Results from Survey of Minnesota's High Risk Pool Enrollees
The State Health Access Data Assistance Center (SHADAC), in conjunction with the Minnesota Comprehensive Health Association (MCHA), recently fielded a survey of MCHA enrollees to assess their potential eligibility for new coverage options in 2014, general characteristics, and awareness about the Affordable Care Act (ACA). Findings from this survey are summarized a newchartbook. The authors found that more than half of MCHA enrollees have incomes above 400 percent of the Federal Poverty Guideline and will likely not be eligible for Medicaid or subsidies through the exchange (nine percent are likely eligible for Medicaid, and 37 percent are likely eligible for subsidies). In addition, more than 80 percent of enrollees are unfamiliar with how health reform may impact their health insurance coverage, indicating that MCHA administrators face a significant amount of work conducting outreach and education about the new coverage options available in 2014. If the profile of Minnesota’s high-risk pool enrollees is indicative of high-risk pool membership more broadly, these findings are relevant for a number of other states and the federal government, whose high-risk pool populations will be moving to new coverage in 2014.
Analysis of Possible Improvements to Coverage Measurement in the Current Population Survey (CPS)
In a newworking paperprepared for the U.S. Census Bureau, SHADAC researchers describe their evaluation of possible improvements to the measurement of health insurance coverage in the CPS Annual Social and Economic Supplement. Between March and May 2010, the Census Bureau tested a set of experimental health insurance coverage questions that were developed with the goals of improving the measurement of past-year coverage and providing a richer set of coverage measures, including point-in-time coverage and duration of coverage measures. SHADAC evaluated this test, and the results of SHADAC's evaluation informed revisions to the question series, which was re-tested in March 2013 in context of the full survey (a "content test"). Pending results from the content test, the Census Bureau will make a final decision about implementing the re-designed question series later this year.
News from the States
ACA Impact Analyses: Pennsylvania, West Virginia
“An Analysis of Medicaid Expansion in Pennsylvania,”was prepared by the Pennsylvania Independent Fiscal Office and estimates the fiscal and economic impact of an ACA Medicaid expansion in the state from 2014 through 2021. The analysis projects that the state’s Medicaid enrollment would grow by 182,000 through 2021 with no expansion and by 589,000 through 2021 under full expansion. Gross State Product and total taxable income for Pennsylvania would increase by $3.0 billion and $2.0 billion, respectively, under full expansion in 2016 and would continue to grow gradually, reaching $3.3 billion and $2.2 billion in 2021.
Areportprepared by CCRC Actuaries for the West Virginia Offices of the Insurance Commissioner uses actuarial analyses and the Gruber Microsimulation Model (“GMSIM”) to estimate the financial impact of expanding Medicaid in the state and to project population insurance coverage under an expansion scenario. The authors estimate that between 2014 and 2023, West Virginia’s Medicaid/CHIP spending (state dollars only) would increase by $351.5 million (17.6%) under an expansion scenario and decrease by $26.5 million (1.3%) under a non-expansion scenario. The authors also estimate that the state’s projected number of uninsured in 2016 would drop by 45,000 under expansion, falling to 76,000 (from 121,000 under a non-expansion scenario).
New Jersey's Long-Term Uninsured Adults Who Are Eligible for Coverage under the ACA
A newreportfrom the Rutgers University Center for State Health Policy uses data from the Center's New Jersey Family Health Survey (NJFHS) to describe the socio-demographic characteristics, health status and access to care of the non-elderly (age 19 to 64) long-term (12 months or more) uninsured population in New Jersey that is eligible to gain Medicaid or subsidized private coverage under the ACA. According to the report, the Medicaid-eligible portion of this population is more likely than existing Medicaid enrollees to be male, childless, non-citizen, and Hispanic; to report some perceived barrier to care; and to exhibit low utilization. The subsidy-eligible portion of this group is more likely than comparable non-group respondents to be unmarried and Hispanic; to report poorer perceived health; and to report inferior access to care.
