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…”

Medicaid Patients and Access to Care

N.J. doctors least willing to accept Medicaid patients under Obamacare, By Susan K. Livio, March 31, 2015, Star-Ledger: “The Affordable Care Act has provided a path for 420,500 low-income New Jersey residents to gain insurance through the Medicaid program, but a new study says the state ranks last in the nation in doctors willing to treat them.  Just 38.7 percent of New Jersey physicians said they accepted new Medicaid patients in 2013 — far below the national average of nearly 69 percent, according to the most recent data available from the U.S. Centers for Disease Control and Prevention. New Jersey is the only state where fewer than half of the doctors accepted new Medicaid patients. California, at 54.2 percent is second-lowest in the nation…”

Medicaid Expansion and Diabetes Diagnosis

  • With expansion of Medicaid, some states are identifying more new diabetes cases, By Sabrina Tavernise, March 23, 2015, New York Times: “The number of new diabetes cases identified among poor Americans has surged in states that have embraced the Affordable Care Act, but not in those that have not, a new study has found, suggesting that the health care law may be helping thousands of people get earlier treatment for one of this country’s costliest medical conditions.  One in 10 Americans have diabetes, and nearly a third of cases have not been diagnosed. The disease takes a toll if it is caught too late, eventually causing heart attacks, blindness, kidney failure and leg and foot amputations. The Centers for Disease Control and Prevention estimates that the disease accounts for $176 billion in medical costs annually. The poor and minorities are disproportionately affected…”
  • Diabetes study shows benefits of expanded Medicaid under Obamacare, By Noam N. Levey, March 23, 2015, Los Angeles Times: “Low-income patients with diabetes are getting better access to medical care in states that have expanded Medicaid coverage through the Affordable Care Act, suggests a new study that provides one of the first indications of the sweeping law’s health effects.  Residents of other states are at risk of being left behind.  The number of Medicaid patients with newly identified diabetes surged 23% in states that expanded their programs, an option provided by the law, but there was virtually no increase in states that declined to expand coverage, researchers found…”

Medicaid Expansion – Ohio

Ohioans new to Medicaid get care, By Catherine Candisky, March 6, 2015, Columbus Dispatch: “Divorced with four children, Pam Harris had no health insurance — choosing between medications to treat her depression and rheumatoid arthritis or paying utility bills — when she suffered her first stroke two years ago.  After leaving the hospital, the 40-year-old, who lives in Jamestown in Greene County, couldn’t afford follow-up care or physical therapy. Church friends showed her exercises she could do at home.  And after she returned to work with an advocacy group for families with children with behavioral issues, colleagues accompanied her to presentations, stepping in when she couldn’t find the words.   Last fall, Harris suffered a second stroke, but her recovery has been much better. This time, she had health insurance as one of the nearly half-million poor adults who became eligible through Ohio’s expansion of tax-funded Medicaid last year…”

Medicaid Expansion and Safety-Net Hospitals

Economy boosts safety-net hospitals in states not expanding Medicaid, By Phil Galewitz, March 1, 2015, Washington Post: “Hospitals that treat many poor and uninsured patients were expected to face tough financial times in states that did not expand Medicaid under the Affordable Care Act.  That’s because they would get less Medicare and Medicaid funding under the health-care law, while still having to provide high levels of charity care.  But in some of the largest states that did not expand Medicaid, many ‘safety net’ hospitals fared pretty well last year — better than in 2013 in many cases, according to their financial documents…”

