Community Paramedic Program

These house calls save money for EMS, social services, By Robert Mittendorf, September 4, 2017, Bellingham Herald: “Bellingham Fire Capt. Jeff Brubaker carries a pager like any other firefighter, and he still uses his paramedic skills to help people. But these days he’s not riding a fire engine or an ambulance and most of his patients haven’t called 911. Not as much as they used to, at least. Brubaker is Bellingham Fire Department’s community paramedic, a relatively new position that puts him in touch with people who are frequent 911 callers but who don’t need emergency care…”

Health Insurance Coverage in the US

  • More people remain insured since Obamacare, CDC says. But many pay more out of pocket, By Daniel Chang, August 29, 2017, Miami Herald: “More Americans had health insurance during the first three months of 2017 than before the Affordable Care Act became law in March 2010, according to the National Health Interview Survey released Tuesday — but more have coverage with high out-of-pocket costs, which can discourage patients from visiting the doctor and filling a prescription…”
  • Bipartisan group of governors calls on Congress to shore up elements of Affordable Care Act, By Amy Goldstein, August 31, 2017, Washington Post: “A bipartisan group of governors is trying to jump-start efforts to strengthen private insurance under the Affordable Care Act, urging Congress to take prompt steps to stabilize marketplaces created by law while giving states more freedom from its rules…”

Medicaid Expansion – Nevada

High-stakes health-care debate hits Nevada’s Medicaid program, By Ben Botkin, August 5, 2017, Las Vegas Review-Journal: “Marta Jensen, Nevada’s point person on Medicaid, watched on C-SPAN recently as the U.S. Senate debated health care reform. She had four different bills pulled up on her computer. The stakes were high for Nevada. Each of the bills would have repealed at least parts of the Affordable Care Act and affected Medicaid, the federal-state program that provides poor and disabled Americans with medical coverage. More than one-fifth of the state’s residents now receive their health insurance through Medicaid…”

Safety Net Clinics – Minnesota

Safety net clinics in Minnesota face loss of federal funds, By Glenn Howatt, July 27, 2017, Star Tribune: “While the U.S. Congress continues to debate the future of Obamacare and Medicaid, Minnesota’s safety net clinics worry that they will lose $27 million in federal aid that helps pay for health care of the uninsured. Unless Congress acts by October to renew the funding, Minnesota’s 17 safety net providers would have to cut services and possibly close some of the more than 70 clinics across the state…”

Medicaid Privatization – Iowa

Medicaid firms spending less on care for Iowa’s poor, disabled, By Tony Leys, March 15, 2017, Des Moines Register: “The three private firms running Iowa’s Medicaid program have found ways to trim spending on care for the poor or disabled Iowans they cover, a new report suggests. But all three continue to lose tens of millions of dollars on the controversial project.  The companies’ per-member monthly spending on health care for adults fell by as much as 28 percent from the three months ending in September 2016 to the three months ending in December 2016, the new report shows…”

Health Care Spending – Massachusetts

Low-income communities see fewer health care dollars, AG report finds, By Priyanka Dayal McCluskey, October 13, 2016, Boston Globe: “Massachusetts’ health insurance market has an income inequality problem, according to a report from Attorney General Maura Healey’s office, whose findings mirror national studies.  The analysis found that more health care dollars are spent on higher-income communities than on lower-income communities — even though the latter tend to have greater medical needs. Healey’s office called this a ‘distressing’ trend that has persisted for years…”

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…”

Medicaid and Home Health Visits

House calls might save Medicaid money for states, By Michael Ollove, August 25, 2016, Stateline: “Doctors who make house calls may seem like something from America’s Norman Rockwell past. But they never disappeared entirely, and there is new evidence that home visits can play an important role in providing health care to the aged and chronically ill — while saving taxpayers millions.  The federal Centers for Medicaid and Medicare Services (CMS) said this month that a demonstration project has shown that delivering comprehensive primary care services at home helped to keep Medicare recipients with multiple chronic illnesses or disabilities out of hospitals, emergency rooms and nursing homes…”

Child Food Allergies in Low-Income Households

Why having a food allergy costs more for the poorest kids, By Deborah Netburn, April 27, 2016, Los Angeles Times: “What is the financial toll of having a kid with a food allergy? The answer may depend on how much money you have. A new study published this week in Pediatrics found that food-allergic children from households that earn less than $50,000 a year incur 2.5 times the cost of emergency room visits and hospital stays compared with their peers from families that are in a higher-income bracket.  At the same time, families that make more than $100,000 a year report spending more of their own money on visits to allergy specialists for their kids, as well as medicines paid for out of pocket, compared with families from lower-income groups…”

