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SHADAC and SHARE Newsletter, January 16, 2013November 18, 2016:
News: January 16, 2013
New SHADAC 2011 ACS Products
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New SHADAC 2011 American Community Survey (ACS) Products
We have updated the SHADAC Data Center with the 2011 ACS insurance estimates and issued a State Chart Book using the new data. The maps and tables included in the Chart Book provide state-level insurance coverage estimates for the nonelderly population (age 0 to 64), children (age 0 to 18), and nonelderly adults (age 19 to 64). The chart book also presents separate estimates within each age group for the population with household incomes at or below 200 percent of the federal poverty level.
New Reform-Related Questions in the National Health Interview Survey (NHIS)
The National Center for Health Statistics (NCHS) made a number of changes to the NHIS questionnaire in response to new data requirements generated by the need to monitor the impacts of the Affordable Care Act (ACA) on the health care system. SHADAC released an Issue Brief describing these changes and how they will assist researchers and policymakers monitor and inform health reform.
SHADAC Providing Technical Assistance to States on Medicaid Income Conversion
On December 28, 2012, the Centers for Medicare and Medicaid Services (CMS) released guidance on state options for converting Medicaid and CHIP net income eligibility thresholds to equivalent modified adjusted gross income (MAGI) thresholds. As a contractor to the Department of Health and Human Services (DHHS), SHADAC is providing technical assistance to states to help them decide which conversion methods to use, and to help them implement the conversions with state data if they choose this method. States seeking technical assistance can contact SHADAC via e-mail at firstname.lastname@example.org or via phone at 612-486-2439.
Sara Rosenbaum to Lecture on the Future of Health Reform at the University of Minnesota
Sara Rosenbaum, the Harold and Jane Hirsh Professor of Health Law and Policy at George Washington University School of Public Health and Health Services, will present the Tenth Annual Deinard Memorial Lecture on Law & Medicine, “Slouching toward Health Reform: The Future of the Affordable Care Act,” at the University of Minnesota. SHADAC Director and University of Minnesota Professor Lynn Blewett will provide comments. The lecture is sponsored by the Joint Degree Program in Law, Health & the Life Sciences and the Center for Bioethics, and it will take place on January 31, 2013, from 11:30 a.m. to 1:00 p.m. CDT, in the Coffman Memorial Union Theater. Click here to register for the event, which is free and open to the public.
News from the States
Analysis of Oklahoma's Efforts to Streamline Enrollment Systems
In a new HealthAffairs article, “Hard Work Streamlining Enrollment Systems Pays Dividends to the Sooner State,” NASHP Program Director and MaxEnroll Co-Director Alice Weiss examines Oklahoma’s pioneering efforts to streamline and modernize Medicaid enrollment. Oklahoma is the only state so far to implement an online application system for Medicaid, and its automated eligibility determination system for Medicaid is among the most modern and efficient nationwide, with the state is expected to achieve a nearly three-to-one return on its investment in 2015.
ACA Economic Impact Analyses: Arkansas, California, Iowa, and Missouri
“The Economics Impact of the Affordable Care Act on Arkansas,” prepared by RAND for the Arkansas Center for Health Improvement, projects that 400,000 Arkansans will gain coverage under the ACA. Medicaid is expected to grow by approximately 190,000 new enrollees, with the remainder of the newly insured purchasing coverage through Arkansas’ State Partnership Exchange. The report estimates that in 2016, Arkansas will see an influx of approximately $1.5 billion in federal dollars for the Medicaid expansion and exchange subsidies, a $67 million decrease in state spending on uncompensated care, and a $3 million increase in state spending on new Medicaid enrollees who were eligible prior to the expansion.
“Medi-Cal Expansion under the Affordable Care Act: Significant Increase in Coverage with Minimal Cost to the State,” is authored by researchers at the UC Berkeley Labor Center and the UCLA Center for Health Policy Research and estimates that the California’s Medicaid program will see an enrollment increase of between 990,000 and 1,420,000 by 2019. Overall, the federal government will pay for at least 85 percent of the total new Medi-Cal spending between 2014 and 2019, including spending for the newly eligible and the already eligible.
Milliman prepared a financial impact review of the ACA on Iowa’s Medicaid budget for the Iowa Department of Human Services. The report estimates approximately 182,000 new Medicaid enrollees (a 37 percent increase) under a scenario of moderate participation and approximately 114,000 new enrollees (a 23 percent increase) under a low participation scenario. The total fiscal impact to Iowa’s Medicaid budget from 2013 to 2020 (state fiscal years) would range from a savings of $72 million under low participation to a cost of $237 million under high participation.
“The Missouri Medicaid Expansion: Good for All Missourians,” prepared jointly by authors from Washington University, the Missouri Budget Project, and Saint Louis Missouri School of Law, estimates the impact of Medicaid expansion in Missouri at the local level. The report concludes that the most dramatic impact will be felt in rural areas. Of the state’s 114 counties, the biggest eligibility growth is anticipated in rural ones: In 21 rural counties, more than 10 percent of the county population would be eligible for Medicaid under the expansion. The Medicaid initiative is estimated to bring an additional $1.56 billion in federal funds into the state’s economy in 2014.
Data Update: Revisions to SHADAC-Enhanced Current Population Survey (CPS)
The SHADAC Data Center has been updated to include revised SHADAC-Enhanced CPS estimates for calendar years 2000 to 2009. The CPS uses population controls based on the 2000 Census for calendar years 2000 to 2009 while using population controls based on the 2010 Census for calendar years 2010 and 2011. To ensure a consistent time series, SHADAC researchers averaged the SHADAC-Enhanced CPS estimates for 2000 to 2009 so that they occur linearly across years based on actual population growth as determined by the 2010 Census.
Report: Data-Based Approaches to Determining Affordable ESI Access among Exchange Applicants
The Urban Institute released a report titled, “Access to Employer-Sponsored Insurance and Subsidy Eligibility in Health Benefits Exchanges: Two Data-Based Approaches.” The report was commissioned by the California HealthCare Foundation and addresses the question of how the new health insurance exchange can assess whether an applicant has access to affordable employer-sponsored insurance. The report identifies two data-based approaches that exchanges can use: One approach relies on Medicaid Third Party Liability (TPL) or Medicare coordination-of-benefits data to develop a list of all employers within the state that offer ESI, and one relies on the Urban Institute’s Health Policy Simulation Model (HIPSM) to target post-enrollment audits based on each consumer’s likelihood of being offered ESI.
Webinar: Employer Use of the Massachusetts Health Connector - Lessons for ACA Implementation
The Robert Wood Johnson Foundation’s Health Care Financing and Organization (HCFO) Program will host a webinar featuring Wake Forest University Professor Mark Hall, JD. Professor Hall will review findings from his HCFO-funded analysis of lower-than anticipated employer use of the Massachusetts Health Connector, and he will discuss the implications of these findings for states designing and operating Small Business Health Options (SHOP) exchanges under the Affordable Care Act. The webinar will take place on January 24, 2013, from 1:00 p.m. to 2:30 p.m. EDT. Register for the webinar here.
Save the Date: SHADAC and HCFO Webinar on the American Community Survey (ACS)
SHADAC and the Health Care Financing & Organization (HCFO) program will jointly host a webinar on the use of the ACS for state health policy research. SHADAC Senior Research Fellows Elizabeth Lukanen and Joanna Turner will discuss the topics that are included in the ACS, the advantages and disadvantages of the ACS relative to other data sources, what data can be linked to the ACS, and how researchers can obtain access to the survey data. Urban Institute Senior Fellow Genevieve Kenney will discuss the use of ACS data in her work researching health insurance coverage among low-income children and families. The webinar will take place on March 7, 2013, from 1:00 p.m. to 2:30 p.m. EDT. Registration information will be posted to the SHADAC website as soon as it is available.
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