Health Insurance Coverage

  • Health law drives down U.S. rate of uninsured adults, survey finds, By Noam N. Levey, February 24, 2015, Los Angeles Times: “America’s uninsured rate plummeted last year, with the improvement driven by states that have fully implemented the Affordable Care Act, a new nationwide Gallup survey indicates.  Led by Arkansas and Kentucky, which both had double-digit declines, seven states saw the percentage of adults without insurance fall by more than 5 percentage points between 2013 and 2014…”
  • Survey: Uninsured rate hit new low in 2014, By Ricardo Alonso-Zaldivar (AP), February 24, 2015, ABC News: “Even as it faces another Supreme Court challenge, President Barack Obama’s health care law has steadily reduced the number of uninsured Americans, according to an extensive survey released Tuesday.  The Gallup-Healthways Well-Being Index found that the share of adults without health insurance dropped to its lowest level in seven years in 2014 as Obama’s overhaul took full effect.  The trend appears likely to continue, since 55 percent of those who remained uninsured told the pollster they plan to get coverage rather than face rising tax penalties…”
  • The stark North-South divide in health insurance, By Aimee Picchi, February 24, 2015, CBS News: “When it comes to health care coverage, America is becoming a land of geographically based haves and have-nots.  States with the lowest uninsured rates are clustered in the Northeast and upper Midwest, while those with the highest rates of uninsured Americans are mostly inSouthern states such as Georgia and Louisiana, according to a new study from Gallup. One reason is that many Southern states opted out of expanding Medicaid coverage under Obamacare…”
  • Medicaid enrollment surges across the U.S., By Kimberly Leonard, February 24, 2015, US News and World Report: “Much of the focus of the health care law in recent months has centered on whether the government could get millions of people to sign up for private health insurance through federal or state exchanges. But the Affordable Care Act also expands health insurance for Americans with the lowest incomes – by giving them greater access to public coverage through Medicaid and the Children’s Health Insurance Program…”
  • Congress is told ruling against health law would impact poor, By Robert Pear, February 24, 2015, New York Times: “The Obama administration told Congress on Tuesday that it had no plans to help low- and moderate-income people if theSupreme Court ruled against the administration and cut off health insurance subsidies for millions of Americans.  Sylvia Mathews Burwell, the secretary of health and human services, said a court decision against the administration would do “massive damage” that could not be undone by executive action.

Medicaid Expansion – Kentucky

Study: Ky Medicaid expansion showing benefits, By Chris Kenning, February 13, 2015, Louisville Courier-Journal: “One year after it was enacted, Kentucky’s Medicaid expansion is benefiting patients and health care providers — and is expected to generate jobs and economic growth that will more than offset $1.1 billion in state costs through 2021, according to a state study released Thursday. The expansion, which enrolled 375,000 people in the health care program for the poor and disabled last year, is now projected to create 40,000 jobs and add $30 billion to the economy in the next six years — more than initially predicted…”

States and Medicaid Expansion

Complicated politics of Medicaid expansion are playing out state by state, By Abby Goodnough, February 10, 2015, New York Times: “In Pennsylvania, Gov. Tom Wolf, a newly elected Democrat, is scrapping his Republican predecessor’s conservative approach to expanding Medicaid under the Affordable Care Act. Mr. Wolf said this week that he would instead pursue a straightforward expansion of the government health insurance program for the poor, no longer charging premiums or limiting benefits for some enrollees. In Tennessee and Wyoming, however, bills to extend Medicaid to far more low-income residents under the law were quashed by Republican legislators last week, despite having the support of the states’ Republican governors. Opponents in both states said that, among other things, they did not believe the federal government would keep its promise of paying at least 90 percent of the cost of expanding the program. It currently pays the full cost, but the law reduces the federal share to 90 percent — a permanent obligation, it says — by 2020…”

