Enrollment-Driven Expenditure Growth: Medicaid Spending during the Economic Downturn, FY 2007-2011 (Research Report)
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This report presents data on changes in Medicaid's enrollment and spending between federal fiscal year 2007 and federal fiscal year 2011, a period which includes the worst economic downturn in the United States since the Great Depression of the 1930s. The paper also examines what factors drove Medicaid spending over the period, and concludes that overall spending growth from 2007 to 2011 was driven largely by the enrollment growth that resulted from many people losing jobs and income during the recession. However, on a per enrollee basis, Medicaid spending has grown more slowly than other sectors of the health system.
Developing Subannual Estimates of Health Insurance Coverage from the American Community Survey: Challenges and Promising Next Steps (Research Report)
|Posted to Web: April 24, 2013||Publication Date: April 24, 2013|
Following the introduction of a question on health insurance coverage in 2008, the American Community Survey (ACS) has increasingly been used as a source for state-level health insurance estimates. This reflects a number of key advantages of the ACS, including a survey design that supports state representative estimates for all states and the large size of its sample. As a result, the ACS yields relatively precise state-level estimates of annual health insurance coverage. This paper explores the feasibility of expanding the value of the ACS for tracking health insurance coverage by generating subannual estimates.
Financial Burden of Medical Spending by State and the Implications of the 2014 Medicaid Expansions (Research Report)
|Posted to Web: April 17, 2013||Publication Date: April 17, 2013|
This study is the first to offer a detailed look at medical spending burden levels, defined as total family medical out-of-pocket spending as a proportion of income, for each state. It further investigates which states have greater shares of individuals with high burden levels and no Medicaid coverage, but would be Medicaid eligible under the 2014 rules of the Affordable Care Act should their state choose to participate in the expansion. This work suggests which states have the largest populations likely to benefit, in terms of lowering medical spending burden, from participating in the 2014 adult Medicaid expansions.
Uninsured New Yorkers After Full Implementation of the Affordable Care Act: Source of Health Insurance Coverage by Individual Characteristics and Sub-State Geographic Area (Research Report)
|Posted to Web: April 03, 2013||Publication Date: March 28, 2013|
The Urban Institute developed a New York state-specific version of its Health Insurance Reform Simulation Model (HIPSM) to support to the state in its effort to assess the implications of the implementation of the Affordable Care Act (ACA). Initial findings from this work were made available in March of 2012.The tables presented here provide sub-state analyses, focusing on those without insurance coverage of any kind prior to reform. We show the share of uninsured expected to gain coverage under the ACA, and include the distribution of characteristics for those anticipated to gain insurance of each type whenever sample sizes allow.
The Financial Burden of Medical Spending Among the Non-Elderly, 2010 (Research Report)
|Posted to Web: February 15, 2013||Publication Date: February 15, 2013|
We estimate the financial burden of medical spending among the non-elderly using an alternative data source than previous studies. We investigate whether higher burden levels are largely due to higher medical spending, lower income, or some combination. Furthermore, we study individual characteristics correlated with burdens exceeding a given threshold. Although medical spending is higher for individuals facing higher burden levels, the effect of low income on high burden status dominates. Multivariate analysis shows that individuals covered by non-group insurance and the unhealthy have significantly higher risk of facing higher burden levels, while those with public insurance have much lower risk.
Trends in U.S. Health Care Spending Leading Up to Health Reform (Research Report)
|Posted to Web: November 19, 2012||Publication Date: November 19, 2012|
Using the 2001-2009 MEPS, we examine a variety of trends that illustrate patterns of health care use in the U.S. and find that growth rates in per capita spending varied by type of service. We decompose trends into changes in the fraction using services, the intensity of utilization among users, and the cost per unit. We also decompose spending changes into changes in the distribution of individuals' socio-economic characteristics, health insurance status, and prevalence of chronic conditions. We find the majority of the increase in per capita health spending over the decade is explained by factors (e.g., technology growth) outside our model.
Massachusetts under the Affordable Care Act: Employer-Related Issues and Policy Options (Research Report)
|Posted to Web: October 04, 2012||Publication Date: September 25, 2012|
Using the Health Insurance Policy Simulation Model, this report analyzes four policy options for assessing employers who do not provide affordable health insurance to their workers as Massachusetts brings its health reform law into compliance with the Affordable Care Act (ACA). Overall coverage and costs are similar across all options, but replacing the state's Fair Share Contribution (FSC) requirement with the ACA assessment would eliminate a source of state revenue. Similarly, maintaining the FSC for small employers only would raise one-fifth as much revenue as leaving the current assessment in place.
Enrollment-Driven Expenditure Growth: Medicaid Spending during the Economic Downturn, FFY2007-2010 (Research Report)
|Posted to Web: July 25, 2012||Publication Date: July 25, 2012|
This report presents data on changes in Medicaid's enrollment and spending between federal fiscal year 2007 and federal fiscal year 2010, a period which includes the worst economic downturn in the United States since the Great Depression of the 1930s. The paper also examines what factors drove Medicaid spending over the period, and concludes that overall spending growth from 2007 to 2010 was driven largely by the enrollment growth that resulted from many people losing jobs and income during the recession. However, on a per enrollee basis, Medicaid spending has grown more slowly than other sectors of the health system.
|Posted to Web: May 14, 2012||Publication Date: May 11, 2012|