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The Affordable Care Act's Medicaid Expansion Is Shifting Resources Away from Low-Income Children

The Affordable Care Act's Medicaid Expansion Is Shifting Resources Away from Low-Income Children
Author: Charles Blahous
Publisher:
Total Pages: 0
Release: 2022
Genre:
ISBN:
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In this study, we find that Medicaid expansion under the Affordable Care Act (ACA) is generally associated in expansion states with a shift of program financial resources away from children toward nonaged nondisabled adults. We examine Medicaid expenditures per capita for beneficiary categories including children, aged adults, and the disabled, as well as for nonaged nondisabled adults, who were the focus of the ACA's Medicaid expansion. We compare the growth of per capita expenditures on these groups from fiscal year (FY) 2013 to FY 2019 between states that chose to expand Medicaid on January 1, 2014, and states that had not expanded at the time data were collected. Nonexpansion states exhibited a remarkable stability in the distribution of program resources between these categories, with each category receiving nearly the same percentage of Medicaid financial resources in FY 2019 as in FY 2013. After controlling for changes in the beneficiary population within expansion states, we find that per capita spending growth on Medicaid's previously eligible population was largely similar for expansion states and nonexpansion states but that this overarching similarity masked significant shifts of program financial resources between more specific beneficiary categories within expansion states. The most striking of these shifts was a dramatic shift of financial resources away from children in expansion states. States that expanded Medicaid per the terms of the ACA spent only 5.9% more per capita on children in FY 2019 than they did in FY 2013 compared with growth of 22.7% in per capita spending on children in nonexpansion states and of 27.0% in average healthcare spending per capita for the US population as a whole.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 161
Release: 2018-04-02
Genre: Medical
ISBN: 030946921X
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The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Medicaid Expansion Under the Affordable Care Act

Medicaid Expansion Under the Affordable Care Act
Author: Gail Norman
Publisher: Nova Science Publishers
Total Pages: 0
Release: 2014
Genre: Medicaid
ISBN: 9781634634427
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Historically, Medicaid eligibility has generally been limited to certain low-income children, pregnant women, parents of dependent children, the elderly, and individuals with disabilities; however, as of 1 January 2014, states have the option to extend Medicaid coverage to most nonelderly, low-income individuals. The Patient Protection and Affordable Care Act established 133% of the federal poverty level (FPL) as the new mandatory minimum Medicaid income eligibility level for most nonelderly individuals. This book provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the book describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrolment and expenditure estimates for the ACA Medicaid expansion are provided. The book reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.Historically, Medicaid eligibility has generally been limited to certain low-income children, pregnant women, parents of dependent children, the elderly, and individuals with disabilities; however, as of January 1, 2014, states have the option to extend Medicaid coverage to most nonelderly, low-income individuals. The Patient Protection and Affordable Care Act established 133% of the federal poverty level (FPL) as the new mandatory minimum Medicaid income eligibility level for most non-elderly individuals. This book provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the book describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrollment and expenditure estimates for the ACA Medicaid expansion are provided. The book reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.

Medicaid Expansion Under the Affordable Care Act

Medicaid Expansion Under the Affordable Care Act
Author: Gail Norman
Publisher: Nova Science Publishers
Total Pages: 130
Release: 2014-01-01
Genre: LAW
ISBN: 9781634634434
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Historically, Medicaid eligibility has generally been limited to certain low-income children, pregnant women, parents of dependent children, the elderly, and individuals with disabilities; however, as of January 1, 2014, states have the option to extend Medicaid coverage to most nonelderly, low-income individuals. The Patient Protection and Affordable Care Act established 133% of the federal poverty level (FPL) as the new mandatory minimum Medicaid income eligibility level for most nonelderly individuals. This book provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the book describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrollment and expenditure estimates for the ACA Medicaid expansion are provided. The book reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.

