Medicaid

States expanding Medicaid eligibility under the ACA can substantially expedite Medicaid enrollment and retention for SNAP participants, 97 percent of whom will qualify for Medicaid, according to this study. Even in states where SNAP provides broad-based categorical eligibility that extends SNAP’s gross income limits to at least 185 percent of the federal poverty level, 94 percent of SNAP recipients will qualify for Medicaid. Data showing SNAP receipt can thus verify Medicaid applicants’ financial eligibility, allow administrative renewal for Medicaid beneficiaries, and facilitate Medicaid enrollment for numerous eligible consumers when expanded coverage begins in early 2014.

Older youth face many challenges including continuing health care as they approach adulthood. The Affordable Care Act will provide new coverage for young adults. This 10 state study provides new data on Medicaid health costs for youth turning age 18. On average, boys are more expensive than girls at this age. Three groups are particularly high cost, disabled youth enrolled in Supplemental Security Income, foster care youth, and those with behavioral health problems. These three groups account for less than 20 percent of all youth that age, but over half the cost of the program.

The Heritage Foundation has repeatedly and misleadingly claimed that Urban Institute research shows most states would experience budget problems if they implemented the ACA's Medicaid expansion. In fact, every comprehensive fiscal analysis done at the state level has concluded that expansion would yield net state budget gains, with revenues and savings that exceed increased state costs. All states must pay for national health reform but only those that expand Medicaid will receive large, offsetting allotments of federal Medicaid dollars, with resulting economic activity, jobs, and state revenue. Solid research shows that Medicaid expansion saves lives and improves access to care.

National health expenditures have grown at record-low rates for the past three years. The recession has been cited as an important driver of recent trends leading many to wonder if slower spending growth will continue as the economy recovers. We review the trends in health spending growth over the last decade and show that growth began to slow well before the most recent recession. We also consider trends in incomes and insurance coverage and suggest that declines in real incomes and a shift towards less generous insurance arrangements have slowed the growth in provider revenues and forced cost containment efforts. The question remains, however, as to whether the changes that slowed health spending growth over the last decade will be maintained or extended as the economy recovers and the Affordable Care Act expands health insurance coverage.

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.

Maternal depression can have severe and lasting consequences for both a mother and her child. This brief uses the National Survey of Drug Use and Health to estimate the prevalence, severity, and treatment of major depression among low-income mothers with young children (ages 0-5). We find that one out of eleven low-income mothers with young children had a major depressive episode in the past year, and nearly one-third did not report receiving any treatment. While uninsured low-income mothers had much lower treatment rates than insured low-income mothers, rates were comparable across treatment providers, suggesting that Medicaid fills an important gap.

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.

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.