Social and Behavioral Sciences Commons^™

The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays

Health Management and Policy Presentations

We estimate the dynamics and interactions of governmental spending on Medicaid and other public health services in all 50 states over a 15 year period. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

Aca Implementation In Kentucky: Experiences Of An Expansion State, Glen P. Mays

Health Management and Policy Presentations

Kentucky's implementation of the Affordable Care Act has included early successes with insurance coverage expansion through Medicaid and a state-operated health insurance exchange. Signals of improvements in health care accessibility and delivery of preventive services are evident in the first year after coverage expansions. Challenges associated with political opposition, delivery system transformation, and public health financing remain on the state's policy agenda.

The Never-Ending Struggle: Us Press Coverage Of Contraception 2000–2013, Ana C. Garner, Edgar Mendez

College of Communication Faculty Research and Publications

In 1873, the Comstock Act labeled contraceptive information and materials obscene and banned their distribution. The issue divided the United States then, and it divides the nation today. This essay examines 2000–2013 press coverage of contraception in the New York Times and the Los Angeles Times, two newspapers that have covered contraception since 1873. Press coverage reveals that contemporary efforts to regulate women’s bodies are cloaked in discussions about the Affordable Care Act, religious freedom, morality, and employer rights. Accepting the ideology that contraception is no longer a reproductive rights issue allowed the press to exclude women from …

An Analysis Of Political And Legal Debates Concerning Medicaid Expansion In Virginia, Rick Mayes, Benjamin Paul

Political Science Faculty Publications

The Supreme Court’s historic June 2012 ruling regarding the Affordable Care Act (ACA) in National Federation of Independent Business v. Sebelius set the stage for a massive federalism battle over Medicaid expansion in the United States. The original language of the Act was intended to nationalize Medicaid by having every state expand their program’s eligibility to all individuals up to 138% of the federal poverty level. This would have significantly reshaped Medicaid, a joint federal-state health insurance program, into a universal entitlement for all low-income citizens. Currently, Medicaid eligibility varies dramatically from state to state. The Court held that the …

Reducing The Geographic Variance In Medical Expenditures: The Benefits Of A Primary-Care-Oriented Health System, Noah Bricker

Undergraduate Economic Review

The Affordable Care Act states that a primary goal of health care reform should be to lower costs and promote fiscal responsibility. With these two goals in mind, the bill proposes a more primary-care-oriented health system by enacting a 5-year temporary Medicare fee increase for primary care physicians as a means to increase the number of physicians and incentivize more primary care services. Using county and regional level Medicare data, this paper finds that an increase in the number of primary care physicians per capita would reduce per beneficiary Medicare spending and as a consequence, lower national health expenditures substantially.

Life-Care Awards In The Age Of The Affordable Care Act, Joshua Congdon-Hohman, Victor Matheson

Economics Department Working Papers

Prior to January 1, 2014, it would have been reasonable to assume that persons injured in an act of negligence would be forced to pay for their future medical care costs out-of-pocket rather than being able to rely on health insurance. The passage of the Affordable Care Act (ACA) has the potential to radically change how victims pay for future medical expenses, and now nearly every tort award that provides money to the plaintiff for the full payment of medical costs without consideration of the availability of health insurance will serve to overcompensate victims for their expected medical costs. New …

Mandate-Based Health Reform And The Labor Market: Evidence From The Massachusetts Reform, Jonathan T. Kolstad, Amanda E. Kowalski

Upjohn Institute Working Papers

We model the labor market impact of the key provisions of the national and Massachusetts "mandate-based" health reforms: individual mandates, employer mandates, and subsidies. We characterize the compensating differential for employer-sponsored health insurance (ESHI) and the welfare impact of reform in terms of "sufficient statistics." We compare welfare under mandate-based reform to welfare in a counterfactual world where individuals do not value ESHI. Relying on the Massachusetts reform, we find that jobs with ESHI pay $2,812 less annually, somewhat less than the cost of ESHI to employers. Accordingly, the deadweight loss of mandate-based health reform was approximately 8 percent of …

