Medicaid Enrollment

Medicaid rolls surge under Affordable Care Act, By Margot Sanger-Katz, December 18, 2014, New York Times: “In Idaho, the number of people who signed up for Medicaid has jumped by 13.4 percent. In Georgia, it’s up 12.9 percent. In North Carolina, the rate has climbed 12.4 percent. None of those states opted to expand their Medicaid programs as part of the Affordable Care Act, but all have seen substantial enrollment increases in state health insurance…”

Children’s Health Insurance Coverage

  • Children’s health program faces cloudy future under ACA, By Christine Vestal, December 4, 2014, Stateline: “The Children’s Health Insurance Program got a big boost under the Affordable Care Act, which called for an increase in federal funding for the program and required states to maintain 2010 enrollment levels through 2019. But in the waning days of the lame-duck Congress, it is still not clear when or whether funding for the federal-state, low-income children’s health plan known as CHIP will be authorized beyond Sept. 30, when it is set to expire…”
  • Reports: Fewer uninsured children in Florida, but challenges ahead for public program, By Daniel Chang, December 4, 2014, Miami Herald: “In Florida, as in the rest of the nation, the number of children without healthcare coverage has declined during the last five years — but the Sunshine State still has one of the country’s highest rates of uninsured children, a challenge that could be met or missed depending on policy decisions on the state and federal levels, according to a brief published this week by the Georgetown University Center for Children and Families. While the number of uninsured children aged 18 and younger in the state has decreased from about 668,000 in 2008 to 445,000 in 2013, according to the report, Florida has the highest rate in the South and fifth highest in the nation…”

Availability of Medicaid Doctors

  • Half of doctors listed as serving Medicaid patients are unavailable, investigation finds, By Robert Pear, December 8, 2014, New York Times: “Large numbers of doctors who are listed as serving Medicaid patients are not available to treat them, federal investigators said in a new report. ‘Half of providers could not offer appointments to enrollees,’ the investigators said in the report, which will be issued on Tuesday. Many of the doctors were not accepting new Medicaid patients or could not be found at their last known addresses, according to the report from the inspector general of the Department of Health and Human Services. The study raises questions about access to care for people gaining Medicaid coverage under the Affordable Care Act…”
  • Report: Many U.S. Medicaid doctors often unavailable, By Bill Toland and Kate Giammarise, December 10, 2014, Pittsburgh Post-Gazette: “A new federal report suggesting a substantial percentage of U.S. doctors who are supposed to see Medicaid patients are unable or unavailable to do so bolsters outgoing Republican Gov. Tom Corbett’s claim that Pennsylvania’s working poor could be better served with private health insurance coverage. In a report issued Tuesday, the U.S. Office of the Inspector General found that ‘slightly more than half of providers could not offer appointments to enrollees.’ Medicaid enrollees are supposed to select their doctors from a list of providers connected to each Medicaid managed care plan…”
  • Doctors face steep Medicaid cuts as fee boost ends, By Ricardo Alonso-Zaldivar (AP), December 10, 2014, ABC News: “Primary care doctors caring for low-income patients will face steep fee cuts next year as a temporary program in President Barack Obama’s health care law expires. That could squeeze access just when millions of new patients are gaining Medicaid coverage. A study Wednesday from the nonpartisan Urban Institute estimated fee reductions will average about 40 percent nationwide. But they could reach 50 percent or more for primary care doctors in California, New York, New Jersey, and Illinois – big states that have all expanded Medicaid under the health law…”

