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SHADAC and SHARE Newsletter, February 6, 2013November 18, 2016:
News: February 6, 2013
SHADAC Collaborates on Fiscal Impact Analysis of the ACA Medicaid Expansion in Oregon
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SHADAC Collaborates on Fiscal Impact Analysis of the ACA Medicaid Expansion in Oregon
In its role as a technical assistance provider for the Robert Wood Johnson Foundation’s State Network initiative, SHADAC collaborated with Oregon Health and Science University (OHSU) and Manatt Health Solutions to produce an analysis of the fiscal effects of expanding Medicaid in Oregon under the ACA. The analysis, prepared for the Oregon Health Authority, projects that the Medicaid expansion would provide coverage to more than 240,000 newly eligible Oregonians and encourage approximately 20,000 previously eligible Oregonians to enroll in coverage. Analysts estimate $11.3 billion in new federal health care expenditures in the state and a net savings of $79 million to the state general fund from SFY 2014 through SFY 2020.
Recording Available: Lecture by Sara Rosenbaum on the Future of Health Reform
The Tenth Annual Deinard Memorial Lecture on Law & Medicine, “Slouching toward Health Reform: The Future of the Affordable Care Act,” took place at the University of Minnesota on January 31, 2013. Sara Rosenbaum, the Harold and Jane Hirsh Professor of Health Law and Policy at George Washington University School of Public Health and Health Services, was the keynote speaker and SHADAC Director and University of Minnesota Professor Lynn Blewett provided commentary. The lecture was sponsored by the Joint Degree Program in Law, Health & the Life Sciences and the Center for Bioethics. A recording of the event is available online.
SHARE Profile: Preliminary Findings from Connecticut’s Health Enhancement Program
Dr. Richard Hirth, Research Director at the Center for Value-Based Insurance Design (V-BID) at the University of Michigan, issued preliminary findings on Connecticut’s state employee Health Enhancement Program (HEP). The program provides financial incentives for participants to obtain high-value services and has thus far seen significant positive results: For example, monthly emergency room visits fell from approximately 3,500 in July 2011 to about 2,700 in May 2012. Dr. Hirth and his team are currently conducting a rigorous SHARE-funded evaluation of HEP to identify trends in utilization and expenditures made by HEP enrollees relative to control populations, with results available within the next year.
News from the States
12th Annual Kaiser 50-State Survey of Medicaid/CHIP Eligibility and Enrollment Policies
The Kaiser Family Foundation released findings from its 12th annual 50-state survey of eligibility, enrollment, renewal and cost-sharing policies in Medicaid and CHIP. The survey found that between January 2012 and January 2013: 11 states expanded eligibility for low-income families, 23 states simplified enrollment/renewal procedures, and four states decreased premiums and/or cost-sharing. Additionally, 47 states applied for or received increased federal funds to make major upgrades to Medicaid enrollment systems.
Impact of ACA on Hospital-Based Uncompensated Care in Minnesota
The Health Economics Program (HEP) at the Minnesota Department of Health (MDH) released an analysis estimating the impact that ACA implementation will have on hospital-based uncompensated care in Minnesota. HEP analysts estimate that hospital uncompensated care in the state will decline by about $134 to $168 million in 2016 as a result of implementing the ACA and providing a basic health plan, which is a reduction of nearly 60 percent from the base scenario without these changes. For more information on the relationship between insurance coverage and hospital uncompensated care costs, see “SHADAC Issue Brief #8, “Expanding Access to Health Insurance coverage Lessons the Burden of Uncompensated Care.”
ACA Economic Impact Analyses: Montana, Nebraska, Ohio, and New Hampshire
“Montana and Major Components of Healthcare Reform,” prepared by the Montana Department of Public Health and Human Services (DPHHS), projects that Montana’s Medicaid program will see an enrollment increase of between 53,594 (assuming low participation) and 79,801 (assuming high participation) by FY 2017. The report estimates that the FY 2017 financial impact to the state will range from approximately $2,250,000 in increased spending to approximately $11,000,000 in net savings.
Milliman prepared an updated analysis of the fiscal impact of the ACA on Nebraska’s Medicaid program for the Nebraska Department of Health and Human Services, Division of Medicaid and Long-Term Care (DHHS). The report estimates approximately 158,935 new Medicaid enrollees in SFY 2016 under a full participation scenario and 117,120 new enrollees under a mid-range participation scenario. The authors anticipate increased state spending from SFY 2013 through SFY 2020 ranging from $402.1 million under full participation to $285.3 million under moderate participation.
“Expanding Medicaid in Ohio: Preliminary Analysis of Likely Effects,” prepared jointly by authors from the Health Policy Institute of Ohio, Ohio State University, Urban Institute, and Regional Economic Models, Inc. (REMI), uses the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM) to estimate that the state would see net fiscal gains from 2014 through 2022 totaling $1,431 million. The report estimates that 456,000 uninsured Ohioans would gain coverage by 2022 through an expansion of Medicaid, reducing the projected number of uninsured in Ohio in 2022 from 1,091,000 to 635,000.
“An Evaluation of the Impact of Medicaid Expansion in New Hampshire,” prepared by researchers at The Lewin Group, estimates that total Medicaid enrollment in New Hampshire would grow by 62,200 under expansion by 2020, with the state’s number of uninsured dropping to approximately 71,000 in 2014. The authors estimate an $85.5 million cost to the state and a $2.5 billion cost to the federal government (which becomes designated revenue for the state) from 2014 to 2020.
Federal Poverty Guidelines for 2013
The Department of Health and Human Services released its 2013 federal poverty guidelines, which will be used to determine subsidies for health insurance purchased by low- and moderate-income people through the insurance exchanges beginning on October 1, 2013. The 2013 poverty guideline for one person is $11,490, and $23,550 is the guideline for a family of four. Details about the new guidelines and the method by which they were calculated are available in the January 24, 2013 Federal Register. To review the difference between federal poverty guidelines and federal poverty levels, read SHADAC’s blog post on the topic.
Medical Expenditure Panel Survey (MEPS) Statistical Briefs on Employer-Sponsored Insurance (ESI) and the Long-Term Uninsured
The Agency for Healthcare Research and Quality (AHRQ) released two new statistical briefs using MEPS data.
The National Center for Health Statistics (NCHS) has released several products from the January-June 2012 NHIS as part of its Early Release Program.
AcademyHealth, together with the Center for the Study of Social Policy, will host a webinar to provide an overview of efforts in California at the state and local levels to enroll newly eligible individuals and to reform the delivery system to accommodate the anticipated influx of new enrollees under the state’s expanded Medicaid program. The webinar will offer lessons for other states on enrollment and delivery system reform based on California’s experience. The event will take place on Wednesday, February 13, 2013, at 2:00 p.m. EDT. Register here.
SHADAC Blog Conference Updates
Scholarship Opportunity for State Officials: 2013 State Interest Group Meeting
The State Health Research and Policy (SHRP) Interest Group will host its annual meeting on Saturday, June 22, 2013, in Baltimore as an adjunct to the 2013 AcademyHealth Annual Research Meeting (ARM). A limited number of scholarships are available for state officials to cover the cost of travel and registration for the Interest Group meeting and the ARM itself (excluding hotel costs). To apply for a scholarship, please e-mail Hilary Kennedy by Friday, April 12, 2013, indicating the reason for your interest in attending and how your attendance and participation relates to your position as a state official.
Calls for Papers