Medicaid and Addiction Treatment

How Medicaid cuts could exacerbate the opioid epidemic, By Ronald Brownstein, July 13, 2017, The Atlantic: “When Christie Green took her job three years ago as public-health director for the Cumberland Valley District in southeastern Kentucky, she had nearly two decades of experience in the state’s public-health system. But Green still wasn’t prepared for what she saw when her predecessor took her around this hardscrabble swathe of Appalachia centered on Clay County, which The New York Times once described as the hardest place in the United States to live. ‘In the first week,’ Green recently told me, ‘I met more people who were raising their grandchildren than I had in my entire career before that…’”

Medicaid and Addiction Treatment

Medicaid expansion has delivered access to addiction treatment, report finds, By Sarah Fentem, July 7, 2017, National Public Radio: “This week, as senators have decamped from Washington for the Fourth of July recess, the future of the Senate’s Affordable Care Act replacement plan — and by extension, Medicaid — remains uncertain. Just days before the recess, a report from the Urban Institute, a public policy think tank, detailed big increases in Medicaid spending on opioid addiction treatment under the Affordable Care Act. It’s a trend that could be reversed if the Senate’s plan passes…”

Health Insurance Coverage in the US

  • Charity care dips at Wisconsin hospitals, with more people insured; trend could end with Obamacare repeal, By David Wahlberg, June 11, 2017, Wisconsin State Journal: “Hospitals in Madison and throughout Wisconsin have provided less charity care in recent years as more people have gained insurance through the Affordable Care Act, with some hospitals directing the savings to disease prevention. That could change if Congress overturns the law, known as Obamacare, and increases the ranks of the uninsured. And if Medicare payment cuts that helped pay for the law’s expanded coverage also remain, hospitals could end up shifting more costs to people with private insurance, officials say…”
  • What the Obamacare overhaul could mean for Texas’ terrible maternal mortality rate, By Katie Leslie, June 12, 2017, Dallas Morning News: “Texas officials were already investigating why an alarming number of Lone Star women are dying from pregnancy-related complications when a study last year ranked the state’s maternal mortality rate as the nation’s worst. That’s why many doctors and health care advocates are watching Republican-led negotiations in Washington over replacing the Affordable Care Act, with some worried about what the changes could mean for Texas’ maternal health crisis…”
  • Nevada may become first state to offer Medicaid to all, regardless of income, By Alison Kodjak, June 13, 2017, National Public Radio: “Nevadans will find out this week whether their state will become the first in the country to allow anyone to buy into Medicaid, the government health care program for the poor and disabled…”
  • In Texas, people with erratic incomes risk being cut off from Medicaid, By Shefali Luthra, June 14, 2017, Iowa Public Radio: “Worries about whether her children can still get the health care they need are never far from Dawn Poole’s mind. It’s a constant, underlying concern. Much of her anxiety is a direct result of living in Texas. To qualify for Medicaid in the state, most children must come from families with incomes at or below 138 percent of the federal poverty level. In 2017, that’s $33,948 for a family of four. Texas also has one of the country’s strictest Medicaid verification systems: It runs regular checks on family finances after children are enrolled to make sure they continue to qualify…”

States and Medicaid Expansion

3-state study sizes up gains via Medicaid; coverage soars in Arkansas, Kentucky, less so in Texas, By Andy Davis, May 23, 2017, Arkansas Democrat-Gazette: “Three years after their states expanded Medicaid, low-income people in Arkansas and Kentucky continued to be more likely to have a doctor and less likely to have trouble paying medical bills or to delay seeking care because of the cost, a study has found. The study, conducted annually since 2013 by researchers with the Harvard School of Public Health and Brigham and Women’s Hospital in Boston, found those and other improvements in Arkansas and Kentucky continued to be significant compared with smaller or nonexistent gains in Texas, which did not expand Medicaid…”