Access To Healthcare For Vulnerable Asian Subgroup Populations In The United States, Deborah Kim-Lu

Dissertations, Theses, and Capstone Projects

Objectives: This dissertation examines the barriers for access to healthcare for the top four most uninsured Asian American subgroups (Bangladeshi, Cambodian, Korean, and Pakistani communities). Methods: Combining quantitative and qualitative approaches, this study consisted of: (1) an in-depth review of the Health Services Research literature; (2) qualitative interviews with 24 national health experts and advocates on Asian American health; (3) a survey of a non-probability sample of 107 Koreans in the tri-state region (Connecticut, New Jersey, and New York) using the Access to Healthcare Survey for Koreans in the U.S. instrument, which includes a Likert scale with 21 barrier questions …

Medicaid And The Labor Supply Of Single Mothers: Implications For Health Care Reform, Vincent Pohl

Upjohn Institute Working Papers

The Patient Protection and Affordable Care Act expands Medicaid and introduces health insurance subsidies, thereby changing work incentives for single mothers. To undertake an ex ante policy evaluation of the employment effects of the PPACA, I structurally estimate a model of labor supply and health insurance choice exploiting existing variation in Medicaid policies. Simulations show that single mothers increase their labor supply at the extensive and the intensive margin by six and five percent, respectively. The PPACA leads to crowding-out of employer-sponsored health insurance of about 40 percent and increases single mothers' welfare by about $190 per month.

How Will Public Health And Primary Care Come Together In Massachusetts?, Javier Crespo

Public Affairs Capstones Collection

The Patient Protection and Affordable Care Act aims to place public health and prevention practice closer to the clinical care delivery system by mandating basic preventive services and creating a national prevention plan. The Massachusetts health care system has a number of elements that can help foster closer linking of public health practices in the primary care setting. This research set out to examine whether the current healthcare system in Massachusetts will enable public health and primary care integration as intimated upon by the Affordable Care Act. This study will assess the current connection between public health and primary care …

Medicaid Expansion – Good Jobs, Good Health, Evan Barrett

Highlands College

A Montana Public Radio Commentary by Evan Barrett.

Published newspaper columns written by Evan Barrett on this topic, which vary somewhat in content from this commentary, appeared in the following publications:

Missoulian, May 16, 2014

Montana Standard, May 16, 2014

The Effects Of The Changes In Section 317 Rules For Administration Of Federally Purchased Vaccines, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Section 317 of the Public Health Services Act is a federal program that provides funds for the purchase of vaccines. These annual Congressional allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2013, Section 317 rules redefined the population eligible for immunization with Section 317 purchased vaccines. In Tennessee, the response was a policy change …

The New Right Discourse On Health Care, Bryan Kroetsch

Senior Honors Projects

This paper is an analysis of the “New Right” response to the Obama Administration’s Affordable Care Act. It discusses how language has been used by a New Right wing faction to dictate the discourse on health care in the United States while at the same time motivating the citizenry to be fearful of health care and large, bureaucratic government.

Mainecare Stage A Health Homes Year 1 Report: Implementation Findings And Baseline Analysis, Kimberley S. Fox Mpa, Carolyn E. Gray Mph, Katherine Rosingana, Deborah A. Thayer Mba

Population Health & Health Policy

In January 2013, Maine established Health Homes under federal authority pursuant to Section 2703 of the Affordable Care Act to improve care coordination for MaineCare members with chronic conditions. Stage A of the Health Homes initiative focuses on members with complex medical chronic conditions. Stage B, planned for early 2014, will focus on persons with severe and persistent mental health conditions and children with serious emotional disturbances. The Stage A demonstration builds off the State’s existing Maine multi-payer Patient Centered Medical Home (PCMH) Pilot project and Maine’s Medicare Advanced Primary Care Practice (MAPCP) Demonstration by providing add-on payments to primary …

