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University of Wisconsin–Madison
Poverty-related issues in the news, from the Institute for Research on Poverty

Tag: Health care costs

State Medicaid Programs – Oklahoma, Maine, Ohio

  • Oklahoma Medicaid approved for drug pricing experiment, By Ken Miller and Ricardo Alonso-Zaldivar (AP), July 13, 2018, ABC News: “The federal Centers for Medicare and Medicaid Services has approved Oklahoma’s Medicaid program for a first-in-the-nation drug pricing experiment that supporters say could save taxpayer dollars and provide patients with the most effective medications for their ailments. Under the ‘value-based purchasing’ program approved in late June, the state and a pharmaceutical company would agree to a set payment if its medication works as advertised, but only a fraction of that if the drug is not as effective as promised…”
  • Lawmakers await details on LePage’s plan for hospital tax to fund Medicaid expansion, By Kevin Miller, July 18, 2018, Portland Press Herald: “Maine’s highest court will hear arguments Wednesday over the LePage administration’s refusal to begin offering Medicaid coverage to tens of thousands of additional adults. Meanwhile, lawmakers and a representative for Maine’s hospitals say they have yet to see a formal plan from Gov. Paul LePage’s office detailing his 3-week-old proposal he made last month to pay for Medicaid expansion by increasing taxes on hospitals…”
  • Ohio Medicaid’s mental, addiction benefits achieve equality with physical care: state report, By Laura Hancock, July 18, 2018, Cleveland Plain Dealer: “Once Ohio Medicaid patients with mental health or addiction problems enter the health care system, they must be treated on par as those with physical ailments. That means no extra co-pays, prior authorizations or limits on hospitalization or counseling that wouldn’t be imposed on physical health care in Medicaid. The barriers that many patients in the mental health system know too well are supposed to have been recently eliminated. According to a recent report, the Ohio Department of Medicaid is now complying with a federal law that requires equality – technically called ‘parity’ in the health care world – between benefits for mental and physical health care…”

State Medicaid Programs

  • Medicaid is a lifeline for nearly half of this county’s residents, By Phil Galewitz, March 27, 2018, CNN Money: “On a crisp sunny day, Tyson Toledo, a precocious 5-year-old boy, hobbled into a private health clinic to have his infected foot examined. Pediatrician Gayle Harrison told his mother to continue to apply antibiotic ointment and reminded them to come back if the swelling and redness worsened. The appointment at Rehoboth McKinley Christian Health Care Services’ outpatient center in Gallup, New Mexico, comes at no charge for the Toledo family, who live 30 miles away on the Navajo Nation Reservation. That’s because Tyson is covered by Medicaid, the government health insurance program for the poor…”
  • California Medicaid expansion enrolled hundreds of thousands of ineligible people, federal report finds, By Chad Terhune, March 26, 2018, Los Angeles Times: “California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services Department’s chief watchdog…”
  • Utah governor signs Medicaid expansion bill. Now, Utah waits to see if the feds will approve it., By Luke Ramseth, March 28, 2018, Salt Lake Tribune: “Gov. Gary Herbert signed a measure Tuesday to give more than 70,000 needy Utahns access to government health coverage, ending years of failed attempts on Capitol Hill to expand Medicaid in the state. But whether House Bill 472 ever takes effect still remains uncertain. Under President Obama’s signature Affordable Care Act (ACA), the Utah law needs approval by the federal Centers for Medicare and Medicaid Services (CMS), which has sent mixed signals on whether it will fully sign off…”