Medicaid Programs – Oregon, California

  • Oregon to use Kentucky Medicaid system, By Saerom Yoo, December 9, 2014, Statesman Journal: “The Oregon Health Authority will import Kentucky’s online Medicaid enrollment system, marking the second phase of the state’s transition in the face of last year’s Cover Oregon technology mess. OHA Medicaid Director Judy Mohr Peterson made the announcement to legislators in the Capitol on Monday, saying the Kentucky exchange system has been successful, that it has the kind of functionality Oregon needs and that the state has a similar Medicaid population to Oregon…”
  • California managed-care pilot program meets resistance, By Anna Gorman, December 6, 2014, Washington Post: “California’s initial efforts to move almost 500,000 low-income seniors and disabled people automatically into managed care has been rife with problems in its first six months, leading to widespread confusion, frustration and resistance. Many beneficiaries have received stacks of paperwork they don’t understand. Some have been mistakenly shifted to the new insurance coverage or are unaware they were enrolled. And a third of those targeted for enrollment through Nov. 1 opted out, indicating they will stick with their traditional coverage. Prompted by the Affordable Care Act, the federal government is trying to streamline services and cut costs for the 9 million Americans who are in both Medicare and Medicaid. A dozen states have received grants to launch pilot projects, and five are enrolling participants — Virginia, Ohio, Massachusetts, Illinois and California…”

Medicaid Expansion – North Carolina

NC may reverse course on Medicaid expansion, By Mark Barrett, November 16, 2014, Asheville Citizen-Times: “Whether to accept federal money to expand Medicaid is shaping up as one of the biggest questions to face lawmakers when the General Assembly opens its 2015 session in January. If Republicans reverse course, an estimated 500,000 North Carolinians stand to gain coverage under Medicaid, which pays health care costs for poor children, low-income elderly people and the disabled. But doing so also would force the GOP to implement a key component of the Affordable Care Act, President Barack Obama’s signature legislative achievement. Gov. Pat McCrory and outgoing House Speaker Thom Tillis both have said in recent weeks that it is time for the state to look again at the issue…”

Medicaid Provider Access

Shortage of Medicaid doctors? Not if you ask patients, By Austin Frakt, November 10, 2014, New York Times: “One longstanding concern about Medicaid is that too few doctors will accept it, because it tends to pay providers less generously than private plans do. This concern shows up in news articles about Medicaid, driven by evidence from doctors’ offices. But if you ask Medicaid enrollees directly, they reveal that access to primary care is comparable to that for private plans. A report from the inspector general at the Department of Health and Human Services released in late September reinforced concerns about access to care for Medicaid enrollees…”

Medicaid Expansion and the Uninsured

Report: Medicaid expansion reduces uninsured patients, By Jesse Balmert, October 23, 2014, Marion Star: “With more people insured by Medicaid, several hospitals are treating fewer uninsured patients and paying less for charity care, according to a Policy Matters Ohio report released Tuesday. That’s good news for Ohio’s poor — especially those without children — and Gov. John Kasich, who spent Monday explaining to reporters that he supported Medicaid expansion while opposing the larger law it’s attached to — the Affordable Care Act, also known as Obamacare…”

Medicaid Expansion – Mississippi

Health advocates decry lack of Miss. Medicaid expansion, By Emily Wagster Pettus, October 7, 2014, Jackson Clarion-Ledger: “Groups supporting low-income Mississippi residents said Tuesday that elected officials are ignoring 300,000 people and refusing billions of federal dollars by choosing not to expand Medicaid in one of the poorest states in the nation. If the state were to extend Medicaid, as allowed under the health overhaul that President Barack Obama signed into law, many low-wage workers could receive coverage that would enable them to afford doctors’ visits, prescriptions and medical supplies, said Roy Mitchell of the Mississippi Health Advocacy Program…”

Medicaid Expansion for Children – Texas, Florida

Texas and Florida did expand Medicaid — for kids, By Phil Galewitz, September 29, 2014, USA Today: “Republican lawmakers in Florida and Texas snubbed the Affordable Care Act’s Medicaid expansion for adults, but their states did broaden the program this year — for school-age children. Those states were among 21 — including some big Democrat-led states, such as California — that were required to widen Medicaid eligibility for children between the ages of 6 and 18 by 2014. That little-known provision of the health law was one factor helping 1.5 million kids gain coverage in the state-federal health insurance program for the poor, according to a survey of a dozen states by Kaiser Health News…”

