A new study released by the Robert Wood Johnson Foundation and Urban Institute describes the financial burden of medical spending on a state-by-state basis. Using this information, the study hones in on the number of individuals per state that experience high burdens from medical spending, yet currently are not eligible for Medicaid. The study found that Medicaid expansion, under the Affordable Care Act (ACA), has the potential to mitigate the financial burden from medical spending for several vulnerable populations in various regions across the country.

A new report from the Robert Wood Johnson Foundation's State Health Access Data Assistance Center details the number of individuals estimated per state to be excluded from Medicaid coverage after implementation of the Affordable Care Act (ACA). Despite the vast increase in individuals that will gain access to insurance due to the ACA, there remain a large number of non-elderly, low-income adults that will still not be eligible for coverage, even in states that expand Medicaid. The basis for this exclusion is immigration status, as legal permanent residents, under most scenarios, remain ineligible for coverage for the first five years in which they legally reside in the US. Unauthorized immigrants are completely barred from receiving Medicaid.

A report recently released by the Robert Wood Johnson Foundation (RWJF) serves as a guide for states considering Medicaid expansion in the wake of the U.S. Supreme Court decision. The analysis in the RWJF report is limited to financial considerations related to a state’s decision to expand and therefore does not include many financial aspects related to the Affordable Care Act (ACA) as a whole (remaining mandatory provisions, for example). There are six main areas of financial analysis that all states should consider that are included in this report: 1. Cost of newly eligibles 2. Cost of currently eligible but not enrolled 3. Administrative costs 4. Savings from transitioning current Medicaid populations to newly eligible group 5. Savings from reduction in state programs for the uninsured 6. Other revenue gains and savings.

The Census Bureau report published yesterday found that the number of uninsured Americans fell to 48.6 million in 2011, or 15.7 percent of the population. This is the first drop in uninsured Americans since 2007. In 2010, 49.9 million people, or 16.3 percent of the population, were uninsured. Census Bureau officials attribute the drop in large part to provisions under the Affordable Care Act (ACA). The drop in the number of uninsured Americans was fueled by a significant drop in uninsured young Americans aged 19 to 25, from 29.8 percent in 2010 to 27.7 percent in 2011, the Census Bureau said. The rate also decreased among seniors. The Bureau also found that the percentage of Americans covered by private insurance remained flat at 63.9 percent. The percentage of Americans covered by government programs increased for the fifth consecutive year to 32.2 percent in 2011.

A report recently published by the Robert Wood Johnson Foundation in collaboration with State Health Access Data Assistance Center analyzes recent trends in health insurance coverage for children at the state level between 2008 and 2010. The percentage of children with public coverage through Medicaid or the Children’s Health Insurance Program (CHIP) increased substantially, while rates of private coverage and uninsurance declined. However, the report found substantial variation across states. The main findings of this report include the following...

Effective January 2014, the Affordable Care Act (ACA) establishes a new minimum Medicaid eligibility level of 138 percent of poverty for non-disabled adults who were not previously eligible for the program. As with current Medicaid, legal immigrants who have been in the country for five years or fewer are not eligible for this coverage. Nationally, 21.5 million currently uninsured nonelderly adults may meet the income and citizenship criteria to be eligible for Medicaid after the expansion. A brief recently released by the Kaiser Family Foundation uses the American Community Survey to describe the low-income uninsured adult population -- the target group for the Medicaid expansion under the Affordable Care Act -- by state. Many people in this target population have substantial health needs and face barriers to health care, and nearly half have incomes of 50 percent of poverty or less.

The Government Accountability Office (GAO) recently released a report on Medicaid expansion under the Affordable Care Act (ACA). The report does not take into account the June 28th United States Supreme Court decision. Congress asked the GAO to report on the actions states are taking to implement the Medicaid expansion. This report addresses the following questions...

An article entitled “New Estimates of Gaps and Transitions in Health Insurance,” recently published in the Medical Care Research and Review, explores the large numbers of Americans that experience gaps in health care coverage. According to the paper, eighty-nine million people—36.3 percent of Americans ages 4 to 64—were uninsured for at least one month between 2004 and 2007, including 23 million Americans who lost coverage more than once. To minimize disruptions in people’s care and exposure to high costs, the article recommends that policymakers consider steps to stabilize public and private coverage as they implement health reform. For a summary of the article, click here.