion

  • Medicaid report finds more recipient ease of use in expansion states, By Richard Craver, June 22, 2016, Winston-Salem Journal: “The latest in a series of federal reports on the benefits of Medicaid expansion determined that it can reduce third-party debt collections by $600 to $1,000 per individual.  The U.S. Department of Health and Human Services report, released Tuesday, also found that compared with 19 non-expansion states such as North Carolina, Medicaid enrollees in 31 expansion states saw an increase in preventive service visits and access to Medicaid prescription drug refills…”
  • Bevin unveils plan to reshape Medicaid in Ky., By Deborah Yetter, June 22, 2016, Louisville Courier-Journal: “Gov. Matt Bevin on Wednesday announced sweeping changes to the state’s $10 billion-a-year Medicaid program, saying he will seek permission from the federal government to reshape the federal-state health program that covers about 1.3 million Kentuckians.  Bevin, in a press conference at the Capitol Rotunda, hailed his proposal for a ‘waiver’ from the federal government to revise Kentucky’s Medicaid plan as an opportunity ‘to come up with what is going to be truly a transformative and sustainable and fantastic program…'”

Medicaid Expansion – Indiana

Indiana battling feds over Medicaid, By Maureen Groppe, June 20, 2016, Indianapolis Star: “Indiana remains at odds with the federal government over how to evaluate the state’s unique Medicaid program, a standoff that affects not only Indiana, but also other states looking to adopt Indiana’s model. The Centers for Medicare & Medicaid Services gave Indiana a deadline of June 17 to finalize a data-sharing agreement on the jointly funded health care program for the poor. Instead, Indiana responded in a letter Friday that the federal government hasn’t satisfied the state’s concerns about data safety…”

Children’s Health Insurance Coverage

More low-income kids now have health coverage, By Michelle Andrews, May 13, 2016, National Public Radio: “Bolstered by the federal health care law, the number of lower-income kids getting health coverage continues to rise.  During 2014, the first full year of the law’s implementation, 91 percent of children who were eligible for Medicaid or the Children’s Health Insurance Program were enrolled, according to a study by researchers at the Urban Institute. In 2013, that figure was 88.7 percent and only 81.7 percent in 2008. Medicaid and CHIP are both federal-state health coverage programs for lower-income residents, but CHIP provides coverage for kids whose families earn too much to qualify for Medicaid…”

Medicaid Expansion – Oklahoma

In surprising turnabout, Oklahoma eyes Medicaid expansion, By Sean Murray (AP), May 16, 2016, The Oklahoman: “Despite bitter resistance in Oklahoma for years to President Barack Obama’s health care overhaul, Republican leaders in this conservative state are now confronting something that alarms them even more: a huge $1.3 billion hole in the budget that threatens to do widespread damage to the state’s health care system.  So, in what would be the grandest about-face among rightward leaning states, Oklahoma is now moving toward a plan to expand its Medicaid program to bring in billions of federal dollars from Obama’s new health care system.  What’s more, GOP leaders are considering a tax hike to cover the state’s share of the costs…”

Insurance Coverage under the ACA

  • Immigrants, the poor and minorities gain sharply under Affordable Care Act, By Sabrina Tavernise and Robert Gebeloff, April 17, 2016, New York Times: “The first full year of the Affordable Care Act brought historic increases in coverage for low-wage workers and others who have long been left out of the health care system, a New York Times analysis has found. Immigrants of all backgrounds — including more than a million legal residents who are not citizens — had the sharpest rise in coverage rates.  Hispanics, a coveted group of voters this election year, accounted for nearly a third of the increase in adults with insurance. That was the single largest share of any racial or ethnic group, far greater than their 17 percent share of the population. Low-wage workers, who did not have enough clout in the labor market to demand insurance, saw sharp increases. Coverage rates jumped for cooks, dishwashers, waiters, as well as for hairdressers and cashiers. Minorities, who disproportionately worked in low-wage jobs, had large gains…”
  • Obamacare seems to be reducing people’s medical debt, By Margot Sanger-Katz, April 20, 2016, New York Times: “Even if you lack health insurance, you’ll probably be able to get treatment at a hospital in the event of a catastrophe — if you’re struck by a car, say. But having insurance can mean the difference between financial security and financial ruin. A new study is showing that, by giving health insurance to low-income people, Obamacare seems to have cut down on their debt substantially. It estimates that medical debt held by people newly covered by Medicaid since 2014 has been reduced by about $600 to $1,000 each year…”
  • Obamacare expanding coverage for the poor, study finds, By Karen Pallarito, April 20, 2016, Philadelphia Inquirer: “State Medicaid expansions under Obamacare have improved low-income Americans’ insurance coverage, increased their doctor visits and enhanced detection of chronic health conditions, which could lead to improvements in health, a new study suggests. The findings are important as policymakers continue to debate the value of expanding Medicaid, the publicly funded health insurance program for the poor, researchers said…”

Medicaid Expansion – Arkansas

Arkansas GOP governor uses veto to save Medicaid program, By Andrew Demillo (AP), April 21, 2016, Washington Post: “Gov. Asa Hutchinson on Thursday effectively saved Arkansas’ first-in-the-nation hybrid Medicaid expansion by voiding part of a budget bill that would have ended the subsidized insurance for more than 250,000 poor people. The Republican governor vetoed a provision in the Medicaid budget that ordered a Dec. 31 end to the program, which uses federal funds to purchase private insurance for the poor…”

ACA and Free Health Clinics

While more Americans are insured, free clinics still providing a safety net, By Kate Giammarise, March 28, 2016, Pittsburgh Post-Gazette: “The Affordable Care Act and expansion of Medicaid have brought health insurance to millions of previously uninsured Americans. But it’s still mostly business as usual at the Birmingham Free Clinic on Pittsburgh’s South Side, where about 90 percent of patients lack health insurance. The remaining 10 percent of patients at the clinic, located in a Salvation Army building off Carson Street, tend to bounce off and on Medicaid, clinical director Mary Herbert estimated…”

Medicaid Expansion – Wisconsin

Wisconsin uses Affordable Care Act but rejects funding for it, By Guy Boulton, February 29, 2016, Milwaukee Journal Sentinel: “Wisconsin’s decision last week to challenge a fee imposed by the Affordable Care Act set up a comparison not lost on advocates who support the law. The fee has cost the state about $23 million so far. In contrast, Gov. Scott Walker and the Legislature’s opposition to the law is projected to cost $678.6 million in state tax dollars through the 2017 fiscal year. That’s because Wisconsin is the only state in the country to use the Affordable Care Act to expand its Medicaid program while turning down the additional federal dollars available through the law to pay for it…”

State Medicaid Programs

  • Feds OK Medicaid privatization, with another delay, By Tony Leys and Jason Clayworth, February 23, 2016, Des Moines Register: “Gov. Terry Branstad gained federal approval Tuesday for his controversial plan to turn Medicaid over to private managers, but not until April 1.  Branstad originally planned to make the massive shift on Jan. 1. Federal administrators determined in December that Iowa was not ready to turn the 560,000 poor or disabled people who use the program over to three private management companies. They ordered the state to wait until at least March 1…”
  • New twists as Maine lawmakers again consider Medicaid expansion, By Joe Lawler, Feburary 23, 2016, Portland Press Herald: “Sen. Tom Saviello’s Medicaid expansion bill received a chilly reception from his fellow Republicans and the LePage administration Tuesday. The Wilton lawmaker received support from Democrats, however, and remained undeterred…”
  • Bill would block Medicaid expansion for another two years, By Laura Hancock, February 23, 2016, Casper Star-Tribune: “The state Legislature, which recently defeated Medicaid expansion, is debating a bill that would create a two-year state study of health coverage for low-income Wyomingites – a measure critics call a delay tactic for helping the poor and the hospitals who serve them.  But Sen. Charlie Scott, one of the sponsors of Senate File 86, said the measure is a compromise to Medicaid expansion, since the Legislature appears unwilling to extend the federal program to 20,000 low-income Wyoming adults under the Affordable Care Act.

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…”