States and Medicaid Coverage

  • Medicaid is helping poor patients get needed care, even as Republicans push to cut it, study finds, By Noam N. Levey, May 17, 2017, Los Angeles Times: “As the Trump administration and congressional Republicans push for sweeping cuts to the Medicaid safety net, a study released Wednesday provides new evidence the program is significantly improving poor Americans’ access to vital medical care. Low-income patients in Arkansas and Kentucky, two states that expanded Medicaid under the Affordable Care Act, are getting check-ups more regularly and delaying care because of cost less frequently…”
  • Nebraska’s new Medicaid managed care system blamed for problems with billing and getting approval for care, By Martha Stoddard, May 15, 2017, Omaha World-Herald: “Nebraska’s new system for administering the bulk of its Medicaid program has gotten off to a rocky start. Nearly five months after its launch, the system has left behavioral health and home health providers fuming over unpaid claims and frustrated about getting care authorized for patients…”
  • Medicaid spending caps in Republican proposal would cut coverage for Florida children, By Daniel Chang, May 18, 2017, Miami Herald: “Low-income children in Florida gained Medicaid coverage under the Affordable Care Act despite the state’s refusal to expand eligibility for the public health insurance program, according to a study published Wednesday by the non-partisan Urban Institute, a health policy think tank. But those gains may end if the American Health Care Act — the Republican-sponsored bill to repeal and replace the health law known as Obamacare — creates spending caps for Medicaid, according to the consulting firm Avalere Health in a separate report this week…”
  • Big health gains in Medicaid expansion states elude Texas’ poor, By Jenny Deam, May 18, 2017, Houston Chronicle: “The health of Texas’ poor is worse – at times significantly so – than those who live in two Southern states that expanded Medicaid under the Affordable Care Act. A report Wednesday in Health Affairs, a health policy journal, examined four years of medical outcomes in Texas, Arkansas and Kentucky and found that health measurements in the latter two states, both of which expanded Medicaid, dramatically improved in nearly all categories…”

Health Insurance Coverage in the US

Progress reducing U.S. uninsured rate comes to a halt, By Ricardo Alonso-Zaldivar (AP), May 16, 2017, Seattle Times: “Five years of progress reducing the number of Americans without health insurance has come to a halt, according to a government report out Tuesday. More than a factoid, it shows the stakes in the Republican drive to roll back the Affordable Care Act. The report from the Centers for Disease Control and Prevention estimates that 28.6 million people were uninsured in 2016, unchanged from 2015. It was the first year since passage of the health care overhaul in 2010 that the number of uninsured did not budge…”

Health Insurance Coverage in the US

  • Uninsured rate for poor, childless adults declines, By Michael Ollove, April 10, 2017, Stateline: “As the Trump administration and Republicans in Congress explore ways of repealing and replacing the Affordable Care Act, a new study shows how beneficial the law has been to poor adults who don’t have children.  The study by the Urban Institute found that between 2013 and 2015, the rate of poor, childless adults without health insurance fell by 47.1 percent…”
  • Maps show a dramatic rise in health insurance coverage under ACA, By Alyson Hurt, Juan Elosua and Rebecca Hersher, National Public Radio: “New data from the U.S. Census Bureau presents the most detailed picture yet of the dramatic rise in the number of people covered by health insurance since the Affordable Care Act went into effect. County-level data going back to 2010, when the law was signed, shows a patchwork of people living without health insurance that ticked down slowly for the first three years under the ACA. But, once the online insurance exchanges opened at the end of 2013 and Medicaid expanded, the population living without coverage dropped noticeably…”

Medicaid Expansion – Louisiana

Poll: Louisiana residents largely support Medicaid expansion but find ‘Obamacare’ unfavorable, By Elizabeth Crisp, April 11, 2017, Baton Rouge Advocate: “Nearly three-fourths of Louisiana residents approve of the state’s decision to expand Medicaid, a new poll suggests, even as President Donald Trump, who remains widely popular in the state, continues his quest to repeal the federal Affordable Care Act that made expansion possible.  The 2017 Louisiana Survey’s findings on health care suggest a disconnect in the relationship between Medicaid health care coverage and the ACA…”

