The Impact of Medicaid Expansion on Uncompensated Care Costs: Early Results and Policy Implications for States
Since implementation of the Affordable Care Act (ACA), the 30 states that have expanded Medicaid have enrolled more than 10 million people in Medicaid or the Children’s Health Insurance Program and the collective rate of uninsured individuals in these states has fallen from 18 percent to less than 11 percent. Recent research by Manatt Health Solutions looked at the fiscal implications of expansion and found that, in addition to coverage gains, expansion states experienced significant budget savings and revenue gains. This issue brief, the third in this series prepared by Manatt Health Solutions, examines early data on expansion-related decreases in uncompensated care costs and related state budget implications.
The State Network 1332 Waivers Affinity Group continued with a webinar presentation by the team at Manatt Health Solutions. The initial webinar for this affinity group focused on the basics of the waiver process, as well as information on statutory guardrails and what can and cannot be waived. This most recent webinar investigates waiver possibilities more deeply, with more information on specific examples of what can be waived through this process.
The State Network hosted its Annual Meeting in New Orleans, LA on April 29 – May 1, 2015, bringing together state officials and technical experts to provide technical assistance and discuss lessons learned on continuing implementation of the coverage provisions of the Affordable Care Act (ACA). The Annual Meeting included peer-to-peer sharing between stakeholders from exchanges, Medicaid agencies, departments of insurance, and governors’ offices throughout the topic specific breakouts on key ACA implementation issues.
Waivers available under Section 1332 of the Affordable Care Act offer potentially great flexibility to states in achieving the goals of the ACA through very different means than originally envisioned. They take effect as early as January 1, 2017, and require legislative authorization, substantial public engagement, and negotiation with the federal government. Moreover, without grant dollars to fund the development process, unlike for the establishment of state-based exchanges, 1332 waiver proposals will present additional time and resource challenges for states.
States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by authorizing states to rethink the law’s coverage designs. Under State Innovation Waivers, states can modify the rules regarding covered benefits, subsidies, insurance marketplaces, and individual and employer mandates.
A recent report from Manatt Health Solutions reveals that early data from states that expanded Medicaid demonstrate consistent economic benefits, including budget savings and revenue gains. Data from eight states show $1.8 billion in budget savings by the end of 2015 as a result of Medicaid expansion. This webinar reviewed the findings from this study.
As some states continue to debate whether to implement Medicaid expansion under the Affordable Care Act, early results from those that have done so show the impact this decision has had on their state budgets. States that expanded the number of people eligible for Medicaid are seeing big budgetary savings without reducing services. This report, prepared by Manatt Health Solutions, analyzes data from eight states, showing $1.8 billion in budget savings by the end of 2015 as a result of Medicaid expansion.
As states continue to look for new ways to balance their budgets, early results from states that have expanded Medicaid show significant state budget savings after just the first year of expansion. Twenty-six states have expanded Medicaid—this brief focuses on the budget impact in two states: Kentucky and Arkansas.
As of January 27, 2015, two states have received approval from the Centers for Medicare and Medicaid Services to expand Medicaid through private market-based coverage. These premium assistance programs have paved the way for the non-expansion states who continue to discuss how they might expand their Medicaid programs. These new models offer viable alternatives for covering previously uninsured populations while addressing those states’ concerns about some of the budgetary, political, and market challenges associated with traditional Medicaid expansion.
Individual and Family Engagement in the Medicaid Population: Emerging Best Practices and Recommendations
In this issue brief, The Institute for Patient- and Family-Centered Care (IPFCC) outlines action-oriented recommendations and strategies to support enhanced individual and family engagement efforts in Medicaid. Research shows that engaged individuals and families actively working with their health care teams have better outcomes, often choose less expensive options when participating in shared decision-making, and express greater satisfaction with their health care experiences.