Addressing Coverage Challenges for Children Under the Affordable Care Act

Addressing Coverage Challenges for Children Under the Affordable Care Act
Author: Stacey McMorrow
Publisher:
Total Pages: 10
Release: 2011
Genre:
ISBN:
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The Affordable Care Act (ACA) will expand health insurance coverage options for many children and their families. The Medicaid expansion will extend eligibility to many individuals, and federal subsidies to purchase coverage in the health insurance exchanges will improve the affordability of coverage for low-and moderate-income families. To further encourage a reduction in uninsurance, the law also includes an individual requirement to obtain qualifying coverage that applies to most Americans. The ACA will improve accessibility and affordability of coverage for many Americans, but special attention may be required during implementation to ensure that children (age 0 to 18) in particularly complex coverage situations benefit from reform. The ACA will introduce additional coverage options for these children and their families, but ensuring that this population benefits from reform will require special consideration of their complex situations. Some parents or guardians may wish to purchase coverage for children in the exchange while covering themselves with employer coverage or remaining uninsured. Other parents may seek coverage for themselves in the exchange while enrolling their children in public coverage. Eligibility for federal subsidies in such cases is not straightforward and would benefit from clarification. Outreach to immigrant populations will also be important, as will strategies for integrating eligibility and enrollment processes for Medicaid, CHIP and exchange coverage. For those with absent parents, the future of medical support orders will need to evolve to be more consistent with the requirements of the ACA. Addressing such issues will be critical to maximizing coverage for all children under the ACA.

America's Children

America's Children
Author: Institute of Medicine and National Research Council
Publisher: National Academies Press
Total Pages: 216
Release: 1998-10-27
Genre: Medical
ISBN: 0309173930
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America's Children is a comprehensive, easy-to-read analysis of the relationship between health insurance and access to care. The book addresses three broad questions: How is children's health care currently financed? Does insurance equal access to care? How should the nation address the health needs of this vulnerable population? America's Children explores the changing role of Medicaid under managed care; state-initiated and private sector children's insurance programs; specific effects of insurance status on the care children receive; and the impact of chronic medical conditions and special health care needs. It also examines the status of "safety net" health providers, including community health centers, children's hospitals, school-based health centers, and others and reviews the changing patterns of coverage and tax policy options to increase coverage of private-sector, employer-based health insurance. In response to growing public concerns about uninsured children, last year Congress voted to provide $24 billion over five years for new state insurance initiatives. This volume will serve as a primer for concerned federal policymakers and regulators, state agency officials, health plan decisionmakers, health care providers, children's health advocates, and researchers.

Making the Medicaid Expansion an ACA Option

Making the Medicaid Expansion an ACA Option
Author:
Publisher:
Total Pages: 2
Release: 2012
Genre:
ISBN:
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The Supreme Court ruling on the Affordable Care Act upheld the individual mandate and made the expansion of Medicaid coverage to nonelderly adults with incomes below 138 percent of the federal poverty level optional for states. The law intended to require all states to undertake the Medicaid expansion. In this brief, Urban Institute researchers estimate the number of uninsured Americans in each state who would be eligible for Medicaid if every state takes the option of expanding Medicaid coverage. The authors also estimate the number of uninsured Americans who are at risk of not being covered because the Medicaid expansion is now optional.

The Medicaid Expansion and Attitudes Toward the Affordable Care Act

The Medicaid Expansion and Attitudes Toward the Affordable Care Act
Author: Daniel J. Hopkins
Publisher:
Total Pages: 18
Release: 2018
Genre:
ISBN:
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Enacted in 2010, the Patient Protection and Affordable Care Act (ACA) has reshaped U.S. health policy. Yet overall opinions on the law remained relatively stable during the few years before and after enactment. In a polarized era, can the implementation of a complex program such as the ACA influence public opinion through a policy feedback? Research on policy feedbacks and self-interest provide competing expectations. To address that question, we consider the impact of the Medicaid expansion which took place in select states. Using differences-in-differences estimation and 2010-2017 surveys of more than 51,000 non-elderly American adults, we show that the Medicaid expansion made low-income Americans on average 4.4 percentage points more favorable toward the ACA (SD=1.7) relative to those in non-expansion states. Given that we find no such effect for high-income respondents, these results are consistent with an impact via self-interest and with a policy feedback on public opinion.

Communities in Action

Communities in Action
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 583
Release: 2017-04-27
Genre: Medical
ISBN: 0309452961
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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Medicaid and Children's Health Insurance Program Provisions

Medicaid and Children's Health Insurance Program Provisions
Author:
Publisher:
Total Pages: 11
Release: 2009
Genre:
ISBN:
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The America's Affordable Health Choices Act of 2009 (the House bill) and America's Healthy Future Act of 2009 (the Senate Finance proposal) include an individual requirement to obtain health insurance, a Medicaid expansion and subsidies to help low-income individuals buy coverage through an Exchange. This analysis looks at the provisions related to Medicaid and the Children's Health Insurance Program (CHIP) compared to current law.