States and Medicaid Expansion

  • LePage says he’ll block voter-approved Medicaid expansion unless legislators fund it, By Scott Thistle, November 8, 2017, Portland Press Herald: “Just hours after a Medicaid expansion was endorsed by nearly 60 percent of Maine voters, Gov. Paul LePage and his Republican allies vowed to delay, if not derail, the citizen-initiated law that would provide health care to as many as 70,000 low-income residents of the state…”
  • Election results invigorate Medicaid expansion hopes, By Abby Goodnough and Margot Sanger-Katz, November 8, 2017, New York Times: “The election results in Maine and Virginia have energized supporters of expanding Medicaid under the Affordable Care Act in several holdout states. After months of battling Republican efforts to repeal the law, they now see political consensus shifting in their direction…”
  • Medicaid expansion takes a bite out of medical debt, By Alex Smith, November 10, 2017, National Public Radio: “As the administration and Republicans in Congress look to scale back Medicaid, many voters and state lawmakers across the country are moving to make it bigger. On Tuesday, Maine voters approved a ballot measure to expand Medicaid under the Affordable Care Act. Advocates are looking to follow suit with ballot measures in Utah, Missouri and Idaho in 2018…”

State Medicaid Programs – Iowa, Maine

  • Medicaid cuts to roughly 40,000 Iowans approved by the feds, By Clark Kauffman, October 31, 2017, Des Moines Register: “Over the protests of hospitals and medical providers, Iowa has received federal approval to reduce coverage for new Medicaid beneficiaries. An estimated 40,000 Iowans are expected to be affected by the change, which will reduce their coverage for medical care delivered in the days and weeks before they are officially declared eligible for Medicaid…”
  • Maine voters to decide if state will expand Medicaid, By Casey Leins, November 1, 2017, US News & World Report: “On Nov. 7, Maine voters will be the first in the nation to determine the fate of Medicaid expansion in their state. The issue has been a contentious one in Maine since the 2012 Supreme Court ruling granting states the power to decide whether to expand the program to more low-income Americans. Republican Gov. Paul LePage has vetoed the legislature’s five attempts to expand Medicaid, arguing that it is a measure of ‘pure welfare’ that would significantly impact taxpayers, according to The New York Times…”

Medicaid Enrollment

Report: Medicaid enrollments, costs begin to stabilize, By Christina A. Cassidy (AP), October 19, 2017, Washington Post: “States are seeing more stability in their Medicaid programs after experiencing a surge in enrollment and costs associated with the Affordable Care Act, suggesting that one of the major pillars of former President Barack Obama’s health overhaul may be nearing its peak. At the same time, they are experiencing a high level of uncertainty as Republicans in Congress continue to advocate for a major overhaul of a program that provides health insurance to tens of millions of lower-income and disabled Americans…”

Mobile Health Clinics

Mobile clinics assume greater role in preventive care, By Scott Rodd, October 11, 2017, Stateline: “One afternoon last month, the Family Van stopped at the corner of Washington and Roxbury streets in Boston. The regulars had already formed a line, waiting in the lingering summer heat for the red and green RV to arrive. The Family Van, which is funded in part by Harvard Medical School, provides free blood pressure tests, HIV counseling and basic medical care to underserved neighborhoods across Boston. The van has been operating since 1992, and mobile health clinics like it have been around for decades, but they are assuming a more prominent role as the U.S. health care system places a greater emphasis on preventive care…”

State Medicaid Programs – Pennsylvania, New York

  • Gov. Wolf to veto controversial Medicaid work requirement bill, By Kate Giammarise, October 5, 2017, Pittsburgh Post-Gazette: “Gov. Tom Wolf will veto a budget-related bill passed by the Republican-controlled state House and Senate that would have required the administration to include a work-search requirement in the Medicaid program and could have limited certain Medicaid benefits…”
  • Erie County’s white Medicaid recipients cost taxpayers the most money, By Sandra Tan, October 6, 2017, Buffalo News: “The Medicaid costs for Erie County residents enrolled in the government health care program are expected to soon crack $2 billion even though the number of local Medicaid recipients has leveled off after years of growth. White Medicaid recipients are the ones costing the program more, according to a Medicaid data report being released today…”

At-Home Health Care

The return of the doctor house call, By Mattie Quinn, September 28, 2017, Governing: “‘Do you hear that?’ asks Beth Hungate, as she walks into an apartment in the historic neighborhood of Richmond, Va., known as ‘the Fan.’ Hungate, a nurse practitioner at Virginia Commonwealth University’s (VCU) medical center, is there to see a patient of hers, a woman named Luckie Locke. Locke has been in quite a bit of discomfort recently and requested that Hungate stop by. But as Hungate walks through the door, she notices an incessant beeping noise. Hungate scans the apartment for the source of the beeping; eventually she traces it to a carbon monoxide detector. She calls her clinical coordinator to get a nonemergency fire department truck to come by. ‘You see? I would have never known this if I wasn’t coming to her house,’ Hungate says…”

State Medicaid Programs – New Mexico, Colorado

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…”