Distribution of the Uninsured by PUMA: Interactive Map
Enroll America released aninteractive mapping toolthat shows the distribution of the nonelderly uninsured in any given state by Public-Use Microdata Area (PUMA; an area within a state that contains at least 100,000 residents). Clicking on any PUMA in a state provides details about the number of uninsured and their distribution by income, age, and race/ethnicity. The estimates used for the tool were produced by the Centers for Medicare and Medicaid Services (CMS) and the Assistant Secretary for Planning and Evaluation (ASPE) using the 2011 American Community Survey (ACS).
MEPS Briefs: Access and Experiences Regarding Health Care; Changes in Employer-Sponsored Insurance Premiums
A newbrieffrom researchers at the Agency for Healthcare Research and Quality (AHRQ) analyzes access to health care and quality of care received by non-elderly adults in the U.S., as reported by respondents to the Fall 2010 Household Component of the Medical Expenditure Panel Survey (MEPS-HC). Among key findings from the report: Individuals ages 18-64 who were uninsured were the least likely (62.0%) to report usually or always being able to get needed medical care (compared to being unable to access care or having to delay care); their counterparts with private insurance were the most likely (84.6%) to report usually or always having access to care when needed. Uninsured individuals ages 18 to 64 were also more than twice as likely (61.9%) as those with public-only (27.3%) or private insurance (26.4%) to report having had no medical office or clinic visits in the previous 12 months.
Asecond AHRQ briefanalyzes changes in premium prices for employer-sponsored insurance (ESI) based on results from the Insurance Components of the 2008 and 2011 MEPS (MEPS-IC), estimating average premiums for 2011 and changes relative to 2008 by type of coverage (single, employee-plus-one, and family). The report estimates that average premiums in 2011 were $5,385 for single coverage, $10,524 for employee-plus-one coverage, and $15,206 for family coverage. From 2008 to 2011, the overall change in average annual health insurance premiums for family coverage was 20.7 percent.
Educating Consumers about the ACA Premium Tax Credits
A newreportproduced by the Consumers Union and Kleimann Communication Group presents findings from a study of consumer responses to a newbrochurethat aims to clarify the advanceable and refundable features of the new tax credits that will be available to lower- and middle-income families for insurance coverage purchased through the Exchange in 2014. The report's authors found that the brochure provided consumers with a “useable idea” of whether they would qualify for tax credits, and it inspired them to take action if they did qualify. The authors recommend that the brochure (which is in the public domain) or similar materials be widely used to raise consumer awareness of premium tax credits. The findings from this study will be discussed in two upcoming webinars, one on May 21, 2013, from 1:30 - 2:30 ET, and one on May 23, 2013, from 2:30 - 3:30 ET (register).
Joanna Turner Elected Secretary/Treasurer for Social Statistics Section of the American Statistical Association
SHADAC Senior Research Fellow Joanna Turner was elected to serve as 2014-2015 Secretary/Treasurer of theAmerican Statistical Association’s Social Statistics Section. The Social Statistics Section seeks to advance research in social statistics, both in areas involving the use of statistical methods of inquiry and in areas involving the use of statistical data and the development of statistical measurement. Ms. Turner, who will take office on January 1, 2014, has previously been involved in the Social Statistics Section as the Publications Officer. She came to SHADAC in 2010 after nine years as a statistician at the U.S. Census Bureau, where she worked on the American Community Survey, the Current Population Survey, and the Small Area Health Insurance Estimates program.
Jessie Kemmick Pintor, SHADAC Research Assistant and PhD student in Health Services Research, Policy and Administration, has been awarded a highly competitiveDoctoral Dissertation Fellowship(DDF) from the University of Minnesota for the 2013-2014 academic year. Her proposed dissertation is titled, "Latino Children at the Intersection of Immigration and Health Care Policy: A Mixed Methods Study of Parental Documentation Status, State-Level Policy, and Access to Coverage and Care." The DDF selection committee evaluates applicants based on progress in their program, publications, presentations, research, and potential for impact in their field.
Come visit the SHADAC booth (#309) at the 2013 AcademyHealth Annual Research Meeting, from June 23-25, 2013, in Baltimore, MD. SHADAC experts will be available to answer your questions about state and national data sources on coverage and access, to discuss our technical assistance offerings, and to walk you though theSHADAC Data Center.
Calls for Papers
Society for Medical Decision-Making 2013 Annual Meeting
Abstract submission deadline: May 17, 2013. View the call for papers.
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.