A forum on Medicaid and state budgets: a summary
When it comes to state budgets, the Medicaid program is almost always the proverbial 800-pound gorilla in the room. On March 15, 2007, the Federal Reserve Bank of Chicago and the Civic Federation co-sponsored a forum to discuss the growing cost of Medicaid and how states are responding.
Medicaid Expansion and the Unemployed
We examine how a key provision of the Affordable Care Act—the expansion of Medicaid eligibility—affected health insurance coverage, access to care, and labor market transitions of unemployed workers. Comparing trends in states that implemented the Medicaid expansion to those that did not, we find that the ACA Medicaid expansion substantially increased insurance coverage and improved access to health care among unemployed workers. We then test whether this strengthening of the safety net affected transitions from unemployment to employment or out of the labor force. We find no meaningful ...
Medicaid and the elderly
In 2009, Medicaid spent over $75 billion on 5.3 million elderly beneficiaries. This article describes the Medicaid rules for the elderly and discusses their economic implications.
The Medicaid Expansion and the Uptake of Medication-assisted Treatment for Opioid Use Disorder: Evidence from the Rhode Island All-payer Claims Database, 2012–2018
This article uses the all-payer claims database for the state of Rhode Island to assess recent progress in the state toward the goal of expanding access to medication-assisted treatment (MAT) for opioid use disorder (OUD). The analysis highlights the role played by the Affordable Care Act (ACA) and the associated Medicaid expansion in furthering that goal. Using measures that account for changes in health insurance enrollment, we find that the MAT rate per 100,000 enrollees in Rhode Island effectively doubled between 2012 and 2018, while the prevalence of OUD in the sample also doubled over ...
The Costs of Payment Uncertainty in Healthcare Markets
What does it cost healthcare providers to collect payment in the complex U.S. health insurance system? We study this question using rich data on repeated interactions between a large sample of physicians and many different payers, and investigate the consequences when these costs are high. Payment uncertainty is high and variable, with 19% of Medicaid visits not reimbursed after the first claim submission. In such cases, physicians either forgo substantial revenue or incur costs to collect payment. Using physician movers and practices that span state boundaries, we find that providers respond ...
The Lifetime Medical Spending of Retirees
Using dynamic models of health, mortality, and out-of-pocket medical spending (both inclusive and net of Medicaid payments), we estimate the distribution of lifetime medical spending that retired US households face over the remainder of their lives. We find that households who turned 70 in 1992 will, on average, incur $122,000 in medical spending, including Medicaid payments, over their remaining lives. At the top tail, 5 percent of households will incur more than $300,000 and 1 percent of households will incur over $600,000 in medical spending inclusive of Medicaid. The level and the ...
Can Community Development Improve Health? Emerging Opportunities for Collaboration between the Health and Community Development Sectors
The two sectors of community development and health have long worked in the same neighborhoods, but they have not always worked together. This is starting to change, due in part to a growing recognition among health experts of the social, economic, and environmental factors that drive health outcomes. These social determinants of health have become the basis for new collaborations between community development and health professionals. This paper introduces professionals in both sectors to this emerging area of practice through a series of case studies of innovators in the southeastern United ...
States may face higher spending in give-and-take of Medicare/Medicaid changes
Despite a markedly improved outlook for state finances, New Englands states still face significant fiscal pressures moving forward into the current and next fiscal years. Prominent among these challenges are two changes to the Medicaid and Medicare programs that could significantly increase state health care costs.
The American Recovery and Reinvestment Act of 2009: a review of stimulus spending in New York and New Jersey
The ARRA stimulus package was designed to spur economic and employment growth in response to a deepening U.S. recession and the weakened fiscal conditions of many state governments. An analysis of the local allocation of ARRA funds shows that the $35 billion of stimulus spending in New York was relatively concentrated in expanded funding for Medicaid, while a large share of the $12 billion allocated to New Jersey went to extending unemployment insurance benefits. While ARRA funding supplemented tax revenues in both states in fiscal years 2010 and 2011, the program's spending components are ...
Missouri’s Medicaid Contraction and Consumer Financial Outcomes
In July 2005, a set of cuts to Medicaid eligibility and coverage went into effect in the state of Missouri. These cuts resulted in the elimination of the Medical Assistance for Workers with Disabilities program, more stringent eligibility requirements, and less generous Medicaid coverage for those who retained their eligibility. Overall, these cuts removed about 100,000 Missourians from the program and reduced the value of the insurance for the remaining enrollees. Using data from the Medical Expenditure Panel Survey, we show how these cuts increased out-of-pocket medical spending for ...