Hospitals and Medicaid Expansion

  • Hospitals see major drop in charity care, September 24, 2014, The Tennessean: “The number of uninsured patients admitted to hospitals has dropped markedly this year, reducing charity care and bad debt cases, particularly in states that have expanded Medicaid coverage under the new federal health care law, a government report released Wednesday found. The report from the Department of Health and Human Services said hospitals in states that have taken advantage of new Medicaid eligibility levels have seen uninsured admissions fall by about 30 percent. The report estimated that the cost of uncompensated hospital care will be $5.7 billion lower in 2014…”
  • Affordable Care Act reduces costs for hospitals, report says, By Robert Pear, September 24, 2014, New York Times: “The Obama administration increased the pressure on states to expand Medicaid on Wednesday, citing new evidence that hospitals reap financial benefits and gain more paying customers when states broaden eligibility. In states that have expanded Medicaid, the White House said, hospitals are seeing substantial reductions in ‘uncompensated care’ as more patients have Medicaid coverage and fewer are uninsured…”

Health Insurance Coverage in the US

  • 42 million people lacked health insurance in 2013, Census Bureau says, By Guy Boulton, September 16, 2014, Milwaukee Journal Sentinel: “An estimated 42 million people, or 13.4% of the population, were without health insurance coverage for all of 2013, according to the U.S. Census Bureau. The percentage was much higher for adults between 19 and 64 years old, with 18.5%, or almost one in five, uninsured last year. The estimates released Tuesday by the Census Bureau will become the baseline to track changes in the number of people who gain health insurance because of the Affordable Care Act. The parts of the law that will expand insurance coverage did not kick in until this year and are not reflected in the 2013 data…”
  • Number of Americans without health insurance falls, survey shows, By Sabrina Tavernise, September 16, 2014, New York Times: “Federal researchers reported on Tuesday that the number of Americans without health insurance had declined substantially in the first quarter of this year, the first federal measure of the number of uninsured Americans since the Affordable Care Act extended coverage to millions of people in January. The number of uninsured Americans fell by about 8 percent to 41 million people in the first quarter of this year, compared with 2013, a drop that represented about 3.8 million people and that roughly matched what experts were expecting based on polling by private groups, like Gallup. The survey also measured physical health but found little evidence of change…”

Medicaid Expansion – Virginia

With Medicaid expansion blocked, McAuliffe unveils modest plan to insure more Virginians, By Laura Vozzella and Jenna Portnoy, September 8, 2014, Washington Post: “Gov. Terry McAuliffe (D), who vowed in June to defy the Republican-controlled legislature and expand healthcare to 400,000 uninsured Virginians, unveiled a much more modest plan Monday after being thwarted by federal rules and a last-minute change to state budget language. McAuliffe outlined measures to provide health insurance to as many as 25,000 Virginians, just a fraction of those he had hoped to cover by expanding Medicaid under the Affordable Care Act…”

Hospitals and Medicaid Expansion

  • Report: Hospitals in Medicaid-expansion states performing well, By Chelsea Keenan, September 8, 2014, Cedar Rapids Gazette: “Hospitals in states that expanded Medicaid are seeing higher revenues and a reduction in uninsured patients, according to a new report by PwC’s Health Research Institute. The report analyzed financial data from the country’s five largest for-profit health systems, which represent 538 hospitals in 35 states. ‘There were lots of debates in (Washington) D.C. around these issues,’ said Gary Jacobs, a managing director at PWC. ‘There were lots of promises and good intentions. But the jury was still out on how it would shape up.’ The growth in the 26 Medicaid expansion states and Washington, D.C., starkly contrasts the experience in the 24 states that did not expand the program, the report found…”
  • Hospital officials frustrated with financial losses since state did not expand Medicaid, By Shannon Muchmore, September 8, 2014, Tulsa World: “Tulsa hospital executives are frustrated at losing out on reimbursements because of what they say are purely political decisions. Hospitals in Oklahoma are projected to lose more than $4 billion in reimbursements between 2013-22 because the state chose not to expand Medicaid, according to a recent report by the Urban Institute…”