State Medicaid Programs

  • Virginia Republicans divided on Medicaid expansion, By Megan Pauly, March 14, 2018, National Public Radio: “Virginia is among 18 states that have not expanded Medicaid under the Affordable Care Act. But this year, the state legislature is going into a special session to continue discussions about whether or not to include it in its budget. By the time the regular session adjourned Saturday, members of Virginia’s GOP-controlled House of Delegates and Senate could not reach agreement on whether or not to expand Medicaid…”
  • Proposed Medicaid work requirements could end up costing Minnesota, By Glenn Howatt, March 18, 2018, Star Tribune: “Republican legislators who are proposing work requirements for Minnesota’s Medicaid recipients say it would promote personal responsibility and save taxpayer dollars, but doctors and county officials who work in the system predict that people would lose needed health care in exchange for savings that are likely to disappoint…”
  • Mississippi Medicaid saves $4.6M in one year by identifying unnecessary, expensive scripts, By Anna Wolfe, March 22, 2018, Clarion Ledger: “By identifying unnecessary, expensive prescriptions covered by the state’s Medicaid program, Mississippi officials say they’ve saved nearly $5 million…”
  • Expanding Medicaid to cut Medicaid: Texas turns to Trump administration to fund family planning, By Phil Galewitz and Anna Gorman, March 22, 2018, St. Louis Post-Dispatch: “President Donald Trump’s administration is weighing whether to allow Texas to receive millions of federal Medicaid dollars for its family planning program, which bars abortion providers.  The Lone Star State eliminated its Medicaid-funded family planning program five years ago when state officials said they wanted to specifically exclude Planned Parenthood because the group provides abortions. Dozens of women’s health clinics closed as Texas established a wholly state-funded program that officials say today serves 220,000 women…”

Safety Net Hospitals

‘Safety net’ hospitals face federal budget cuts, By Michael Ollove, January 16, 2018, Stateline: “A double whammy of federal budget cuts might force many hospitals, particularly those that serve poor or rural communities, to scale back services or even shut their doors. The $3.6 billion in cuts this year — $2 billion from a program that sends federal dollars to hospitals that serve a high percentage of Medicaid or uninsured patients, and $1.6 billion from a drug discount program — will have the greatest effect on so-called safety net hospitals that provide medical care for all comers, no matter their ability to pay…”

Community Health Clinics

Congress won’t act; Now community health centers weigh closures, By Michael Ollove, December 18, 2017, Stateline: “Unless Congress provides funding before the end of the year, many of the nation’s 9,800 community health clinics will face service cuts or closure — potentially crippling a vital part of the health system that provides care in poor and underserved communities across every state. And the fallout could mean the loss of more than 160,000 jobs and a hit to state economies of more than $15 billion as staff cutbacks and layoffs ripple through the country. California alone could lose up to 15,841 jobs and nearly $1.7 billion next year…”

States and Medicaid Expansion

  • LePage says he’ll block voter-approved Medicaid expansion unless legislators fund it, By Scott Thistle, November 8, 2017, Portland Press Herald: “Just hours after a Medicaid expansion was endorsed by nearly 60 percent of Maine voters, Gov. Paul LePage and his Republican allies vowed to delay, if not derail, the citizen-initiated law that would provide health care to as many as 70,000 low-income residents of the state…”
  • Election results invigorate Medicaid expansion hopes, By Abby Goodnough and Margot Sanger-Katz, November 8, 2017, New York Times: “The election results in Maine and Virginia have energized supporters of expanding Medicaid under the Affordable Care Act in several holdout states. After months of battling Republican efforts to repeal the law, they now see political consensus shifting in their direction…”
  • Medicaid expansion takes a bite out of medical debt, By Alex Smith, November 10, 2017, National Public Radio: “As the administration and Republicans in Congress look to scale back Medicaid, many voters and state lawmakers across the country are moving to make it bigger. On Tuesday, Maine voters approved a ballot measure to expand Medicaid under the Affordable Care Act. Advocates are looking to follow suit with ballot measures in Utah, Missouri and Idaho in 2018…”

State Medicaid Programs – Iowa, Maine

  • Medicaid cuts to roughly 40,000 Iowans approved by the feds, By Clark Kauffman, October 31, 2017, Des Moines Register: “Over the protests of hospitals and medical providers, Iowa has received federal approval to reduce coverage for new Medicaid beneficiaries. An estimated 40,000 Iowans are expected to be affected by the change, which will reduce their coverage for medical care delivered in the days and weeks before they are officially declared eligible for Medicaid…”
  • Maine voters to decide if state will expand Medicaid, By Casey Leins, November 1, 2017, US News & World Report: “On Nov. 7, Maine voters will be the first in the nation to determine the fate of Medicaid expansion in their state. The issue has been a contentious one in Maine since the 2012 Supreme Court ruling granting states the power to decide whether to expand the program to more low-income Americans. Republican Gov. Paul LePage has vetoed the legislature’s five attempts to expand Medicaid, arguing that it is a measure of ‘pure welfare’ that would significantly impact taxpayers, according to The New York Times…”