States and Medicaid Expansion

  • In health bill’s defeat, Medicaid comes of age, By Kate Zernike, Abby Goodnough and Pam Belluck, March 27, 2017, New York Times: “When it was created more than a half century ago, Medicaid almost escaped notice. Front-page stories hailed the bigger, more controversial part of the law that President Lyndon B. Johnson signed that July day in 1965 — health insurance for elderly people, or Medicare, which the American Medical Association had bitterly denounced as socialized medicine. The New York Times did not even mention Medicaid, conceived as a small program to cover poor people’s medical bills. But over the past five decades, Medicaid has surpassed Medicare in the number of Americans it covers. It has grown gradually into a behemoth that provides for the medical needs of one in five Americans — 74 million people — starting for many in the womb, and for others, ending only when they go to their graves…”
  • Medicaid expansion becomes trendy with death of GOP health bill, By Maggie Fox, March 31, 2017, NBC News: “All of a sudden, Medicaid is trendy again. The governor of Kansas vetoed a bill on Thursday that would have expanded Medicaid in his state. But the legislature is reserving the option of trying to override the veto and Virginia and North Carolina are moving toward expansion. Several other states are considering it.  It’s a fast turnaround made by states that had resolutely resisted taking part on a major plank of the 2010 Affordable Care Act — the expansion of Medicaid to cover more people…”
  • The states where Obamacare’s footprint might get even bigger, By Russell Berman, March 29, 2017, The Atlantic: “Now that the Affordable Care Act has survived its most serious threat in Congress, the law’s footprint across the country might grow even larger in the months ahead. Several states that initially opted out of Obamacare’s Medicaid expansion are now reconsidering their decision as a result of last year’s elections and as Republicans come under new pressure to accept the billions in federal dollars available under the law. The most aggressive push is coming in deep-red Kansas, where the Republican-controlled Senate on Tuesday sent Governor Sam Brownback legislation that could expand the state’s version of Medicaid to as many as 150,000 new enrollees…”
  • Brownback vetoes Medicaid expansion; House pauses override debate, By Jonathan Shorman, March 30, 2017, Wichita Eagle: “The fate of Medicaid expansion in Kansas remains undecided – at least until Monday – as supporters of expansion scramble to find votes to override Gov. Sam Brownback’s veto. Brownback vetoed the proposal Thursday morning, one day after receiving it. ‘The cost of expanding Medicaid under ObamaCare is irresponsible and unsustainable,’ he said in his veto message…”
  • Arkansas lawmakers send Medicaid expansion to governor, By John Lyon, March 31, 2017, Times Record: “The House on Thursday approved and sent to the governor’s desk a bill that will fund Arkansas’ Medicaid expansion program for another year. House members voted 77-13 to approve Senate Bill 196 by the Joint Budget Committee, a bill to appropriate $8.3 billion in federal and state Medicaid money for traditional Medicaid and the Medicaid expansion program…”
  • Georgia to explore Medicaid changes after GOP health plan’s implosion, By Greg Bluestein, March 27, 2017, Atlanta Journal-Constitution: “Gov. Nathan Deal said Monday his administration is exploring changes to Georgia’s Medicaid program after a sweeping Republican overhaul of the Affordable Care Act was scuttled in a stunning rebuke to Donald Trump and Congressional leaders. The Republican governor said there are limits to what the state can request ‘as long as mandates under the basic Obamacare legislation stand in place.’ But he said the state would review healthcare options that could include changes to ‘mandated minimum coverage’ provisions that require the state Medicaid program to cover a range of health services to recipients…”

States and Medicaid Expansion

  • Study: Medicaid expansion made it easier to get a doctor’s appointment, By Michelle Andrews, March 6, 2017, Governing: “More than 14 million adults have enrolled in Medicaid since the health law passed, and that has caused some hand-wringing over whether there would be enough primary care providers to meet the demand. But a study out this week suggests that the newly insured people are generally able to get timely appointments for primary care…”
  • Stakes high in Illinois as Congress rethinks Medicaid, By Lisa Schencker, March 3, 2017, Chicago Tribune: “Soccer coach Lesly Durand noticed last fall that he was running out of breath more easily on the field, and getting unusually tired carrying bags of equipment.  The 61-year-old Evanston man didn’t know why, so he called his doctor. That call led to tests, which led to the discovery of five blocked arteries and then, ultimately, bypass surgery.  ‘The doctors said, ‘I can’t believe you’re still alive,”said Durand, who gained insurance a couple of years ago under the Affordable Care Act’s expansion of Medicaid…”
  • U.S. House ACA reform may turn up heat on N.C. Medicaid expansion, By Richard Craver, March 8, 2017, Winston-Salem Journal: “North Carolina Republican legislative leaders may have more incentive — but likely no new motivation — to expand the state’s Medicaid program as part of a proposal in the U.S. House for repealing and replacing the federal Affordable Care Act…”

