As the Supreme Court mulls yet another challenge to the constitutionality of the Affordable Care Act (ACA), we have new evidence of the law’s positive impact on young adults, who were allowed to stay on their parents’ insurance until age 26 under the Dependent Coverage Provision (DCP). The ACA helped young adults with cancer maintain continuous coverage, which is key to maintaining access to cancer treatment.
In arecent retrospective cohort study, my colleagues and I found that cancer patients who turned 19 in 2010-2012 (who were eligible to stay on their parents’ insurance) were 15% less likely to lose coverage than those who turned 19 in 2007-2009, before the ACA. We used commercial claims data to identify about 2,800 young adults with a cancer diagnosis between 2000 and 2015, and compared them to their peers prior to the ACA’s implementation. We matched the two groups on cancer type, diagnosis date, and clinical characteristics, and compared time to loss of insurance over 5 years.
Health insurance is complicated. When you’re struggling to make ends meet, that means not getting coverage. When Governor Corbett released his Healthy PA plan as an “alternative” to a traditional expansion of the Medicaid program, it was laced with complexity. His determination to make it different from the existing Medicaid program meant creating new private insurance plans. These ended up being run by many of the same companies that were already administering the Medicaid program but now would have two entirely different sets of plans.
As the February 15 deadline for open enrollment on the ACA marketplaces approaches, surveys tells us that many uninsured people remain unaware or misinformed about whether they qualify for subsidies to help purchase health insurance. Prior to the ACA, many people looked to agents and brokers to understand their options and to help them find an individual plan.
But agents and brokers face obstacles in fully engaging in the marketplaces, as an RWJF/Urban Institute Issue Brief concluded from interviews with insurance professionals after the first open enrollment period. They reported obstacles such as IT issues, poor training, inadequate customer support, and difficulty being paid from state marketplaces. Further, the authors noted, agents and brokers tend to have minimal experience working with a low-income population, and may lack relationships with communities with historically low levels of insurance.
Liquidation of one of the 23 non-profit health insurers created by the Affordable Care Act has heightened concerns about the fiscal stability of other CO-OP plans. In the latest of the LDI/RWJF Data Brief series, Scott Harrington goes right to the source: the quarterly National Association of Insurance Commissioners financial reports to state insurance regulators. The new data brief reviews funding, enrollment, underwriting results, and rates.
The story of the Medicaid fee bump is, first and foremost, a story of a policy to improve access to primary care for Medicaid recipients, by paying physicians more to see them. But it is also a story of how research can answer an important policy question, and how it can affect policy as it is being made. That's the story we tell here via Storify, the internet utility that enables elements of social media streams to be assembled into stand-alone story-like narratives.
Medicaid fee bump” for primary care services through December 31, 2016. The proposal would increase pay rates to Medicare levels and expand eligibility to obstetricians, gynecologists, and non-physician practitioners, such as physician assistants and nurse practitioners.</p> <p>The two-year federally financed Medicaid “fee bump” was built into the ACA with the goal of improving primary care availability for the influx of new Medicaid recipients. According to a recent <i>New England Journal of Medicine</i> <a href="/voices/2015/01/21/bumped-up-medicaid-fees-for-primary-care-linked-to-improved-appointment-availability#disqus_comments">study</a> by LDI Executive Director Dan Polsky and co-authors at Penn and the Urban Institute – this strategy may have succeeded. The problem of course, is that the provision expired January 1, 2015.
“So how about that Disneyland measles outbreak?” As a researcher who studies vaccine refusal, I’ve been asked this question a lot recently. More than 50 people have come down with measles after exposure at the iconic Southern California amusement park, and nationwide measles diagnoses exceeded 90 in the month of January alone. (For the record, that’s a lot of measles cases to see in one month in the US in recent years, although 2014 was also banner year for the virus.)
As they had in an earlier case, a notable group of bipartisan economic scholars and professors have filed an amicus brief in support of the government’s position in King v. Burwell, the Supreme Court case challenging the availability of premium subsidies on the federal exchange. Once again, three Penn professors (and LDI Senior Fellows)—Ezekiel Emanuel, Mark Pauly, and Dan Polsky—signed on to the brief.
Two new studies challenge the assumption that simply building supermarkets in so-called ‘food deserts’ will yield nutritional and health benefits. These ‘deserts’ are geographic areas, usually urban and poor, that lack full-service grocery stores and fresh produce. LDI Senior Fellow Carolyn Cannuscio and colleagues suggest that social considerations shape peoples’ choices on where to shop, and Victoria Mayer and Penn colleagues stress that improving peoples’ diets requires not only improved access but also greater affordability.
Did the two-year Medicaid “fee bump,” fully financed by the federal government, succeed in its goal of improving primary care availability for growing numbers of Medicaid patients? Most states facing the decision of whether to use state funds to continue to pay for Medicaid primary care services at Medicare levels were unconvinced, and Medicaid fees returned to previous levels in 34 states as of January 1, 2015. A new study suggests that Medicaid patients' access to new primary care appointments in those states may suffer.
As the Affordable Care Act’s health insurance marketplaces begin their second year of open enrollment, LDI examines the current and potential impact of the ACA on the health of minority populations. This fifth post of a five-part series outlines the seldom-mentioned provisions for American Indians and Alaskan Natives.
As the Affordable Care Act’s health insurance marketplaces begin their second year of open enrollment, LDI examines the current and potential impact of the ACA on the health of minority populations. This fourth post of a five-part series describes the current initiatives to diversify the health care workforce with greater minority participation.
In spirit as well as new program models, the Affordable Care Act aims to address many of the long-standing health care-related disparities that exist for racial and ethnic minority populations. This is the third post in a five-part series describing the benefits and shortfalls of the ACA's implementation to date.