SHADAC Report: State Estimates of Low-Income Uninsured Who Are Ineligible for ACA Medicaid Expansion
A new SHADAC brief provides the first state-specific estimates of the percent of low-income uninsured nonelderly adults who will be ineligible for the ACA Medicaid expansion as a result of their immigration status—i.e., unauthorized immigrants and legal resident immigrants who have not yet completed five years of permanent U.S. residency. The report emphasizes that unauthorized immigrants and recent legal residents are much more likely than average to be low-income and uninsured. Because of this issue, the data in this report have significant implications for safety-net planning and capacity assessment.
SHARE Webinar: Joel Cantor to Present Expanded Findings from Young Adult Coverage Analysis
The next SHARE webinar will feature Dr. Joel Cantor, Director of the Center for State Health Policy at Rutgers University, who will address a range of questions from a SHARE-funded analysis building upon earlier work using the Current Population Survey to evaluate state and federal efforts to expand young adult dependent coverage. Dr. Cantor will be joined by Dr. Thomas Buchmueller, Professor of Risk Management and Insurance and Professor of Business Economics and Public Policy at the Ross School of Business at the University of Michigan, who will discuss findings from similar research on young adult coverage using the National Health Interview Survey (NHIS) and the Survey of Income and Program Participation (SIPP). The webinar will take place on Tuesday, April 2, 2013, from 1:30 p.m. to 2:30 p.m. EDT. Learn more and register.
SHARE-Funded Research in HSR: CHIP Coverage Outcomes Based on Income Eligibility and Premium Contributions
A research team led by José Escarce, MD, PhD, Professor of Medicine in the David Geffen School of Medicine at UCLA, published findings from its SHARE-funded research in an article in Health Services Research (HSR). The authors of the article, led by Carole Roan Gresenz, PhD, use a selection correction simulation model to examine the effects of Children's Health Insurance Program (CHIP) income eligibility thresholds and premium contribution requirements on health insurance coverage outcomes among children. They find that premium contribution requirements decrease enrollment in public coverage and increase enrollment in private coverage, with larger effects for greater contribution levels.
Jean Abraham Considers Health Policy Applications of Microsimulation Models in HSR
Jean Abraham, PhD, Associate Professor in the Division of Health Policy and Management at the University of Minnesota School of Public Health, published an editorial in Health Services Research (HSR) in which she examines the current and future use of microsimulation models to information U.S. health policy making. This analysis draws upon work conducted with SHADAC for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network.
Webinar Recording Available: Using the American Community Survey (ACS) for Health Services Research
On March 12, 2013, Changes in Health Care Financing and Organization (HCFO) sponsored a webinar on the use of ACS data to conduct health services research. SHADAC Senior Researchers Elizabeth Lukanen and Joanna Turner spoke at the event, discussing 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 and Research Associate Victoria Lynch provided a user perspective. A recording of the webinar is now available.
News from the States
Report: 2013 Cover Michigan Survey
The Center for Healthcare Research and Transformation (CHRT) at the University of Michigan releaseda report on findings from the 2013 Cover Michigan Survey. The survey, which has been conducted yearly since 2009, asks Michigan residents about key issues relating to health care coverage, access to care, and health status. This report compares data from 2010 and 2012 and focuses on the relationship between coverage status and access to care. Among other key findings, respondents who lacked coverage reported using emergency rooms and urgent care centers as their usual sources of care at considerably higher rates than those who had coverage.
Report: 2011 Massachusetts Household and Employer Insurance Surveys
A report prepared by the Massachusetts Division of Health Care Finance and Policy and released by the Center for Health Information and Analysis presents findings from the 2011 Massachusetts Household and Employer Insurance Surveys. According to the report, 97 percent of Massachusetts had health insurance coverage, and 76 percent of Massachusetts employers offered coverage in 2011. However, employers reported an increase in premiums in 2011, continuing a six-year trend of annual premium growth averaging six to seven percent.
2012 Ohio Medicaid Assessment Survey: Public Use Dataset Available
The public use data set for the 2012 Ohio Medicaid Assessment Survey—which examines health system access, health status, and health determinant characteristics of Ohio’s Medicaid, Medicaid-eligible, and non-Medicaid populations—is now available. The dataset includes all of the data collected during the survey except zip code and census tract and is available for download in SAS, STATA, SPSS, and R versions. SAS formats are also available.
ASPE Brief: MAGI Income Conversion Methodologies
The Assistant Secretary for Planning and Evaluation (ASPE) issued a research brief on methodologies for converting current state Medicaid income eligibility thresholds to the ACA’s Modified Adjusted Gross Income (MAGI) standard. The purpose of the brief is to provide background on the complexity of the income conversion process and context for how the recommended (i.e., “standardized”) conversion methodology was determined. The brief is also meant to provide additional context for states that are considering proposing alternative conversion methodologies to the Centers for Medicare and Medicaid Services (CMS) for approval.
HHS Brief Assesses State Readiness for Implementation of Streamlined Eligibility and Enrollment Systems under ACA
A new report from the Office of the Inspector General at the Department of Health and Human Services (HHS) assesses states’ readiness to implement streamlined systems for determining eligibility and enrolling applicants in state Health Insurance Exchanges, Medicaid, and the Children’s Health Insurance Program (CHIP) required under the ACA. Thirty-five of the 45 states that responded to a survey on the topic anticipate implementing the streamlined systems by January 1, 2014, although they reported a number of challenges to doing so, including funding issues and the need for additional information and guidance on certain topics.
Report: In States That Forgo Medicaid Expansion, Employers Will Face Higher ACA Tax Penalties
In states that opt not to expand Medicaid, workers between 100 and 138 percent of the Federal Poverty Level (FPL) may enroll in subsidized coverage through the Health Insurance Exchange, in which case their employers may face tax penalties under the “shared responsibility” provision of the ACA. A reportfrom Jackson Hewitt Tax Service, Inc., examines the tax impact for employers if states forgo the ACA Medicaid expansion. The report uses 2011-2012 Current Population Survey (CPS) data to estimate by state the number of nonelderly individuals working part-time who may be eligible for premium tax credits through the exchange. The report then provides state-by-state estimates of the potential tax liabilities for employers in the event of non-expansion.
The State Health Access Data Assistance Center (SHADAC) is a program of the Robert Wood Johnson Foundation and a part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota.