Racial/Ethnic Differences in Uninsurance Rates under the ACA (Research Report)
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This report is the first state-level projection of ACA coverage gains for racial/ethnic groups. Absent ACA coverage provisions, Latinos, blacks, and American Indian/Alaska Natives are overrepresented among the uninsured. With the ACA and current state Medicaid expansion decisions, uninsurance rates are projected to fall for each racial/ethnic group, narrowing coverage differences between whites and each minority group, except for blacks. If all states were to expand their Medicaid programs, we project that uninsurance rates would fall further for all racial/ethnic groups, with blacks experiencing a marked reduction. Effective outreach can further reduce uninsurance rates for all racial/ethnic groups
State Variation in Hospital Use and Cost of Firearm Assault Injury, 2010 (Research Report)
|Posted to Web: December 16, 2014||Publication Date: December 16, 2014|
Hospital use and hospital mortality related to firearm-assault injuries varies considerably across demographic groups and states, as does the percentage of firearm-assault injury hospital costs borne by the public. Healthcare data from six states--Arizona, California, Maryland, New Jersey, North Carolina, and Wisconsin--show that hospital use for firearm-assault injury is disproportionately concentrated among young males, particularly young black males. Additionally, uninsured victims have higher hospital mortality rates for firearm-assault injury. Across all six states, the public pays a substantial portion of the hospital cost for injuries caused by firearm assault.
Understanding Older Drivers: An Examination of Medical Conditions, Medication Use, and Travel Behavior (Research Report)
|Posted to Web: August 25, 2014||Publication Date: August 25, 2014|
Almost 90% of people 65 and older are drivers. While older people are among the safest on the road they are more likely to use multiple medications which could interfere with driving safely. This report provides baseline information on the relationship between medical conditions, medication use, and the travel behavior of older drivers from two large national data bases: the 2009 National Household Travel Survey and the 2011 National Health and Aging Trends Study. We found that most older drivers take multiple medications and drive frequently but also self-regulate their behavior in important ways that reduce crash risk.
Trends in Prescription Drug Spending Leading Up to Health Reform (Article)
|Posted to Web: July 15, 2014||Publication Date: April 01, 2014|
Over the past decade, prescription drug expenditures grew faster than any other service category and comprised an increasing share of per capita health spending. Using the 2005 and 2009 Medical Expenditure Panel Surveys, this analysis identifies the sources of spending growth for prescription drugs among the nonelderly population. We find that prescription drug expenditures among the nonelderly increased by $14.9 billion (9.2%) from 2005 to 2009 and expenditures increased in 12 out of the 16 therapeutic classes. Changes in the number of users and expenditures per fill were the drivers of spending fluctuations in these categories. The main results also provide insight into generic entry, the price gap between brand and generic drugs, and from a health reform evaluation perspective, the importance of separating pre-policy secular trends in expenditures from changes attributable to specific forces, such as shifts toward generic versions of blockbuster drugs.
The Effects of Express Lane Eligibility on Medicaid and CHIP Enrollment among Children (Article)
|Posted to Web: May 19, 2014||Publication Date: May 14, 2014|
We estimate the impact of Express Lane Eligibility (ELE) implementation on Medicaid/CHIP enrollment in eight states using 2007-2011 data from the Statistical Enrollment Data System. We use fixed effects difference-in-differences models to allow the experience of non-ELE states to serve as a counterfactual to assess the changes in the ELE states. Across specifications, ELE effects on Medicaid enrollment among children were consistently positive, ranging between 4.0 and 7.3 percent, with most estimates statistically significant at the 5 percent level. Our results imply ELE has been an effective way for states to increase enrollment and retention among children eligible for Medicaid/CHIP.
An Estimated $84.9 Billion In Uncompensated Care Was Provided In 2013; ACA Payment Cuts Could Challenge Providers (Article)
|Posted to Web: May 19, 2014||Publication Date: January 31, 2014|
Millions of uninsured people use health care services every year. We estimated providers' uncompensated care costs in 2013 to be between $74.9 billion and $84.9 billion. In the aggregate, at least 65 percent of providers' uncompensated care costs were offset by government payments designed to cover the costs. Medicaid and Medicare were the largest sources of such government payments, providing $13.5 billion and $8.0 billion, respectively. Anticipating fewer uninsured people and lower levels of uncompensated care, the Affordable Care Act reduces certain Medicare and Medicaid payments. Such cuts in government funding of uncompensated care could pose challenges to some providers, particularly in states that have not adopted the Medicaid expansion or where implementation of health care reform is proceeding slowly.
Measuring Marketplace Enrollment Relative to Enrollment Projections: Update (Policy Briefs/Health Policy Briefs)
|Posted to Web: May 07, 2014||Publication Date: May 06, 2014|
This brief compares Affordable Care Act Marketplace enrollment as of April 19, 2014 (the most recent state-specific data) to projected enrollment for 2014 and 2016 and estimates of the number of people eligible for subsidies. Nationally, by April 19, the Marketplaces had enrolled 115 percent of projected 2014 enrollment. Collectively, both State-Based Marketplaces (SBMs) and Federally Facilitated Marketplaces (FFMs) exceeded projected enrollment. However, there is considerable variation across the states within each group.
The Best Evidence Suggests the Effects of the ACA on Employment Will Be Small (Policy Briefs/Timely Analysis of Health Policy Issues)
|Posted to Web: May 01, 2014||Publication Date: May 01, 2014|
A recent report by the CBO concluded that the ACA could reduce the number of people working, almost entirely because workers would choose to work less due to incentives in the law. This report places the ACA and its employment effects in the context of other social programs. It assesses the evidence on likely employment effects from four recent and directly relevant studies. The best evidence to date suggests the employment effects of the ACA are likely to be small, and that the CBO estimate may be toward the high end of the range of potential ACA effects on employment.
|Posted to Web: April 29, 2014||Publication Date: April 29, 2014|