Exploratory analyses of the 2014 Medicaid expansions showed a decrease in pancreatic cancer mortality (0.18 deaths per 100 000, 95% confidence interval = 0.32 to 0.05) in states that expanded Medicaid by 2014 compared with nonexpansion states. Gov. What Medicaid expansion means and why it matters Several analyses did not satisfy tests of the parallel trends assumption, including analyses of breast, liver, and White cancer mortality rates, which should be interpreted with caution (see Supplementary Table 1, available online for detailed information). TIP: New states are expanding Medicaid each year, so make sure to check out the Current Status of State Medicaid Expansion Decisions. Now, thanks to expansion, at least600,000more adults in North Carolina will gain coverage through Medicaid. In his JanuaryState of the State address, Mississippi Gov. CI = confidence interval, CrI = credible interval (Bayesian). When you support The American Prospect, youre supporting fellow readers who arent able to give, and countering the class system for information. The early Medicaid expansions were relatively small in scope relative to the 2014 expansions. Cancer is a leading cause of death in the United States, resulting in approximately 600 000 deaths per year (1). Visit RelayNCfor information about TTY services. According to Jamal Jones, the chief administrative officer at Piedmont Health Services, a federally qualified health center in Raleigh, Medicaid expansion will help reduce the numbers of uninsured and help health care centers stay afloat, extend outreach and serve patients in counties where many working poor and underserved live. The sky-high premiums of private insurance were beyond her reach. In April 2020, we reported that many rural hospitals have closed after years of financial struggles. Lessons from early Medicaid expansions under health reform: interviews with Medicaid officials, Methods for evaluating changes in health care policy: the difference-in-differences approach, Health and access to care during the first 2 years of the ACA Medicaid expansions, Changes in insurance coverage and stage at diagnosis among nonelderly patients with cancer after the Affordable Care Act, The impact of health insurance on preventive care and health behaviors: evidence from the first two years of the ACA Medicaid expansions, Changes in insurance coverage among cancer patients under the Affordable Care Act, Effect of Medicaid expansions of 2014 on overall and early-stage cancer diagnoses. Sommers BD, Arntson E, Kenney GM, Epstein AM.. After delivery, Deanna no longer qualified for Medicaid and went without coverage. However, these estimates are unreliable given the failed parallel trends assumption, which non-parallel trends contributed to the mortality increases (Supplementary Table 5, available online). Weiner AB, Jan S, Jain-Poster K, Ko OS, Desai AS, Kundu SD.. Insurance coverage, stage at diagnosis, and time to treatment following dependent coverage and Medicaid expansion for men with testicular cancer, Expansion coverage and preferential utilization of cancer surgery among racial and ethnic minorities and low-income groups. County population by characteristics: 2010-2018. Details regarding the hierarchical Bayesian model, covariate selection, and assessments of the adequacy of draws from the posterior distribution are given in Supplementary Table 2 and Supplementary Figure 1 (available online). Additionally, the states that expanded Medicaid in 2014-2016, which were excluded from the primary analyses, were grouped with nonexpansion states to form a comparison group of states that did not expand Medicaid in 2010-2011. These state efforts track with continued activity at the federal level: the Consolidated Appropriations Act and the 2022 Bipartisan Safer Communities Actincluded an array of provisions to expand access and funding for behavioral health, such as provisions to require guidance on expanding Medicaid-covered mental health services in schools, expand Certified Community Behavioral Health Clinics (CCBHC), fund new psychiatry residency positions, and eliminate administrative requirements to prescribe buprenorphine. Each health plan has their own network of providers. Barnes JM, Johnson KJ, Adjei Boakye E, Sethi RV, Varvares MA, OsazuwaPeters N.. Impact of the patient protection and Affordable Care Act on costrelated medication underuse in nonelderly adult cancer survivors. Credit: Jaymie Baxley/NC Health News. South Dakota voters approved expanding Medicaid last November but it won't take effect until July 1. Dan is a writer on CNET's How-To team. Several states have recently implemented Medicaid managed care programs. In our sensitivity DDD analyses, for each percent increase in residents living in poverty, there were expansion-associated decreases in cancer mortality overall and across most subgroups, though most decreases were not statistically significant (Supplementary Table 4, available online). Nonexpansion states are those that had not implemented Medicaid expansion as of December 31, 2017; includes AL, FL, GA, ID, KS, ME, MS, MO, NE, NC, OK, SC, SD, TN, TX, UT, VA, WI, and WY. Having affordable health insurance helps families be able to go to the doctor, go to the hospital, and get prescription medicine. Due to potential impacts of the economic recession in 2008-2009, 1 analysis treated 2002-2007 as the preexpansion period. The pandemic also highlighted workforce shortages and unmet need among people who use long-term services and supports (LTSS) delivered in home and community settings (HCBS). Madeline Guth To learn more, view our full privacy policy. High-quality, comprehensive data are essential for identifying and addressing health disparities and measuring progress over time and the majority of states are implementing strategies to improve race, ethnicity, and language (REL) data completeness. Finally, Medicaid expansion is associated with increased access to surgery and decreased time to treatment initiation for some cancers, though data show mixed results (4350). States that expanded in 2014-2016 were excluded. Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270, www.kff.org | Email Alerts: kff.org/email | facebook.com/KFF | twitter.com/kff. of cancer deaths by cancer site and race subgroups, County-level attributes weighted by county population, mean (SD). Simmons Cancer Institute, Springfield, IL, USA, 6 In: Oakes JM, Kaufman JS, eds. Five multi-state, for-profit parent firms, Medicaid-covered mental health services in schools, Certified Community Behavioral Health Clinics (CCBHC, 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision, How the Pandemic Continues to Shape Medicaid Priorities: Results from an Annual Medicaid Budget Survey for State Fiscal Years 2022 and 2023, Status of State Medicaid Expansion Decisions: Interactive Map. It is unclear whether the lack of an overall effect is due to inadequate follow-up or whether there was minimal impact on cancer mortality. Behavioral health conditions (i.e., mental health and substance use disorders) are more prevalent in Medicaid enrollees compared to people with other coverage, with data from 2020 showing that approximately 39% of Medicaid enrollees were living with a mental health or substance use disorder. For over a decade North Carolina and other states have refused to expand Medicaid as allowed under the Patient Protection and Affordable Care Act (PPACA). Economic and Employment Effects of Medicaid Expansion Under ARP Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA. When analyzing the 2014 Medicaid expansions with limited follow-up, there was a statistically significant expansion-associated decrease in pancreatic cancer mortality. Below are six reasons why Medicaid expansion would benefit North Carolina: Medicaid expansion saves lives. Changes in cancer mortality rates associated with Medicaid expansions occurring in 2014. We encourage you to use this PDF flyer to spread the word. The preferred estimates indicate that Medicaid expansion is associated with statistically significant lower premiums for gold plans (17 percent) and the second-lowest-priced silver plans (25 percent). To date, 39 states have elected to expand; however, California, Connecticut, Minnesota, New Jersey, Washington, and Washington DC had limited expansions earlier in 2010 or 2011 (4). CI = confidence interval. Jennifer Tolbert Medicaid expansion is foundational in improving access to health care in rural areas, for better mental health and for veterans, working adults and their families. Please, become a member, or make a one-time donation, today. United States Census Bureau. Paul Woolverton. Visit RelayNCfor information about TTY services. Unadjusted DID analyses were performed by calculating the DID estimate: (Rateearly expansion, 2012-16 Rateearly expansion, 2007-09) (Ratenonexpansion, 2012-16 Ratenonexpansion, 2007-09) (see the Supplementary Methods, available online). The Affordable Care Act expanded Medicaid coverage to adults making up to 138% of the federal poverty level. Whereas employment in most health care sectors has rebounded from the sharp drop in March 2020, employment in long-term care facilities remains well-below pre-pandemic levels. If you have a provider you want to continue seeing, click here to see which network they are in. Capitated managed care remains the predominant delivery system for Medicaid in most states. A few years ago, Evita began experiencing incredible tooth pain. Data with additional follow-up will be needed to clarify the trends. It revealed that Medicaid expansion in a state allows more low-income people to qualify for the health care program. Spring booster jabs will be offered to those aged 75 and over and people at highest risk of severe COVID-19 disease from tomorrow (Monday). In North Carolina, the Uninsured Say Medicaid Expansion Will Be Life It also increased federal matching funds for states that expanded their coverage. Do not give any personal information because we cannot reply to you directly. The American Rescue Plan passed earlier this year included financial incentives to encourage expansion, but those 12 still havent wavered. Start here Check if you can enroll Update income/household Use your new coverage Medicaid & CHIP coverage Using your new Medicaid or CHIP coverage Medicaid expansion & what it means for you Some states have expanded their Medicaid programs to cover all people with household incomes below a certain level. The parallel trends assumption was tested by comparing changes in cancer mortality rates between early expansion and nonexpansion states during the preexpansion period (see the Supplementary Methods and Supplementary Table 1, available online) (5). Were getting all the train cars lined up and as soon as the budget passes, the train can leave the station, Kinsley says. North Carolina, like other states, is currently dealing with an opioid and substance abuse crisis. County-level data from the CDC were limited to ages 25-64years due to differences in calculating age-adjusted rates (15- to 19-year-olds and 20- to 24-year-olds were combined