States and Medicaid Coverage

  • The adults a Medicaid work requirement would leave behind, By Abby Goodnough, February 25, 2017, New York Times: “On a frigid morning here, Nancy Godinez was piling bread and other staples into her car outside a food pantry. She had lost her job as a custodian, her unemployment checks had run out, and her job search had proved fruitless.  One thing she still had was health insurance, acquired three years ago after Arkansas’ Republican-controlled legislature agreed to expand Medicaid under the Affordable Care Act. The coverage, she said, has allowed her to get regular checkups and treatment for tendinitis in her foot.  But unless she finds a new job, Ms. Godinez, 55, could be at risk of losing her insurance, too…”
  • Obamacare 101: What’s going to happen to 70 million Americans who rely on Medicaid?, By Noam N. Levey, March 2, 2017, Los Angeles Times: “It’s the program that everyone confuses with Medicare.  But Medicaid, the half-century-old government health plan for the poor, is actually bigger than its more famous cousin, covering some 70 million Americans at any one time.  Expanding Medicaid was a central pillar of the Affordable Care Act, helping to bring health coverage to more than 20 million previously uninsured people…”
  • Who are the 700,000 Ohioans receiving health insurance under Medicaid expansion?, By Rich Exner, Cleveland Plain Dealer: “Who are the 700,000 Ohioans who have received health insurance under Medicaid expansion? And has the insurance really made a difference?  A state report conducted for the Ohio General Assembly provides a snapshot, based on questioning of new Medicaid recipients added as a result of Obamacare…”
  • Texas brings ‘disadvantages’ to debate of federal Medicaid spending caps, study warns, By Robert T. Garrett, February 28, 2017, Dallas Morning News: “For years, Texas GOP leaders have said they’d gladly give up open-ended flows of federal Medicaid money for a set ‘block grant’ that lets them run the health insurance program for the poor the way they want.  They may get their wish.  As part of repealing and replacing Obamacare, U.S. House Speaker Paul Ryan and Republican House leaders such as Rep. Kevin Brady of The Woodlands have proposed that states choose between Medicaid block grants and per capita caps. President Donald Trump and Senate Republican leaders have called for similar changes…”

Medicaid Expansion – Maine

Mainers to vote on whether to expand access to Medicaid under ACA, By Scott Thistle, February 21, 2017, Portland Press Herald: “Maine Secretary of State Matthew Dunlap confirmed Tuesday that a campaign asking voters to approve an expansion of the state’s Medicaid system under the federal Affordable Care Act has submitted enough valid signatures to place the question on the November ballot…”

Health Insurance Coverage

  • Major hospitals pull out of Alabama Medicaid reform, call for delay, By Amy Yurkanin, February 14, 2017, Birmingham News: “An overhaul of the state’s Medicaid program that has already been postponed a year could face more delays after the departure of several health care systems over concerns about the program’s direction and costs.  State leaders have been working since 2012 to transform the Medicaid program from a system that pays for unlimited services to managed care that caps costs at a certain amount per patient to control spending. Last year, federal authorities approved a plan for managed care for Medicaid, which provides health coverage to about a million low-income Alabamians. Regional care organizations in five regions are a key part of the reform effort…”
  • As GOP plows forward on Obamacare repeal, new data show the nation’s uninsured rate hit a record low last year, By Noam N. Levey, February 14, 2017, Los Angeles Times: “The nation’s uninsured rate tumbled further last year, hitting the lowest rate on record, according to new government data that underscored what is at stake in the Republican effort to repeal the Affordable Care Act.  In the first nine months of 2016, just 8.8% of Americans lacked health coverage, survey data from the federal Centers for Disease Control and Prevention show…”
  • Republican health care proposal would cover fewer low-income families, By Alison Kodjak, February 16, 2017, National Public Radio: “House Republicans are debating a plan to replace the Affordable Care Act that would give consumers tax credits to buy insurance, cut back on Medicaid and allow people to save their own money to pay for health care costs.  The outline plan is likely to take away some of the financial help low-income families get through Obamacare subsidies, and also result in fewer people being covered under the Medicaid health care program for the poor…”

