Medicaid Expansion Improves Overall Financial Well-Being, New Report Finds

Medicaid expansion significantly reduced the number of unpaid non-medical bills and the amount of non-medical debt sent to third-party debt collectors, according to a report from the National Bureau of Economic Research. The report estimates that Medicaid expansion is associated with a reduction in collection balances by $600 to $1,000 per person and suggests that expansion populations may have better access to credit markets in the future than if they had not gained coverage. This is the first national study of expansion's effect on multiple measures of financial well-being, according to the authors.

Medicaid Expansion Is Improving Access to Care, According to Report

Individuals with incomes less than 138% of FPL in Medicaid expansion states were more likely to see a doctor, stay overnight in a hospital, and receive their first diagnoses of diabetes and high cholesterol than their counterparts in non-expansion states, according to an analysis of National Health Interview Survey data published in the Annals of Internal Medicine. This is the first evidence of increased healthcare utilization by low-income adults in expansion states, according to the researchers. The percentage of survey respondents who spoke with a doctor increasedfrom 58% pre-expansion (2010 to 2013) to 68% post-expansion in expansion states, while there was no change in non-expansion states. Those who said they had no usual source of care due to costs fell from 13.3% to 6.6% in expansion states while that rate dropped "marginally" in non-expansion states. Despite improved access to care, enrollees did not have improved assessments of their own health, which the authors suggest may be because too little time has passed to allow for health improvements and because increased contact with providers and improved health awareness may negatively affect opinions about one's own health.

Arkansas: Medicaid Expansion Funding Secured, Program to Continue

Governor Asa Hutchinson (R) signed an appropriation bill funding "Arkansas Works," the re-named State's Medicaid expansion, by using a line-item veto of a last-minute provision that would have ended Arkansas Works on December 31, 2016. The provision was added with the understanding that Governor Hutchinson would issue this line-item veto, effectively preserving the program's funding. The procedural maneuver was devised after the original bill failed to receive the required three-fourths majority vote to pass the Legislature. The State must now seek federal waiver approval to institute mandatory premium assistance for beneficiaries with access to cost-effective employer-sponsored insurance, a work referral program, and premiums for beneficiaries with incomes above 100% of FPL. The federal government has pledged to work with State officials to approve the waiver. Separately, Governor Hutchinson said he would seek to end Medicaid coverage of emergency contraceptives in response to a request from a legislator that supported Arkansas Works, according to the Arkansas Democrat-Gazette.

Louisiana: Governor Testifies on Merits of Medicaid Expansion in State Senate

Governor John Bel Edwards (D) and Department of Health and Hospitals Secretary Rebekah Gee provided updated savings estimates and new operational details on the launch of Medicaid expansion at a Senate Health and Welfare Committee meeting last week. Governor Edwards and Gee told lawmakers that expansion will generate an estimated $677 million in savings over five years and approximately $1 billion over 10 years, in addition to the $184 million in anticipated savings for fiscal year 2017. These estimates are in stark contrast to former Governor Bobby Jindal's (R) estimates of $1.7 billion in costs over 10 years. The Medicaid agency's statement also highlighted plans to auto-enroll approximately 200,000 individuals who receive other State services and are Medicaid eligible in anticipation of a July 1 launch date.