Found inside â Page 401POLICY ISSUE Easing Medicaid eligibility standards results in several important unintended consequences and their associated negative implications. KEY CONCEPT 4 Self-Interest and its generous child coverage lowers the discounted ... A June 2017 study showed that per enrollee Medicaid spending declined in expansion states. "This resource book discusses the economic arguments that could (and could not) be put forth to support the case for investing in the social determinants of health on average and in the reduction in socially determined health inequalities. Found inside â Page 286This could contribute to a negative bias on the causal effect of Medicaid participation on ... thankfully, made it simpler for the researchers by instituting a lottery to determine eligibility in an expansion of its Medicaid program. medicaid expansion, General Assembly, health care; Posted November 15, 2021 5:00 a.m. EST EDITOR'S NOTE: Robert Bilbro is a retired Raleigh internist and cardiologist who has served as president . One analysis found that in 2014, among those states reporting both spending and enrollment data, spending per enrollee for the new adult group was much lower than spending per enrollee for traditional Medicaid enrollees. Keywords: No, Is the Subject Area "Socioeconomic aspects of health" applicable to this article? 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 ... A study using birth certificate data found that expansion was associated with an increased proportion of deliveries covered by Medicaid, which was offset by a decrease in the proportion covered by private insurers or other payers but no change in the proportion of women who were uninsured. Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings. Xuesong Han also conducted the data analysis and drafted the manuscript. The only exception to these null results is our finding of a negative effect of Medicaid expansion on the percentage of an establishment's workforce eligible for offered insurance, although we do not find that the effect is concentrated in establishments with a higher percentage of low-wage workers. We dichotomized our outcomes as âdisagree stronglyâ or not. A third study found no significant association of Medicaid expansion with changes in charge-to-cost ratio for certain surgical procedures in safety net hospitals vs. non-safety net hospitals, suggesting that safety net hospitals did not increase charges to private payers in response to expansion-related payer mix changes. Data are available at the Agency for Healthcare Research & Quality Data Center for researchers who meet the criteria for access to the access-restricted data files. The analysis, "The Effects of Medicaid Expansion Under the ACA: A Systematic Review," was published in the June issue of the journal Health Affairs. A recent study by Sabik et al. Not every state that expands Medicaid will experience large savings in their traditional Medicaid programs, but many will. Any positive assumptions about Medicaid expansion also assume that federal funding remains unchanged. Issue Brief (Commonw Fund). The higher percentage of low income persons with a usual source of care and access to multiple preventive care services in Medicaid expanding states compared to those in the non-expanding states may in part reflect Medicaid prior expansion in certain ACA participating states. Compared to the individuals in the expansion group, those in the non-expansion group were less likely to have a usual source of health care (64.5% vs. 56.5%, PR = 0.86, CI = 0.82â0.91) after controlling for demographic factors. Table 3 focuses on the outcomes related to self-assessed health. Court decision will have significant effects on federal costs and the level of uninsured, depending on whether a state accepts or declines the Medicaid expansion. 2016 Oct;51(5):1735-71. doi: 10.1111/1475-6773.12511. Several studies show that people in expansion states have experienced reductions in unmet medical need because of cost, with national and multi-state studies showing those reductions were greater than reductions in non-expansion states. In this case, however, self-employment would rise not only in the expanded Medicaid-eligible population but . e0144429. Medicaid expansion would continue to boost job growth well beyond 2017.8 Ordinarily, health coverage expansions have little effect on net economic activity, because the increased growth triggered by additional health care spending is off-set by economic shrinkage caused by paying for that spending. The quantitative analyses were conducted in Stata . Negative effects could include more uninsurance and . Some studies on specific hospital patient groups found no significant changes associated with expansion in measures of hospital care and outcomes, including rates of emergent admission, admissions from clinic, diagnosis category at admission, admission severity, rapid discharges, lengthy hospitalizations, unplanned readmissions, discharges to rehabilitation facilities, or failure to rescue. The lower utilization of health care services may reflect a higher unmet need of health care among nonexpanding statesâ residents. Yes The authors suggest that this finding shows that the health system has generally been able to absorb new expansion enrollees without sacrificing care for existing enrollees. The study sample was based on pooled data from 3 years (2010â2012) of the Medical Expenditure Panel Survey (MEPS) Household Component, which is a nationally representative survey of the US civilian non-institutionalized population conducted by the Agency for Healthcare Research and Quality (AHRQ). The access-restricted de-identified data file was used to acquire the resident state of the participants, and the participants were assigned to one of two groups based on their statesâ Medicaid expansion status (Yes or No/under discussion).
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