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.

Chart of the Day: Adverse Tiering for HIV/AIDS Patients

Aug. 3, 2017

It’s called “adverse tiering” and it’s a benefit strategy designed to dissuade patients with expensive chronic conditions from enrolling in marketplace plans. The ACA prohibited plans from refusing to cover patients with pre-existing conditions and from charging them higher premiums. To avoid high-cost patients, some plans have structured their formularies to require substantial cost sharing for drugs in a certain class, particularly for expensive conditions such as HIV/AIDS.

The Economics of Medicaid Reform and Block Grants

Jun. 27, 2017

Paula Chatterjee, Benjamin D. Sommers

In The JAMA Forum, Paula Chatterjee and colleagues explore the rationale for and potential effects of repealing the Affordable Care Act (ACA). The authors argue that Medicaid will be disproportionately affected, as 12 of the 20 million individuals who gained coverage through the ACA are on Medicaid. They assess arguments for Medicaid reform, examine policy implications, and explore potential effects on patients. They examine how these changes would affect current Medicaid payment models, and posit that providers may be more limited in services they can offer to Medicaid recipients...

‘A Giant Step in the Wrong Direction’

Jun. 26, 2017

Forty economists and health policy experts, including Dan Polsky and Zeke Emanuel, have signed a strongly worded letter opposing the Better Care Reconciliation Act (BCRA), the Senate proposal to repeal the Affordable Care Act.

Market environment and Medicaid acceptance: What influences the access gap?

May. 1, 2017

Amy Bond, William Pajerowski, Dan Polsky, and Michael R. Richards

In Health Economics, LDI Fellow Amelia Bond and colleagues raise important questions about potential positive effects of provider and insurer concentration on primary care appointment availability for new Medicaid patients. The study assesses whether the two health care industry trends of expanding Medicaid and greater integration and consolidation among insurers and providers may have implications for each other.

Using “secret shopper” data on primary care physicians' real-world behavior, the authors observed provider willingness to accept new privately insured and...

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