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.

What State Legislators Say About Medicaid, and Why It Matters

May. 29, 2018

Medicaid’s federal-state partnership structure has long permitted states to adopt modifications to coverage design, including benefits and cost-sharing. That structure, combined with an Administration signaling its support for greater state flexibility and funding constraints, could produce substantial shifts in state Medicaid policy.

The Future of Medicaid: State Legislator Views on Policy Waivers

Research Brief
May. 23, 2018

A survey of state legislators revealed clear partisan differences in Medicaid reform priorities and policy preferences that states are pursuing in Section 1115 waiver applications. While there was some agreement across parties on broad goals for the Medicaid program, such as reducing health care spending and increasing affordability of health care, there was little consensus on specific policy changes needed to meet these goals.

Safeguards Needed in Medicaid Work Requirements

May. 10, 2018

In a push to encourage “personal responsibility,” the Centers for Medicare and Medicaid Services (CMS) has approved work requirements as a condition for receiving Medicaid benefits in four states - Kentucky, Indiana, Arkansas, and most recently New Hampshire, with applications from other states pending.

Shift in U.S. Payer Responsibility for the Acute Care of Violent Injuries After the Affordable Care Act: Implications for Prevention

Apr. 11, 2018

Abstract [from journal]

Background: Investment in violence prevention programs is hampered by lack of clearly identifiable stakeholders with a financial stake in prevention. We determined the total annual charges for the acute care of injuries from interpersonal violence and the shift in financial responsibility for these charges after the Medicaid expansion from the Affordable Care Act in

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Prior Authorization Requirements for Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors Across US Private and Public Payers

Research Brief
Mar. 28, 2018

A comprehensive review of prior authorization (PA) requirements for a new class of expensive cholesterol-lowering drugs known as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors has found unusually complex and burdensome demands across public and private insurance plans in the United States. These findings raise concerns that current policies may create undue barriers to care even in medically appropriate patients, particularly since requirements were just as stringent for patients with a genetic condition that creates more clear-cut eligibility for PCSK9 inhibitor treatment.

Early Medicaid Expansion Associated With Reduced Payday Borrowing in California

Oct. 25, 2017

Heidi Allen, Ashley Swanson, Jialan Wang, Tal Gross

In Health Affairs, Heidi Allen and colleagues, including Ashley Swanson, analyzed the impact of California’s early Medicaid expansion under the Affordable Care Act (ACA) on the use of payday loans, a form of high-interest borrowing often used by low- and middle-income households. No studies to date have focused on how health insurance coverage affects the use of alternative financial products. This research is especially important given the documented relationship between poverty, medical debt, and bad credit outcomes.

Using a difference-in-differences research design, the...

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