States and Medicaid Expansion

  • States that decline to expand Medicaid give up billions in aid, By Tony Pugh, September 2, 2014, The State: “If the 23 states that have rejected expanding Medicaid under the 2010 health care law continue to do so for the next eight years, they’ll pay $152 billion to extend the program in other states – while receiving nothing in return. This massive exodus of federal tax dollars from 2013 through 2022 would pay 37 percent of the cost to expand Medicaid in the 27 remaining states and Washington, D.C., over that time. Most of the money, nearly $88 billion, would come from taxpayers in just five non-expansion states: Texas, Florida, North Carolina, Georgia and Virginia. The findings are part of a McClatchy analysis of data from the Urban Institute, a nonpartisan research center that’s advised states on implementing the health care law, the Affordable Care Act…”
  • NC’s $10 billion Medicaid challenge: Pay for other states or take federal money?, By Ann Doss Helms and Tony Pugh, September 2, 2014, Charlotte News and Observer: “North Carolina taxpayers could spend more than $10 billion by 2022 to provide medical care for low-income residents of other states while getting nothing in return, a McClatchy Newspapers analysis shows. The federal health law tried to expand Medicaid to millions of low-income, uninsured adults. But many Republican-led states, including North Carolina, opted out of the plan championed by President Barack Obama…”

ACA Coverage

  • Reports: ACA coverage reached more than 9 million, By Kaitlyn Krasselt, July 15, 2014, USA Today: “Far more people are insured because of the Affordable Care Act than the White House estimated in May, new research shows. At least three new studies on the ACA’s effect show big increases in the number of newly insured Americans, with the highest estimate topping out at 9.5 million from the Commonwealth Fund. That compares with the 8 million reported by the White House in May. It’s hardly all good news for the administration’s efforts, however. Analysts from the Rand Corporation estimate that while 14.5 million people gained coverage in the last year, about 5 million people were insured before the ACA and lost coverage because of the law — leading to a net gain of around 9 million. . .”
  • Groups under Health Act are said to aid millions, By Abby Goodnough, July 15, 2014, New York Times: “More than 4,400 consumer assistance programs created under the Affordable Care Act helped an estimated 10.6 million people explore their new health insurance options and apply for coverage during the initial six-month enrollment period, according to a new Kaiser Family Foundation survey. But the programs that operated in states with their own online insurance marketplaces got more funding and helped more people than those in states on the federal exchange, the survey found. In the District of Columbia and 16 states that ran or were working toward running their own exchanges, the programs helped about twice as many people, relative to the uninsured population, as they did in 29 states served by the federal exchange. . .”

Part-Time Work

  • A part-timer boom, or blip? By Robert Samuelson, July 16, 2014, Washington Post: “There may be a dark lining to the sunny June employment report, which recorded an increase of 288,000 payroll jobs for the month. Most — or all — of the increase may have been part-time jobs. If that’s a trend, it could signal a weaker economy. It could also vindicate critics of the Affordable Care Act (the ACA or Obamacare). They have argued that the added costs of providing health insurance for full-time workers would cause many firms to emphasize part-time employment. Is it a trend? Writing in the Wall Street Journal, Mortimer Zuckerman — real estate developer and editor in chief of U.S. News & World Report — says yes. Some data seem convincing. In June, part-time jobs (defined as less than 35 hours a week) increased by 1,115,000, reports the Bureau of Labor Statistics (BLS); full-time jobs fell by 708,000. . .”
  • Yes, some people are working part-time. No, that’s not a disaster for the recovery. By Jared Bernstein, July 18, 2014, Washington Post: “By many indicators, the recent job market is clearly improving. It still has a long way to go, but the pace of employment growth is up and unemployment has fallen sharply in recent months. Importantly, the recent decline in the jobless rate has been for the right reason: people getting jobs as opposed to people leaving the labor market (since only jobseekers are counted as unemployed, if they give up the job search, the unemployment rate is artificially lowered). Still, those in the business of disparaging the ‘Obama recovery’ latched onto the spike in part-time work in the last jobs report as an indicator that the silver lining has a dark cloud around it. Based on the rise in part-time jobs in June, a Wall Street Journal opinion piece complained. . .”
  • Part-Time Workers Deserve the Shift, Not the Shaft, By Megan McArdle, July 17, 2014, Bloomberg View: “The plight of low-wage retail workers has generated much talk in recent years. As I’ve written before, I don’t find problematic the existence of jobs that do not pay enough to support a family. Retail jobs have never paid well, because retail margins tend to be pretty slim. The problem is not that retail is a low-wage job, but that an increasing number of people can’t find any other sort of job. The natural response of many people is to say, well, these are the jobs we have now, so they should pay what factory jobs used to. Yet like the manufacturing jobs that went away, many of those low-wage retail jobs also face competition — from higher-productivity firms. . .”