for age adjustments) (22,23). The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. In those states, most single, childless adults remain ineligible for Medicaid coverage regardless of what they earn each year. Now, were trying to get the word out about why Medicaid expansion matters to communities most impacted by the issue. It is unlikely that the estimated number of cancer deaths prevented arose strictly from the approximately 500 000 individuals gaining coverage under the 2010-2011 expansions. Small Area Income and Poverty Estimates (SAIPE) Program. What Does Medicaid Expansion Mean In North Carolina? - Aeroflow Urology In particular, nearly all states added or expanded audio-only telehealth coverage. We know that those in high-priority groups are at higher risk of serious illness from COVID-19, and I therefore welcome the start of the rollout which will offer a further dose to these people. Because Pr is 1-sided, Prless than.025 is required for statistical significance. A lock icon or https:// means youve safely connected to the official website. Nonexpansion states are those that had not implemented Medicaid expansion as of December 31, 2016; includes AL, FL, GA, ID, KS, ME, MS, MO, NE, NC, OK, SC, SD, TN, TX, UT, VA, WI, WY. Sign Up Here for Engagement Programs and Updates. For the county-level analyses, 3715 county-year units were included in the analysis (see Supplementary Figure 2, available online, for the CONSORT diagram). However, the trends diverged beginning in 2010, when the first early Medicaid expansions occurred. In rural Black communities, people often lack adequate access to basic preventive health care services to treat chronic diseases, and many uninsured people avoid doctors visits until its a life-or-death scenario. Today, Governor Roy Cooper signed House Bill 76, Access to Healthcare Options, into law. Most states have or plan to adopt permanent Medicaid telehealth expansions that will remain in place after the pandemic, including expansions of allowable modalities, services, and providers. Instead, the assistance remains solid, with the feds picking up90%of the tab. 68 0 obj <> endobj Below are six reasons why Medicaid expansion would benefit North Carolina: Medicaid expansion saves lives. Financial insolvency as a risk factor for early mortality among patients with cancer. *22. The site is secure. MCOs are expected to play a large role in helping enrollees maintain coverage during the unwinding of the continuous enrollment provision. Medicaid expansion allows more low-income people living in the state to qualify for the health care program based on their income. Without adequate insurance coverage, its more challenging to arrange follow-up visits and ensure patients have access to medications they need. TheARPA federal incentive reignited discussionaround Medicaid expansion in afewnon-expansion states during the last state legislative session. New enrollment determinations for the expansion population are expected to shift to the federal marketplace. Mortality rate is the age-adjusted deaths per 100 000 population. The Administration is expected to release revised regulations about Medicaid managed care and assuring access in Medicaid in the Spring of 2023. Not at this time. But since the major Affordable Care Act Provisions took hold in 2014, charity care and bad debt have fallen among hospitals. His mother was also diagnosed with fibroids, benign growths in her uterus. Additionally, the changes in the uninsured rate for the state groups from 2006 to 2017 were examined based on US Census Bureau estimates (31). The trends in cancer mortality rates for all cancers combined changed similarly over time for Medicaid expansion and nonexpansion states, with the exception of 2009. States have been expanding behavioral health benefits and access to care, including by adopting strategies to bolster the behavioral health workforce. [After expansion] Emergency Department team members will be able to refer uninsured patients to the Department of Social Services or Access East, the care management arm of ECU Health, to connect them with Medicaid resources, Patterson says. ZJ8'j1Z#|D. Investigating the systems and circumstances that contribute to inequality. In our sensitivity DID analyses, there were statistically significant expansion-associated decreases in overall cancer mortality and pancreatic cancer mortality across all sensitivity analyses (Supplementary Table 4, available online). The 2014 expansion states included AZ, AR, CA, CO, CT, DE, DC, HI, IL, IA, KY, MA, MD, MI, MN, NV, NH, NJ, NM, NY, ND, OH, OR, RI, VT, WA, and WV. However, we found no detectable expansion-associated decrease in overall cancer mortality (non-statistically significant DID estimate favoring nonexpansion states). I continue to encourage everyone to receive the doses they are eligible for as and when they become available.. States are also using MCO financial quality incentives (e.g., performance bonuses, withholds) tied to health equity-related performance goals and other MCO contract requirements to advance health equity. Hence, exploratory (unadjusted) DID analyses were performed to compare mortality rates from 2011-2013 with 2015-2017 in states that expanded Medicaid in 2014 relative to nonexpansion states (additional follow-up time was available due to no county-level data restrictions); states that expanded Medicaid from 2015-2017 were excluded.
Om Hleem Baglamukhi Mantra,
Houses For Sale At Lake Mcconaughy Ne,
Kevin Skarupa Waypoint,
Teleportation Circle Pathfinder,
Articles W