Medicaid Enrollment

Report: Medicaid enrollments, costs begin to stabilize, By Christina A. Cassidy (AP), October 19, 2017, Washington Post: “States are seeing more stability in their Medicaid programs after experiencing a surge in enrollment and costs associated with the Affordable Care Act, suggesting that one of the major pillars of former President Barack Obama’s health overhaul may be nearing its peak. At the same time, they are experiencing a high level of uncertainty as Republicans in Congress continue to advocate for a major overhaul of a program that provides health insurance to tens of millions of lower-income and disabled Americans…”

Mobile Health Clinics

Mobile clinics assume greater role in preventive care, By Scott Rodd, October 11, 2017, Stateline: “One afternoon last month, the Family Van stopped at the corner of Washington and Roxbury streets in Boston. The regulars had already formed a line, waiting in the lingering summer heat for the red and green RV to arrive. The Family Van, which is funded in part by Harvard Medical School, provides free blood pressure tests, HIV counseling and basic medical care to underserved neighborhoods across Boston. The van has been operating since 1992, and mobile health clinics like it have been around for decades, but they are assuming a more prominent role as the U.S. health care system places a greater emphasis on preventive care…”

State Medicaid Programs – Pennsylvania, New York

  • Gov. Wolf to veto controversial Medicaid work requirement bill, By Kate Giammarise, October 5, 2017, Pittsburgh Post-Gazette: “Gov. Tom Wolf will veto a budget-related bill passed by the Republican-controlled state House and Senate that would have required the administration to include a work-search requirement in the Medicaid program and could have limited certain Medicaid benefits…”
  • Erie County’s white Medicaid recipients cost taxpayers the most money, By Sandra Tan, October 6, 2017, Buffalo News: “The Medicaid costs for Erie County residents enrolled in the government health care program are expected to soon crack $2 billion even though the number of local Medicaid recipients has leveled off after years of growth. White Medicaid recipients are the ones costing the program more, according to a Medicaid data report being released today…”

At-Home Health Care

The return of the doctor house call, By Mattie Quinn, September 28, 2017, Governing: “‘Do you hear that?’ asks Beth Hungate, as she walks into an apartment in the historic neighborhood of Richmond, Va., known as ‘the Fan.’ Hungate, a nurse practitioner at Virginia Commonwealth University’s (VCU) medical center, is there to see a patient of hers, a woman named Luckie Locke. Locke has been in quite a bit of discomfort recently and requested that Hungate stop by. But as Hungate walks through the door, she notices an incessant beeping noise. Hungate scans the apartment for the source of the beeping; eventually she traces it to a carbon monoxide detector. She calls her clinical coordinator to get a nonemergency fire department truck to come by. ‘You see? I would have never known this if I wasn’t coming to her house,’ Hungate says…”

State Medicaid Programs – New Mexico, Colorado

Community Paramedic Program

These house calls save money for EMS, social services, By Robert Mittendorf, September 4, 2017, Bellingham Herald: “Bellingham Fire Capt. Jeff Brubaker carries a pager like any other firefighter, and he still uses his paramedic skills to help people. But these days he’s not riding a fire engine or an ambulance and most of his patients haven’t called 911. Not as much as they used to, at least. Brubaker is Bellingham Fire Department’s community paramedic, a relatively new position that puts him in touch with people who are frequent 911 callers but who don’t need emergency care…”

Health Insurance Coverage in the US

  • More people remain insured since Obamacare, CDC says. But many pay more out of pocket, By Daniel Chang, August 29, 2017, Miami Herald: “More Americans had health insurance during the first three months of 2017 than before the Affordable Care Act became law in March 2010, according to the National Health Interview Survey released Tuesday — but more have coverage with high out-of-pocket costs, which can discourage patients from visiting the doctor and filling a prescription…”
  • Bipartisan group of governors calls on Congress to shore up elements of Affordable Care Act, By Amy Goldstein, August 31, 2017, Washington Post: “A bipartisan group of governors is trying to jump-start efforts to strengthen private insurance under the Affordable Care Act, urging Congress to take prompt steps to stabilize marketplaces created by law while giving states more freedom from its rules…”

