Archive for Affordable Care Act

 

Medicaid Expansion Brings Improvements to Expansion States

States that expanded their Medicaid programs under the Affordable Care Act have experienced fewer hospital admissions, shorter lengths of stays in the hospital, and lower hospital costs, according to a new Health Affairs study.

Specifically, they experienced:

  • a 3.1 percent decline in inpatient days
  • a 3.5 percent decrease in discharges for conditions considered “ambulatory care-sensitive,” such as diabetes, chronic respiratory problems, and pneumonia
  • a reduction of nearly three percent in hospital costs.

Learn more about how Medicaid expansion has improved the health of the population in states that expanded their Medicaid programs in the Health Affairs study “Medicaid Expansion Associated With Reductions in Preventable Hospitalizations.”

ACA May be Improving, Saving Lives

The insurance expansion made possible by the Affordable Care Act may be improving and even saving lives, some studies and anecdotal evidence suggest.

While observers warn that it is difficult to attempt to render a final verdict on the reform law’s insurance expansion and its impact, various studies and observations point to encouraging developments.  Among them:

  • High blood pressure is being detected at a higher rate now among people who bought insurance as a result of the ACA than it was prior to the law’s passage.
  • Fewer 19-26 year-olds, now permitted to remain on their parents’ health insurance, are choosing not to see a doctor about their asthma because of the cost of seeking care.
  • Women in Michigan report having an easier time obtaining birth control pills.
  • Participants in a Michigan program are reporting an increased likelihood of learning they have chronic medical conditions than was the case before they were insured.
  • People between their mid-50s and mid-60s living in states that expanded their Medicaid programs, and who took advantage of that expansion, had a lower death rate than similar people in non-expansion states.

Learn more about some of the documented and observed benefits of the Affordable Care Act’s improved …

CMS Adopts Methodology for Medicaid DSH Cuts

Medicaid DSH money will be allocated among states based on a new methodology under a regulation adopted this week by the Centers for Medicare & Medicaid Services.

But it is not clear when that new methodology may actually be used.

Cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to states were mandated by the Affordable Care Act based on the expectation that the law would greatly reduced the number of uninsured Americans.  While this has been the case, the decline in the number of uninsured has not been as great as expected.  For this reason, Congress has on several occasions delayed the required Medicaid DSH cut.

That cut is now scheduled to take effect next week, on October 1, but a continuing resolution to fund the federal government, passed last week by the House and now under consideration by the Senate, would delay that cut again – at least until November 22.

Learn more about the new regulation governing the future allotments of Medicaid DSH money to the states and the prospects for Medicaid DSH allocation cuts being made anytime soon in the Healthcare Dive article “CMS finalizes Medicaid DSH cuts, but Congress could still delay” and see the …

Millions Eligible for Health Insurance Remain Uninsured

More than 15 million Americans who are currently entitled to free or subsidized health insurance are currently uninsured.

Among them are 11 million who are eligible for Medicaid but have not applied for benefits and 4.2 million who could afford insurance with the help of federal premium subsidies and either have decided not to take advantage of those subsidies or are unaware of the availability of such subsidies.

In addition, another two million people would be eligible for Medicaid if their states expanded their Medicaid program as authorized by the Affordable Care Act.

In light of such figures, it is not entirely surprising that the uninsured rate, according to the census bureau, rose last year for the first time since implementation of the Affordable Care Act.  That uninsured rate, 15 percent at the time the law was adopted in 2010, fell to 7.9 percent in 2017 but rose to 8.5 percent in 2018.  The uninsured rate has especially risen among Hispanics and the foreign born.

Another possible reason for the rise in the number of uninsured Americans:  the federal government has greatly reduced its outreach effort to inform people about the various options they have for obtaining insurance.

Learn more …

ACA Has Reduced Insurance Disparities

The Affordable Care Act is responsible for a major reduction in the disparity of insurance status among racial and ethnic minorities.

According to a new Commonwealth Fund analysis,

All U.S. racial and ethnic groups saw comparable, proportionate declines in uninsured rates…  However, because uninsured rates started off much higher among Hispanic and black non-Hispanic adults than among white non-Hispanic adults, the coverage gap between blacks and whites declined from 11.0 percentage points in 2013 to 5.3 percentage points in 2017. Likewise, the coverage gap between Hispanics and non-Hispanic whites dropped from 25.4 points to 16.6 points.

Learn more about specific differences among racial and ethnic groups, differences based on residence in Medicaid expansion states and non-expansion states, and differences in securing public or private health insurance in the Commonwealth Fund study “Did the Affordable Care Act Reduce Racial and Ethnic Disparities in Health Insurance Coverage?”