Tag: Medicaid expansion
CRS issues report on DSH payments
Posted by Nikki Hurt on December 9, 2013
The Congressional Research Service (CRS) recently published a report about Medicaid disproportionate share hospital (DSH) payments. Since FY1993, DSH payments have been provided to hospitals that serve a high proportion of both uninsured and underinsured patients. Care provided to these patients is often uncompensated or compensated at low rates, rendering DSH payments necessary to help mitigate some of the financial strain associated with treating this patient population. The Affordable Care Act (ACA) was designed to help reduce the uninsured population, and as a result, a provision to reduce DSH payments was included in the law. The 2012 Supreme Court ruling, which made Medicaid expansion optional for states, did not change the DSH payment reduction provision. The final rule outlining the DSH reduction methodology does not take into account a state’s decision on Medicaid expansion, so some states may experience a reduction in DSH payments without the intended accompanied increase in insured individuals. The new CRS report provides an overview of DSH payments, including allocation methodology, current trends in DSH spending, and implications on states after full implementation of the ACA.
Update: Ohio expands Medicaid
Posted by Nikki Hurt on October 22, 2013
After the measure to expand Medicaid failed in the Legislature this summer, the Ohio Controlling Board voted 5-2 to approve Medicaid expansion under the Affordable Care Act (ACA). This decision, which will likely be met by a multitude of legal challenges in the coming months, makes Ohio the 25th state to accept enhanced federal funding to help insure the state’s most impoverished residents. Our map has been updated to reflect these changes.
Medicaid Map Update: Expansion likely in Ohio
Posted by Nikki Hurt on October 14, 2013
The HealthReformGPS map documenting the current status of Medicaid expansion and Marketplace structure has been updated to reflect the likelihood that Ohio will be the newest state to expand Medicaid under the Affordable Care Act (ACA).
Medicaid Expansion and Health Insurance Marketplaces: One Map that Tells the Whole Story
Posted by Nikki Hurt on September 17, 2013
As full implementation is poised to begin, GPS staff have prepared a map designed to provide a status update in one visual. The map blends Medicaid and Marketplace information to present a more comprehensive view of states’ role in implementation, as the extent of their engagement in two central elements of the law, the Medicaid expansion and the establishment of Marketplaces.
The 16 states in blue are…
CMS releases final DSH rule for safety net hospitals
Posted by Nikki Hurt on September 13, 2013
In a final rule released today, the Centers for Medicare and Medicaid Services (CMS) stated that hospitals treating large low-income populations will begin to see a decline in their Disproportionate Share Hospital (DSH) payments. Typically, DSH payments are provided to hospitals that treat many uninsured and low-income populations as a means to offset some of the costs of rendering uncompensated care. DSH payments were set to decrease under the Affordable Care Act (ACA), as the individual mandate and expanded Medicaid eligibility requirements should have reduced the uninsured population. The Supreme Court ruling that state Medicaid expansion is optional hampered this goal, and a CMS fact sheet on the rule claimed that a state’s decision on whether or not to expand Medicaid will not influence the allotment of DSH payment hospitals in that state will receive. In total, CMS will cut $1.1 billion in DSH payments over the next two years.
Commonwealth study explores impact of forgoing Medicaid expansion on vulnerable populations
Posted by Nikki Hurt on September 5, 2013
A new study issued by the Commonwealth Fund found that 42% of those currently uninsured residing in states not expanding Medicaid will not have access to affordable health coverage. The study, In States’ Hands: How the Decision to Expand Medicaid Will Affect the Most Financially Vulnerable Americans, stated that the Supreme Court’s 2012 decision to make Medicaid expansion under the Affordable Care Act (ACA) optional for states will be particularly detrimental to those with the lowest incomes that do not meet Medicaid eligibility under conventional standards. Since about half of the states are not expanding Medicaid, about 2 of every 5 uninsured individuals will not be able to capitalize upon the expanded coverage provisions of the ACA.
CMS released Arkansas Medicaid expansion waiver
Posted by Nikki Hurt on August 14, 2013
The Centers for Medicare and Medicaid Services (CMS) has released the Arkansas waiver detailing how the state intends to use federal funding provided to them through the Affordable Care Act (ACA) to enroll their newly eligible Medicaid population into the state’s health insurance Marketplace. This novel approach to Medicaid expansion, known as premium assistance or premium support, received conceptual approval from CMS in March. Implementing this strategy would enable nearly 250,000 Arkansas residents to join Medicaid. The waiver is posted for public comment, and the submission deadline is September 7th, 2013.
Kaiser Family Foundation simulates impact of Medicaid expansion on local communities
Posted by Nikki Hurt on August 1, 2013
A new interactive feature released by the Kaiser Family Foundation indicates how the Affordable Care Act (ACA) may impact Medicaid enrollment and the uninsured demographic at the local community level. The interactive tool is accompanied by a report, as well as other interactive features, that describes how the Medicaid population will change after the ACA is implemented and how the uninsured population will decrease both in and amongst states post-ACA.
HHS announces funding for primary care residencies
Posted by Nikki Hurt on July 19, 2013
The US Department of Health and Human Services (HHS) announced today the awarding of $12 million in Affordable Care Act (ACA) funding to train more than 300 new primary care residents during the 2013-2014 academic year. The funds, administered by the Health Resources and Services Administration (HRSA), will be provided to 32 Teaching Health Centers in a total of 21 states throughout the country. Due to Medicaid expansion and the growing insured population resulting from the ACA, this allocation of funding is pivotal to meet the anticipated demand of primary care physicians.
CRS memo compares Medicaid and Exchange benefits and costs
Posted by Nikki Hurt on July 9, 2013
The Congressional Research Service (CRS) published a report analyzing the similarities and differences between Medicaid and insurance plans offered on state insurance Exchanges. Under the Affordable Care Act (ACA), the Medicaid expansion and premium subsidies offered through the Exchanges were intended to work in concert by providing insurance coverage to Americans with the lowest incomes. The Supreme Court ruling rendering Medicaid expansion optional threw a serious wrench in this core goal, leaving millions of Americans who would have received coverage through Medicaid expansion not only ineligible for the program, but also outside of the income bracket to qualify for Exchange subsidies. This report, Comparing Medicaid and Exchanges: Benefits and Costs for Individuals and Families, speaks to the complexities and issues that arise when attempting to compare benefits and costs offered through Medicaid and Exchange plans. Some of the most marked differences addressed include: variation in benefits covered by Medicaid and qualified health plans amongst states, cost-sharing requirements, and coverage issues concerning maintenance of effort and churning.