Medicaid Expansion – Nevada

High-stakes health-care debate hits Nevada’s Medicaid program, By Ben Botkin, August 5, 2017, Las Vegas Review-Journal: “Marta Jensen, Nevada’s point person on Medicaid, watched on C-SPAN recently as the U.S. Senate debated health care reform. She had four different bills pulled up on her computer. The stakes were high for Nevada. Each of the bills would have repealed at least parts of the Affordable Care Act and affected Medicaid, the federal-state program that provides poor and disabled Americans with medical coverage. More than one-fifth of the state’s residents now receive their health insurance through Medicaid…”

Safety Net Clinics – Minnesota

Safety net clinics in Minnesota face loss of federal funds, By Glenn Howatt, July 27, 2017, Star Tribune: “While the U.S. Congress continues to debate the future of Obamacare and Medicaid, Minnesota’s safety net clinics worry that they will lose $27 million in federal aid that helps pay for health care of the uninsured. Unless Congress acts by October to renew the funding, Minnesota’s 17 safety net providers would have to cut services and possibly close some of the more than 70 clinics across the state…”

Medicaid Privatization – Iowa

Medicaid firms spending less on care for Iowa’s poor, disabled, By Tony Leys, March 15, 2017, Des Moines Register: “The three private firms running Iowa’s Medicaid program have found ways to trim spending on care for the poor or disabled Iowans they cover, a new report suggests. But all three continue to lose tens of millions of dollars on the controversial project.  The companies’ per-member monthly spending on health care for adults fell by as much as 28 percent from the three months ending in September 2016 to the three months ending in December 2016, the new report shows…”

Health Care Spending – Massachusetts

Low-income communities see fewer health care dollars, AG report finds, By Priyanka Dayal McCluskey, October 13, 2016, Boston Globe: “Massachusetts’ health insurance market has an income inequality problem, according to a report from Attorney General Maura Healey’s office, whose findings mirror national studies.  The analysis found that more health care dollars are spent on higher-income communities than on lower-income communities — even though the latter tend to have greater medical needs. Healey’s office called this a ‘distressing’ trend that has persisted for years…”

States and Medicaid Expansion

  • How expanding Medicaid can lower insurance premiums for all, By Margot Sanger-Katz, August 25, 2016, New York Times: “The Obama administration for years has been pleading with states to expand their Medicaid programs and offer health coverage to low-income people. Now it has a further argument in its favor: Expansion of Medicaid could lower insurance prices for everyone else.  A new study published by in-house researchers at the Department of Health and Human Services compared places that have expanded their Medicaid programs as part of Obamacare with neighboring places that have not. They found that, in 2015, insurance in the marketplace for middle-income people cost less in the places that had expanded Medicaid…”
  • Controversial parts of Medicaid plan remain, By Tom Loftus and Deborah Yetter, August 25, 2016, Louisville Courier-Journal: “Gov. Matt Bevin’s administration unveiled its long-awaited plan to reshape the state’s Medicaid program Wednesday, and while it restores some benefits Bevin proposed be cut two months ago, it retains the most controversial components of the governor’s approach to overhauling the federal-state health plan for low-income and disabled Kentuckians.  Taking aim at the Medicaid expansion launched by his predecessor, Democrat Steve Beshear, under the federal Affordable Care Act, Bevin, a Republican, has said he wants to create a different program that includes more cost-sharing by consumers, encourages more personal responsibility, and brings the state’s soaring costs of Medicaid under control…”

Medicaid and Home Health Visits

House calls might save Medicaid money for states, By Michael Ollove, August 25, 2016, Stateline: “Doctors who make house calls may seem like something from America’s Norman Rockwell past. But they never disappeared entirely, and there is new evidence that home visits can play an important role in providing health care to the aged and chronically ill — while saving taxpayers millions.  The federal Centers for Medicaid and Medicare Services (CMS) said this month that a demonstration project has shown that delivering comprehensive primary care services at home helped to keep Medicare recipients with multiple chronic illnesses or disabilities out of hospitals, emergency rooms and nursing homes…”