Medicaid Expansion – Utah, Louisiana

  • State officials send feds Medicaid expansion plan for low-income parents, By Alex Stuckey, February 3, 2107, Salt Lake Tribune: “As Utah officials continue to wait for federal approval of their small-scale Medicaid expansion plan, they hope to expand coverage to some parents.  Tom Hudachko, state Department of Health spokesman, said Friday that the federal Centers for Medicare and Medicaid Services (CMS) ‘verbally indicated’ to state officials late last year that it would approve that part of the expansion, covering low-income parents with dependent children…”
  • Louisiana’s uninsured rate falls to 12.5 percent; leaders cite Medicaid expansion, By Elizabeth Crisp, February 8, 2017, Baton Rouge Advocate: “Louisiana is one of 10 states that have seen the steepest decreases in the rate of uninsured residents over the past four years, according to survey findings released Wednesday. The 2016 Gallup-Healthways Well-Being Index found that Louisiana’s uninsured rate fell to 12.5 percent last year — down from 21.7 percent in 2013.  The survey’s researchers note that all 10 states that saw their uninsured rates drop have expanded Medicaid through the federal Affordable Care Act…”

State Medicaid Programs

  • Indiana looks to extend Medicaid experiment started under Obamacare, By Phil Galewitz, February 1, 2017, National Public Radio: “As Congress weighs repeal of the Affordable Care Act, the home state of Vice President Mike Pence Tuesday sought to keep its conservative-style Medicaid expansion under the federal health the health law.  Indiana applied to the Trump administration to extend a regulatory waiver and funding until Jan. 31, 2021, for its package of incentives and penalties that are intended to encourage low-income Hoosiers on Medicaid to adopt healthful behaviors. Beneficiaries pay premiums, get health savings accounts and can lose their benefits if they miss payments…”
  • Kasich keeps Medicaid expansion in state budget proposal, By Catherine Candisky, January 31, 2017, Columbus Dispatch: “Amid uncertainty about the expected repeal of the Affordable Care Act, Gov. John Kasich’s final two-year budget proposal maintains Medicaid health coverage for 3 million poor and disabled Ohioans, including the 700,000 childless adults added to the rolls under Obamacare.  To curb costs, Kasich’s plan for Ohio’s tax-funded health insurance program would save hundreds of millions by cutting payments to hospitals and nursing homes, charging premiums to some beneficiaries, and moving nursing home residents and others into private managed-care plans…”
  • Arizona plan to tighten Medicaid eligibility likely to stand better chance under Trump’s watch, By Ken Alltucker, February 1, 2017, Arizona Republic: “State officials again will seek to tighten Medicaid eligibility with new restrictions that could affect tens of thousand of adults enrolled in the government insurance program for low-income Arizonans.  The state’s Medicaid agency is preparing to seek federal permission to require ‘able-bodied’ Medicaid recipients to either be employed or searching for a job while enrolled. The state also proposes to cap lifetime eligibility for Medicaid at five years…”

State Medicaid Programs

  • Obamacare, Medicaid-expansion recipients in Ohio fear repeal, By Catherine Candisky, Alan Johnson and JoAnne Viviano, January 22, 2017, Columbus Dispatch: “Breast-cancer survivor Susan Halpern said she is terrified about losing her health-care coverage if the Trump administration follows through with its promise to repeal the Affordable Care Act.  Bankruptcy could be on the horizon, the Columbus woman said.  ‘I’m trying to figure out a way to survive and keep some kind of health insurance,’ said Halpern, 57, who owns a small social-media business.  Nearly 1 million Ohioans, and 20 million nationwide, are covered under the law’s expansion of Medicaid coverage and creation of an insurance exchange marketplace that offers federal subsidies to help many Americans pay premiums…”
  • Republican states look to customize Medicaid expansion, not eliminate it, By Christine Vestal, January 23, 2017, Stateline: “As candidates two years ago, the Republican governors of Kentucky and Arkansas swore they would do away with ‘Obamacare’ if elected. But a funny thing happened between the campaign trail and the governor’s mansion: Reality set in.  After promising to uproot Kentucky’s Medicaid expansion under the Affordable Care Act, Republican Gov. Matt Bevin simply renamed his Democratic predecessor’s health care plan for low-income adults and proposed changes designed to help people find jobs and get off the rolls…”