Expanding Women’S Healthcare Access In The United States: The Patchwork “Universalism” Of The Affordable Care Act, Randy Albelda, Diana Salas Coronado

Center for Social Policy Publications

This paper explores the promise of the Patient Protection and Affordable Care Act, commonly called “Obamacare” (referred to here as the ACA), with attention to the ways gender matter by tracing the development and implementation of key US social protection systems, an examination of the current health system with particular attention to women’s coverage, and the potential impacts of the ACA, including how it conforms to international human rights norms for health care. The ACA promises to vastly improve the key dimensions of health coverage in the US, but it conforms with other US social policy by relying on market-based …

Implications Of The Affordable Care Act's Medicaid Expansion On Low-Income Individuals On Probation, Marsha Regenstein, Lea Nolan

Health Policy and Management Faculty Publications

Every year, millions of Americans become involved in the local criminal justice system and are held in jails, placed on probation, or some combination of the two. This paper focuses on the probation population, a group of individuals who receive correctional supervision in communities, generally as an alternative to incarceration. Individuals on probation are disproportionately low-income and uninsured; many are likely to qualify for health coverage through state Medicaid expansions and private insurance Marketplaces that are part of the Patient Protection and Affordable Care Act. Opening up access to affordable health insurance coverage for this vulnerable group of individuals is …

U.S. Employment Outlook For 2014: Can The U.S. Economy Stand On Its Own?, Randall W. Eberts

Periodical Articles

No abstract provided.

Challenging Inequality: Professor Fernando De Maio Explores The Statistics Behind Health Disparities

DePaul Magazine

According to the World Health Organization's commission on the social determinants of health, "reducing health inequalities is ... an ethical imperative. Social injustice is killing people on a grand scale." Fernando De Maio, associate professor of sociology at DePaul University, explores this concept by examining avoidable health inequalities in the global sphere. He uses sociological methods to analyze empirical data and hopes statistics can be used to bring about policy change.

Complexity In National Policy Implementation: A Top-Down Look At The Failure Of Healthcare.Gov, Samuel Fandrich

Master in Public Administration Theses

No abstract provided.

Essays On Health Insurance Reform, Brian James Fischer

Legacy Theses & Dissertations (2009 - 2024)

Overlapping generations general equilibrium models are developed to study health insurance reforms in the U.S. The models share common features such as heterogeneity in health, medical expenditures, productivity, endogenous insurance decisions, and capture key aspects of the U.S. insurance system. Each model is calibrated to match the 2007 U.S. economy.

The Patient Protection And Affordable Care Act’S Effects On Patterns Of Coverage In A Ryan White Funded Hiv Clinic: What Are The Implications For The Bluegrass Care Clinic?, Jacqueline Wagner Mccuddy

MPA/MPP/MPFM Capstone Projects

The Ryan White CARE Act of 1991 implemented a federal grant program to help individuals in the US with HIV/AIDS get access to healthcare and diminish barriers to care. Since its enactment, there have been many changes in the environment of HIV/AIDS, including a demographic shift in those most affected by the disease and a growing number of new infections, the introduction of Antiretroviral therapy, and most recently, the implementation of the Patient Protection and Affordable Care Act (PPACA).

The PPACA is expected to have a positive effect on patients with HIV in the US by increasing access to care, …

Cultural Collisions And The Limits Of The Affordable Care Act, Jasmine E. Harris

All Faculty Scholarship

National Federation of Independent Business v. Sebelius (“NFIB”) settled the central constitutional questions impeding the rollout of the Patient Protection and Affordable Care Act (“ACA”): whether the federal government’s “individual mandate” to purchase or hold health insurance and the federal government’s authority to retract existing federal dollars if states fail to expand Medicaid eligibility violate the Constitution. However, a number of residual questions persist in its wake. While most of the focus this year has been on related constitutional issues — such as religious exemptions from offering contraceptive coverage to employees — NFIB also clears the path for a discussion …