State Medicaid Programs

  • Some Iowans will face premiums for Medicaid expansion, By Catherine Lucey, February 1, 2015, Des Moines Register: “As Iowa’s modified Medicaid expansion hits the one-year anniversary mark, some enrollees will be asked to pay small monthly premiums because they have not yet completed a required physical exam and health questionnaire. For Gov. Terry Branstad, setting these health requirements was a key provision for expanding Medicaid in Iowa using funding from President Barack Obama’s health care overhaul. The state received federal approval to make modifications to the traditional Medicaid terms, including setting health requirements and charging contributions…”
  • US’s 1st program using federal funds to buy private insurance for poor survives in Arkansas, By Andrew DeMillo (AP), February 5, 2015, Minneapolis-St. Paul Star Tribune: “Arkansas’ first-in-the-nation program using federal funds to buy private health insurance for the poor will survive another year after the Legislature reauthorized the program Thursday, despite an influx of new Republican lawmakers elected on a vow to kill the hybrid Medicaid expansion. The Arkansas House voted 82-16 to reauthorize funding through June 2016 for the ‘private option’ plan, which was crafted two years ago as an alternative to expanding Medicaid under the federal health law. Arkansas was the first state to win federal approval for such an approach, touted as a compromise for Republican-leaning states…”
  • Medicaid could dump 500,000 Ohioans in 6 months, By Catherine Candisky, February 6, 2015, Columbus Dispatch: “The state will send out letters to 107,000 Medicaid recipients today telling them that their health-care benefits will be terminated on Feb. 28 for failure to verify their income. ‘They should consider this as a final notice,’ said Sam Rossi, spokesman for the Ohio Department of Medicaid. ‘There is personal responsibility. You need to report income for a program like Medicaid.’ An additional 140,000 recipients will receive termination notices next week, with 100,000 scheduled for March. The Ohio Job and Family Services Association and advocates for the poor have urged state officials to delay terminating benefits because fewer than half of those sent renewal notifications in December have responded, and many never received them…”
  • Few lawmakers supported Haslam’s Insure Tennessee, By Dave Boucher, February 4, 2015, The Tennessean: “In 21 months, Gov. Bill Haslam and his administration spent countless hours crafting a health care plan they thought could thread the political needle: satisfy Democrats in Washington, D.C., Republicans in Tennessee and help the working poor. It took considerably less time for the plan to unravel in the General Assembly. After a little more than two days, a few state Senators officially killed Haslam’s plan to provide 280,000 low-income Tennesseans with federally funded health care…”
  • Governor’s panel again urges Medicaid expansion in Idaho, By Bill Dentzer, February 6, 2015, Idaho Statesman: “Members of the governor-appointed group that developed options for expanding Medicaid to cover Idaho’s poorest adults told lawmakers Thursday that opposition to the expansion has blocked money that taxpayers are due under federal health care reform. The panel’s alternative funding plan provides greater accountability, saves money and gives the state more control over how funds are spent, they said. The federal government already has approved similar alternative plans in other states where Medicaid expansion has been politically or ideologically unpopular…”

Health Insurance Coverage

Medicaid, CHIP add 10.1 million since insurance marketplaces opened, By Tony Pugh, February 2, 2015, Fresno Bee: “More than 10.1 million people have enrolled in Medicaid and the Children’s Health Insurance Program in the first 14 months since marketplace enrollment began, the Obama administration reported Monday. That’s a 17.5 percent increase over the average monthly enrollment of both programs just before marketplace health insurance became available in October 2013…”

Medicaid Expansion – Indiana

  • Gov. Pence gets federal OK for Medicaid alternative, By Shari Rudavsky and Maureen Groppe, January 27, 2015, Indianapolis Star: “After months of wrangling between Gov. Mike Pence and the Obama administration, Indiana won approval to expand its own brand of Medicaid that injects personal responsibility into the healthcare program for the poor. About 350,000 low-income Hoosiers who lack insurance could benefit from the program, whose approved expansion was announced Tuesday, the day enrollment began. Coverage could start as early as Feb. 1. Pence said the Healthy Indiana Plan 2.0, a revamped version of a program started by then-Gov. Mitch Daniels, goes beyond standard Medicaid expansion by requiring that participants contribute to the cost of their care…”
  • Indiana will allow entry to Medicaid for a price, By Abby Goodnough, January 27, 2015, New York Times: “After a lengthy back-and-forth, the Obama administration has agreed to let Gov. Mike Pence of Indiana, a Republican, expand Medicaid on his own terms, including some that have not been allowed before under federal rules. The plan will extend coverage to an additional 350,000 Indiana residents with incomes of up to 138 percent of the federal poverty level — about $16,100 for a single person and $27,310 for a family of three — starting next month. As in the 27 other states that have expanded Medicaid under the Affordable Care Act, the federal government will cover the entire cost through this year and at least 90 percent in future years. But Mr. Pence, like several Republican governors before him, insisted on adding a conservative twist to the expansion, mostly by requiring beneficiaries to pay something toward their coverage…”