State Medicaid Programs

  • Criticizing Kansas, feds deny extension of KanCare privatized Medicaid program, By Bryan Lowry and Hunter Woodall, January 19, 2017, Kansas City Star: “Federal officials have rejected Kansas’ request to extend its privatized Medicaid program, KanCare, saying it has failed to meet federal standards and risked the health and safety of enrollees. Kansas is ‘substantively out of compliance with Federal statutes and regulations, as well as its Medicaid State Plan’ based on a review by federal investigators in October, according to a letter sent to the state Jan. 13 from the Centers for Medicare and Medicaid Services…”
  • GOP governors who turned down Medicaid money have hands out, By Thomas Beaumont (AP), January 19, 2017, Seattle Times: “Republican governors who turned down billions in federal dollars from an expansion of Medicaid under President Barack Obama’s health care law now have their hands out in hopes the GOP-controlled Congress comes up with a new formula to provide insurance for low-income Americans.  The other GOP governors, such as Ohio Gov. John Kasich, who agreed to expand state-run services in exchange for federal help — more than a dozen out of the 31 states — are adamant that Congress maintain the financing that has allowed them to add millions of low-income people to the health insurance rolls…”

Health Insurance Coverage

Poor, chronically sick, unemployed most likely to lose coverage if ACA repealed, study finds, By Gillian Mohney and Dr. Darien Sutton-Ramsey, January 20, 2017, ABC News: “With Republican lawmakers promising to repeal and replace the Affordable Care Act under the new administration, researchers have been working to understand how people who gained coverage after the ACA’s passage will be affected.  Those most at risk for losing coverage are more likely to be poor, have a chronic illness or be unemployed, according to a study published today in the Journal of the American Medical Association…”

Medicaid Expansion – Michigan

  • Snyder fights for Medicaid plan in Obamacare repeal, By Jonathan Oosting, January 4, 2017, Detroit News: “Gov. Rick Snyder wants Republican President-elect Donald Trump and the GOP-led Congress to spare Michigan’s unique form of Medicaid expansion as they consider dismantling the Affordable Care Act, calling it a ‘successful’ program that could serve as a national model.  Trump has repeatedly vowed to repeal and replace ‘Obamacare’ but has not made clear whether he wants to pull back state funding for expanded Medicaid eligibility. It is a key but costly provision of the 2010 law that has allowed millions of low-income residents to qualify for government-paid health care coverage…”
  • U-M study shows benefits of Michigan expanding Medicaid, By Kathleen Gray, January 4, 2017, Detroit Free Press: “Even though the state’s bills for the expansion of Medicaid to more than 640,000 low-income Michiganders is growing from $152 million this year to $399 million in 2021, the economic benefit of providing the health care will more than make up for the cost to the state, according to a study released Wednesday by the University of Michigan…”

States and Medicaid Expansion

  • State alternatives to Obamacare, expanded Medicaid to get tested, By Jayne O’Donnell, December 22, 2016, USA Today: “Blocked sweat glands turn into searingly painful growths that send Brittany Young rushing back to the emergency room at Upson Regional Medical Center here.  Young also has the chronic intestinal disease Crohn’s to contend with. Without a job or health insurance, the single mother can’t get the ongoing treatment needed to keep her Crohn’s from progressing. She’s visited the ER six times since losing her Medicaid coverage after her baby was born in June.  Young says she has no money, so she pays nothing.  ‘I guess someone ran the numbers and figured out it saves money to do it this way,’ says Anthony Marchetti, an Upson emergency physician who has treated Young…”
  • Montana may be model for future Medicaid work requirement, By Eric Whitney, December 23, 2016, National Public Radio: “Montana State Senator Ed Buttrey is a no-nonsense businessman from the central part of the state. Like a lot of Republicans, he’s not a fan of the Affordable Care Act and its expansion of Medicaid, health insurance for the poor and disabled…”