Medicaid/CHIP

Publicly-funded programs that cover medical and long-term care for low-income adults, children, and people with disabilities. Medicaid expansion is one of the central tools to increase insurance coverage rates through the Affordable Care Act.

Effects of the ACA on Health Care Cost Containment

Issue Brief
Mar. 2, 2017

This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to “bend the cost curve.” Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.

Primary Care Appointment Availability and the ACA Insurance Expansions

Issue Brief
Mar. 1, 2017

In the current debate in Congress over the Affordable Care Act (ACA), the issue of provider access is a major concern.Our 10-state audit study published in JAMA Internal Medicine finds that primary care appointment availability for new patients with Medicaid increased 5.4 percentage points between 2012 and 2016 and remained stable for patients with private coverage. Over the same period, both Medicaid patients and the privately insured experienced a one-day increase in median wait times. Higher appointment availability for Medicaid patients is a surprising result given the increase in demand for care from millions of new Medicaid enrollees. In this Issue Brief, we summarize our study’s findings, expand on possible explanations, and extend the analysis by examining the relationship between appointment availability and state-level Medicaid expansions. We find that access to primary care increased for Medicaid patients only in states that extended Medicaid eligibility to low-income, nonelderly adults. Combined, these results suggest coverage provisions in the ACA have not overwhelmed primary care capacity.

Insurance Coverage and Access to Care Under the Affordable Care Act

Issue Brief
Dec. 8, 2016

This brief details changes in insurance coverage and access to care under the Affordable Care Act. About 20 million individuals gained coverage under the law and access to care improved.  Despite these gains, more than 27 million individuals are still uninsured, and many others face barriers in accessing care.  As a result of the 2016 elections, the future of the ACA is uncertain.  As the next Administration and policymakers debate further health system reforms, they should consider the scope of the ACA’s effects on their constituents. 

Practice Patterns in Medicaid and Non-Medicaid Asthma Admissions

Aug. 5, 2016

Jeffrey H. SilberPaul R. Rosenbaum, Wei Wang, Shawna Calhoun, James P. Guevara, Joseph J. Zorc, Orit Even-Shoshan

In Pediatrics, Jeffrey Silber and colleagues investigate whether Medicaid and non-Medicaid patients admitted to the hospital for asthma are treated differently in major children’s hospitals. Medicaid provider reimbursement levels can be significantly lower than private insurance reimbursements, making it important to analyze whether this impacts the health care received by Medicaid beneficiaries. The authors used data from 40 children’s hospitals to analyze more than 17,000 matched pairs of Medicaid to non-Medicaid children admitted for asthma in the same hospital over three years...

Primary Care Appointment Availability for Medicaid Patients: Comparing Traditional and Premium Assistance Plans

Research Brief
Jul. 14, 2016

In 2014, Arkansas and Iowa expanded their Medicaid programs and enrolled many of their adult beneficiaries in commercial Marketplace plans. This study suggests that this “private option” may make it easier for new Medicaid patients to get primary care appointments.

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