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…”

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…”