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From this page you can view our recent publications, listed below with the most recent at the top of the list.

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Medicaid Block Grants: Lessons from Rhode Island's Global Waiver
Publication Year: 2013

This brief highlights findings from the SHARE-funded research project led by Dr. Edward Alan Miller (University of Massachusetts Boston) to evaluate the structure and implementation of the Rhode Island Global Consumer Choice Compact Medicaid Waiver (the "Global Waiver").  The authors discuss select findings from this project and the implications of these findings for the debate about block granting Medicaid and for health reform generally.  

Translating Modified Adjusted Gross Income (MAGI) to Current Monthly Income
Publication Year: 2013

The ACA specifies a standard definition of income--Modified Adjusted Gross Income (MAGI)--that will be used to determine eligibility for both Medicaid and the Exchange-based premium tax credits and cost-sharing reductions.  The adoption of MAGI, which measures income annually, creates a number of issues for states, particularly when applying MAGI to eligibility determination for Medicaid, which measures income on a monthly basis.  

In this SHARE brief, Dr. John Czajka brief reviews the income that is included in MAGI and how income is currently counted in determining Medicaid eligibility.  Issues related to measuring MAGI on a monthly basis for Medicaid eligiblity determination are discussed, and Dr. Czajka offers some thoughts on how states might begin to address these issues in their application of MAGI to determine eligibility for Medicaid.

Income Eligibility for Assistance under the ACA: The Question of Monthly vs. Annual Income
Publication Year: 2013

Under the ACA, Medicaid eligibility is determined based on monthly income, while Exchange-based subsidy eligibility is based on annual income.  As a result, monthly income instability among low-income adults could result in subannual loss of Medicaid eligibility without any gain in eligibility for subsidized Exchange-based coverage because of lower-than-required annual income, leading to periodic coverage gaps.

In this issue brief, Dr. John Czajka presents findings from his SHARE-funded analysis of monthly income volatility among the population likely to be newly eligible for Medicaid under the ACA.  According to Dr. Czajka's analysis, more than a fifth of nonelderly adults with family incomes between 50 and 138 percent of poverty are likely to experience significant swings in monthly family income. This will lead to significant numbers of people gaining and then losing eligibility for Medicaid within the course of a given year while not being able to take advantage of subsidized coverage through the Exchange.

State Estimates of the Low-Income Uninsured Not Eligible for the ACA Medicaid Expansion
Publication Year: 2013

The Patient Protection and Affordable Care Act (ACA) will expand access to affordable health insurance for millions of Americans. In states that choose to implement the Medicaid expansion for low-income adults, Medicaid will provide an important new pathway to coverage. Yet, even in states that choose to expand Medicaid a significant proportion of the low-income nonelderly adult population will be excluded from the Medicaid expansion due to their immigration status. Legal permanent residents, in most circumstances, are ineligible for Medicaid benefits for the first five years during which they reside legally in the U.S. and unauthorized immigrants are excluded from Medicaid coverage. This brief provides the first state-specific estimates of the number of uninsured low-income adults that will potentially be excluded from the Medicaid expansion because of their immigration status.

Enhancing the Value of the American Community Survey for ACA Evaluation: Developing More Timely Estimates of Health Insurance Coverage
Publication Year: 2013

This brief explores the pathways by which subannual ACS estimates could be developed, the feasibility of these pathways, the challenges associated with the development of subannual estimates, and potential next steps to generate subannual estimates.  While the focus of this brief is on developing subannual state-level estimate of health insurance coverage in particular, the strategies discussed could apply to other measures (e.g., employment, family income, and housing arrangements).