Medicaid Enrollment

Millions enrolling into Medicaid, now what? By Lisa Bernard-Kuhn, June 26, 2014, Cincinnati Enquirer: “In the coming days Charles McClinon will learn whether he’s a candidate for a potentially lifesaving surgery, a procedure the 50-year-old epileptic says is finally an option for him thanks to expanded Medicaid benefits in Ohio. ‘I’m so hopeful now,’ said the Roselawn resident, who four years ago suffered a serious fall during a seizure that sent him to the emergency room and then into the spiral of medical morass that eventually cost him his job, health insurance and Chicago home. ‘I had always been a very highly functional person living with epilepsy, but after the fall, my seizures had gotten so bad, I just didn’t have the strength and awareness to fight,’ said McClinon. Across the U.S., millions of Americans are tapping into newly available Medicaid benefits. Some, like McClinon, say the coverage offers the chance . . .”

ACA Sign-up Period

Study: Selling health insurance at Christmas is bad idea, By Louise Radnofsky, June 26, 2014, Wall Street Journal: “Tax preparers and some other advocates have complained for a while that the health law’s insurance sign-up period is timed wrong. Now they have a paper in the journal Health Affairs to back them up. Asking lower-income people to contemplate buying coverage around the holiday season is a bad idea, because their decision-making capacity is stretched too thin, say two health policy professors. Crafters of the Affordable Care Act originally envisaged the open enrollment period as a fall activity that would coincide with the sign-up periods for Medicare and also the time when many Americans who get coverage through their jobs have to renew their elections. . .”

Health Care Exchanges

Competition heats up on health care exchanges for 2015, By Jayne O’Donnell and Kaitlyn Krasselt, USA Today: “Insurance companies are gingerly moving onto health care exchanges in some competition-deprived states, and they are requesting rate increases that are largely in line with pre-Obamacare years, state filings show. A few big and many smaller insurers avoided the 2014 state- and federal-run health care exchanges that sold individual insurance plans as required under the new law. Some blame these insurer absences for higher rates than many people expected under the Affordable Care Act, but that’s likely to change for the 2015 plan year, experts say. ‘There’s a lot more competition now than there was prior to the advent of the ACA . . .”

Medicaid Expansion

  • In Texarkana, uninsured and on the wrong side of a state line, By Annie Lowrey, June 8, 2014, New York Times: “On a hazy, hot evening here, Janice Marks ate a dinner of turkey and stuffing at a homeless shelter filled with plastic cots before crossing a few blocks to the Arkansas side of town to start her night shift restocking the dairy cases at Walmart. The next day, David Tramel and Janice McFall had a free meal of hot dogs and doughnut holes at a Salvation Army center in Arkansas before heading back to their tent, hidden in a field by the highway in Texas. None of the three have health insurance. But had Ms. Marks, 26, chosen to sleep on the side of town where she works, or had Mr. Tramel and Ms. McFall, who are both in their early 20s, made their camp where they had eaten their dinner, their fortunes might be different. . .”
  • Long waits persist for those applying for Medicaid coverage in many states, By Phil Galewitz, June 7, 2014, Washington Post: “While an unprecedented 6 million people have gained Medicaid coverage since September, mostly as a result of the Affordable Care Act, more than 1.7 million more are still waiting for their applications to be processed — with some stuck in limbo for as long as eight months, according to officials in 15 large states. The scope of the problem varies widely. California accounts for a lion’s share of the backlog with 900,000 applications pending as of early June. The next-biggest pileup is in Illinois, with 283,000 cases, while New York has no backlog at all. All three states have implemented the health law’s expansion of Medicaid . . . “