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Poor, chronically sick, unemployed most likely to lose coverage if ACA repealed, study finds, By Gillian Mohney and Dr.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…”

Medicaid Expansion – Indiana

Indiana’s Medicaid experiment may reveal Obamacare’s future, By Alana Semuels, December 21, 2016, The Atlantic: “Nearly 20 governors turned away the federal funding to expand Medicaid offered under the Affordable Care Act. Their states’ opposition to Obamacare meant that tens of thousands of low-income people in their states continued to live without health insurance.  But Mike Pence, governor of Indiana, was not one of them. After two years of negotiation, Pence in January 2015 reached an agreement with the Obama administration granting Indiana a waiver to try its own form of Medicaid expansion, called Healthy Indiana Plan (HIP) 2.0. The state would become one of the 31 that participated in the Medicaid expansion, receiving federal money through the Affordable Care Act to cover people between 100 percent and 138 percent of the federal poverty line. (Medicaid already covered a limited number of people living below the poverty line.) But it could also add its own modifications, the most salient being that participants would be required to contribute monthly fees to continue to receive access to health care…”

Medicaid Coverage for Ex-Inmates

Signed out of prison but not signed up for health insurance, December 5, 2016, National Public Radio: “Before he went to prison, Ernest killed his 2-year-old daughter in the grip of a psychotic delusion. When the Indiana Department of Correction released him in 2015, he was terrified something awful might happen again.  He had to see a doctor. He had only a month’s worth of pills to control his delusions and mania. He was desperate for insurance coverage.  But the state failed to enroll him in Medicaid, although under the Affordable Care Act Indiana had expanded the health insurance program to include most ex-inmates. Left to navigate an unwieldy bureaucracy on his own, he came within days of running out of the pills that ground him in reality…”

Rural Health Care – Nevada, Kentucky

  • Health-care ‘have-nots’: Nevada’s rural residents face fraying safety net, By Pashtana Usufzy, November 19, 2016, Las Vegas Review-Journal: “Tears well up in the eyes of lifelong Tonopah resident Acacia Hathaway as she talks about last year’s closure of Nye Regional Medical Center, the only hospital within 100 miles of her home.  ‘It was … like the end of the world here,’ says the 24-year-old mother of three, including a daughter who suffers from Goltz syndrome, a rare illness that requires frequent care from medical specialists.  Now, instead of visiting the local hospital when 4-year-old Ella suffers one of her seemingly inevitable infections, Hathaway or her husband, Justin, drive to Las Vegas – three hours each way. That’s in addition to twice-monthly trips for regular appointments with her doctors — all eight of them…”
  • In depressed rural Kentucky, worries mount over Medicaid cutbacks, By Phi Galewitz, November 19, 2016, National Public Radio: “For Freida Lockaby, an unemployed 56-year-old woman who lives with her dog in an aging mobile home in Manchester, Ky., one of America’s poorest places, the Affordable Care Act was life altering.  The law allowed Kentucky to expand Medicaid in 2014 and made Lockaby – along with 440,000 other low-income state residents – newly eligible for free health care under the state-federal insurance program. Enrollment gave Lockaby her first insurance in 11 years…”

State Medicaid Programs

  • New Mexico seeks copays from Medicaid patients, By Morgan Lee (AP), October 26, 2016, News Tribune: “New Mexico is pursuing federal authority to charge medical co-payments and some other costs to patients enrolled in Medicaid health care for the poor and disabled, the state Human Services Department secretary told lawmakers on Wednesday.  Secretary Brent Earnest said ‘nominal’ co-payments and other charges would provide a small economic incentive to steer patients away from wasteful expenses, such as the use of emergency room services for routine care…”
  • Medicaid expansion credited for getting record number of kids insurance in Ohio, By Catherine Candisky, October 27, 2016, Columbus Dispatch: “More than 95 percent of Ohio children have health coverage as the uninsured rate fell to historic lows in the wake of Obamacare.  A new report from the Georgetown University Center for Children and Families credits Medicaid expansion under the Affordable Care Act for the decline in uninsured children…”
  • In Maryland, diabetics cost Medicaid twice as much, study finds, By Andrea K. McDaniels and Meredith Cohn, October 27, 2016, Baltimore Sun: “People with diabetes cost the state’s Medicaid program twice as much as those without the chronic condition, a study commissioned by the society that represents Maryland’s doctors has found…”

Medicaid Coverage

As Medicaid loses stigma, election may cloud its future, By Ricardo Alonso-Zaldivar (AP), October 24, 2016, Philadelphia Inquirer: “Medicaid, often stigmatized among government health care programs, is finally coming into its own.  The federal-state program for low-income people has been scarcely debated in the turbulent presidential election, but it faces real consequences depending on who wins the White House in the Nov. 8 vote.  Under President Barack Obama, Medicaid has expanded to cover more than 70 million people and shed much of the social disapproval from its earlier years as a welfare program. Two big industries – insurers and hospitals – have a declared stake in the future of the program, which costs more than $530 billion a year. Insurers are leading a new ‘Modern Medicaid Alliance’ to educate lawmakers about how the program has moved closer to private coverage…”

Health Insurance Coverage

  • Obamacare led to similar drops in uninsured rate across all income groups, By Dan Mangan, September 29, 2016, CNBC: “A new report on the effects of health insurance expansion under Obamacare found that every income group ‘experienced significant and similar drops’ in the rate of uninsured people.  ‘The uninsured rate fell by around 40 percent for Americans in all income groups for 2010 through 2015, including individuals with incomes above 400 percent of the federal poverty level,’ the U.S. Health and Human Services Department said Thursday…”
  • 600,000 Veterans may go without health insurance next year: Report, By Maggie Fox, September 29, 2016, NBC News: “More than 600,000 veterans will go without health insurance next year unless 19 states stop holding out against expanding Medicaid, researchers said Wednesday.  Even with Medicaid expansion, hundreds of thousands of vets are going to go without a way to pay for medical care, the report from the left-leaning Urban Institute finds.  But 327,000 of those who will go without health insurance live in the 19 states — all with Republican governors — that have not expanded Medicaid, the researchers said…”

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…”