Encouraged by the Obama administration’s willingness to permit states to employ a private market-based approach to expanding their Medicaid programs, a number of states that had previously rejected Medicaid expansion are now considering doing so.

Among the states either pursuing such an approach or considering doing so are Indiana, North Carolina, South Dakota, and Wyoming.

Meanwhile, if Democrats defeat Republicans in gubernatorial elections in Florida, Wisconsin, and Maine, those states are considered likely to seek to expand their Medicaid programs.

Two considerations appear to be fueling this new interest in expansion in states with Republican governors:  first, those states are noticing others receiving billions of dollars in federal Medicaid expansion money; and second, Pennsylvania’s recent success in gaining federal approval of a market-based approach to Medicaid expansion is suggesting to some governors that they can expand their Medicaid programs without doing so in the manner envisioned when the Affordable Care Act was adopted.

Read more about the prospects of additional states expanding their Medicaid programs and the conditions that are causing those that previously rejected adoption to reconsider their positions in this Reuters article.…

A new report from the U.S. Department of Health and Human Services (HHS) projects that hospitals will save $5.7 billion in uncompensated care costs in 2014.

Most of the savings will come from hospitals in states that have expanded their Medicaid programs, although hospitals in other states will save as well because of improved access to health insurance for previously uninsured working-class and middle-class families.

The study is based on a combination of uncompensated care data from five for-profit hospital companies, surveys by hospital associations in three states, and the Medicare cost report’s S-10 report, which the study concedes is a controversial source of uncompensated care data.

Read more about this new uncompensated care projection in this Kaiser Health News news story or find the HHS report itself here.…

A new report suggests that education is more important to an individual’s overall health than access to health care.

According to the Virginia Commonwealth University’s Center on Society and Health,

More education means better health – in part because more education brings better jobs, improved access to health insurance, and higher earnings that can help pay for medical expenses and a healthier lifestyle. Conversely, people with less education tend to have more challenges accessing health services – lower rates of health insurance coverage and less money to afford copayments and prescription drugs; they are also more likely to live in low-income neighborhoods with limited access to primary care providers.

Improved access to health care may improve overall health but it will not necessarily compensate for the entire difference in health status between those with more and those with less education.  In fact, the disparity even exists, the report notes, in countries like Great Britain where the entire population has access to the same national health care system.

Learn more about the possible effects of education on health status here, in the Virginia Commonwealth University Center on Society and Health policy brief “Health Care:  Necessary But Not Sufficient.”…

Providers may soon have trouble collecting payments for services they have delivered to Medicaid patients whose coverage has lapsed.

Under the Affordable Care Act, people whose enrollment in Medicaid in the past year was made possible by Affordable Care Act eligibility expansions are required by the health care reform law to renew their eligibility annually.  Many, however, do not know this, according to focus groups performed on behalf of the Medicare and CHIP Payment and Access Commission (MACPAC ).

As a result, some of these recipients could find themselves without coverage when they receive care in the near future – a situation that could leave them with significant medical bills while leaving providers unpaid for care they have delivered.

Learn more about this issue and its implications in this CQ HealthBeat article presented by the Commonwealth Fund.…

The non-partisan federal agency charged with advising Congress, the Department of Health and Human Services, and the states on matters involving Medicaid and the Children’s Health Insurance Program (CHIP) met last week in Washington, D.C.

The Medicaid and CHIP Payment and Access Commission (MACPAC) addressed a number of CHIP-related issues during its September 18-19 meetings, including the future of the program, its funding, state experiences with CHIP changes, and consumer protections.

MACPAC also looked at a variety of Medicaid issues, including state Medicaid expansions through premium assistance, enrollment so far in 2014, the Centers for Medicare & Medicaid Services’ Medicaid program integrity plan, early experiences of new enrollees, and future reductions in Medicaid disproportionate share payments (Medicaid DSH).

For a summary of the commission’s deliberations, see this CQ HealthBeat article presented by the Commonwealth Fund.

To see the presentations made during the two-day session go here, to MACPAC’s web site.…