State Medicaid Spending and Enrollment

  • Medicaid costs rise, report says, but not more than most states expected, By Abby Goodnaugh, October 15, 2015, New York Times: “Spending on Medicaid rose nearly 14 percent on average in the last fiscal year, a report has found, largely because of a tide of newly eligible enrollees in the 29 states that had expanded the program by then to cover millions more low-income adults. But for most of those states, the per-member, per-month cost of the new enrollees was not higher — in a few cases, in fact, it was lower — than expected, according to the report, released Thursday by the Kaiser Family Foundation. And almost all of the additional spending was covered by federal funds, which are paying the entire cost of expanding Medicaid through 2016 and at least 90 percent thereafter…”
  • Survey: Big growth in Medicaid enrollees in expansion states, By Christina A. Cassidy (AP), October 15, 2015, Washington Post: “States that opted to expand Medicaid under the Affordable Care Act saw enrollment increase on average by 18 percent during the first full year of expansion, according to a report released Thursday. That will soon have an effect on state budgets, with expansion states to pay a portion of costs to cover the new enrollees beginning in 2017. Currently, the federal government is covering the expanded population at 100 percent. States will eventually pay 10 percent of costs by 2020…”
  • Study: Nearly half of Iowa’s uninsured are eligible for Medicaid, By Ed Tibbetts, October 15, 2015, Quad-City Times: “A new study says nearly half of Iowa’s non-elderly uninsured are eligible for Medicaid, one of the highest rates in the nation. The Kaiser Family Foundation this week released a state-by-state analysis, which said 188,000 non-elderly are uninsured in Iowa, and 47 percent of them are eligible for Medicaid, the program that is run jointly by the federal government and the states to provide coverage for the low-income and disabled people…”

Rural Hospitals

To survive, rural hospitals join forces, By Michael Ollove, August 17, 2015, Stateline: “Ask Sam Lindsey about the importance of Northern Cochise Community Hospital and he’ll give you a wry grin. You might as well be asking the 77-year-old city councilman to choose between playing pickup basketball—as he still does most Fridays—and being planted six feet under the Arizona dust. Lindsey believes he’s above ground, and still playing point guard down at the Mormon church, because of Northern Cochise. Last Christmas, he suffered a severe stroke in his home. He survived, he said, because his wife, Zenita, got him to the hospital within minutes. If it hadn’t been there, she would have had to drive him 85 miles to Tucson Medical Center. There are approximately 2,300 rural hospitals in the U.S., most of them concentrated in the Midwest and the South. For a variety of reasons, many of them are struggling to survive…”

State Medicaid Program – Ohio

Medicaid costs nearly $2 billion below estimates in Ohio, By Catherine Candisky, August 12, 2015, Columbus Dispatch: “Despite higher than expected enrollment of Ohioans newly eligible for Medicaid, overall costs of the tax-funded health insurance program last year were nearly $2 billion below original estimates. According to a report released today by Gov. John Kasich’s administration, total Medicaid spending was $23.5 billion for the fiscal year ending June 30, about 7.6 percent less than projected…”

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…”

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…”

State Medicaid Program – Arizona

Arizona hospitals, doctors avoid 5 percent Medicaid pay cut, By Ken Alltucker, June 10, 2015, Arizona Republic: “Arizona hospitals, doctors and other health providers will get a reprieve after the state’s Medicaid program announced it will cancel a planned 5 percent payment cut because of lower-than-expected use among enrollees and a prescription-drug rebate.  The combination will provide enough financial relief to keep Medicaid’s existing payment rates, according to a spokesman for Gov. Doug Ducey…”

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…”

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…”

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.

Immigrants and Health Insurance Coverage – California

Calif. has novel view of health care for undocumented immigrants, By Anna Gorman, January 17, 2015, USA Today: “Angel Torres hasn’t been to the doctor since coming to the United States illegally more than two decades ago. But now, his vision is getting blurry and he frequently feels tired. Torres, 51, worries he might have diabetes like his brothers. ‘Time is passing,’ he said in Spanish. ‘I need to get checked out.’ Torres is in luck. He lives in California, which has a dramatically different approach to health care for undocumented immigrants than most other states…”