Medicaid Expansion – Kentucky

Kentucky examines Medicaid expansion’s effects, By Chris Kenning and Laura Ungar, January 26, 2015, Louisville Courier-Journal: “One year after Kentucky enacted expanded Medicaid under Obamacare, the health care program for the poor and disabled has grown to serve nearly 1.2 million residents — a quarter of Kentucky’s population. Now, consultants are finalizing a report examining the expansion’s impact on the state’s health care system — and its bottom line — in a review that advocates say will carry important implications and is being watched by other states still considering an expansion. The study, set for release by the Cabinet for Health and Family Services in the coming weeks, will explore how the change has affected areas such as provider reimbursements and uncompensated care; whether it’s beginning to create more jobs or tax revenue; and its future enrollment outlook…”

Medicaid Reimbursement

  • Paid more, doctors saw more Medicaid patients, Penn study finds, By Don Sapatkin, January 21, 2015, Philadelphia Inquirer: “For two years, the Obama administration dramatically raised Medicaid reimbursements for primary-care physicians in the hope that they would see more poor patients. The idea was that states would jump in to continue at least part of the payments. Few did, and the experiment ended Dec. 31, before researchers could report evidence of an impact. Now they have…”
  • Doctors took on more Medicaid patients when Obamacare boosted their pay, By Tim Darragh, January 22, 2015, NJ.com: “Doctors were much more willing to take on poor and low-income patients when the federal government temporarily boosted Medicaid payments, according to the study published Wednesday. The study, published in the New England Journal of Medicine, suggests the two-year increase in Medicaid reimbursements as scheduled in the Affordable Care Act helped bring health care to more of the poor and low-income people who are enrolled in the program. But the findings leave some concern the access to care problems those enrollees had before the program began will resume again, since New Jersey is among 35 states that let it expire on Dec. 31…”

State Medicaid Programs – New Jersey, Ohio

  • N. J. Medicaid fiasco: Thousands stranded without coverage, no fix in sight, By Kathleen O’ Brien, December 23, 2014, Star-Ledger: “The doctor was perfectly clear after examining Aurora Blackwell’s son this fall: The boy needed to get to an emergency room for his worsening digestive problems. Instead, Blackwell took the 4-year-old home and treated him herself — first with prune juice, then suppositories. Why would the devoted young mother of two ignore her pediatrician’s advice? Because the Burlington County woman knew that despite 10 months of phone calls, emails and letters, her family still lacked health insurance. ‘I feel helpless,’ she’d written two months earlier in a plea to Gov. Chris Christie. ‘How much longer do we have to wait?’ The meltdown of the federal government’s website tied to the Affordable Care Act has been well documented. But in New Jersey, something far worse was happening as the state expanded Medicaid access under Obamacare, an NJ Advance Media investigation has found…”
  • Medicaid extension again on Kasich agenda, By Catherine Candisky, December 23, 2014, Columbus Dispatch: “Nearly one year after Ohio expanded Medicaid coverage for poor adults, Gov. John Kasich again faces uncertainty as he seeks approval from the Republican-led legislature to extend new eligibility guidelines for two more years. The governor and other supporters say lives are at stake. As of October, more than 430,000 poor Ohioans had gained health coverage under the expansion paid through federal funding available through the Affordable Care Act…”

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…”