Social and Behavioral Sciences Commons^™

Sociodemographic And Health Status Characteristics Of Maine's Newly Eligible Medicaid Beneficiaries [Data Brief], Zachariah T. Croll Mph, Erika C. Ziller Phd, Barbara Leonard Mph

Medicaid

This data brief identifies key characteristics of groups who will gain access through MaineCare expansion. Researchers Croll and Ziller at the University of Southern Maine, along with Leonardson of the Maine Health Access Foundation present a statistical analysis of uninsured non-elderly adults age 18 – 64 with no children and lower incomes, the population newly eligible for MaineCare through expansion. Drawing from five years of data from Maine’s Behavioral Risk Factor Surveillance System, the report addresses sociodemographic characteristics, health status, and access to care. The survey indicates that those who are likely eligible for expanded MaineCare coverage are twice as …

Three Essays On Property Tax Administration, Yusun Kim

Dissertations - ALL

This dissertation is comprised of three essays on real property tax administration and related state-local fiscal relations. All three essays exploit variation in state policies as natural experiments to study the various features of the property tax system.

The first essay examines how county governments respond to a state policy that reduced counties' share of state Medicaid costs, in a state where counties are mandated to financially contribute to the state program. The key motivation of this study is to understand the consequences of a change in the way a large public insurance program is co-financed by different levels of …

Three Essays On The Societal Impact Of Health Policies And Laws, Xuanhao He

Economics ETDs

This dissertation provides evidence to the two contentious debate over health policies and laws in the US, Medicaid expansion and sex offender registration and notification. In Chapter 2, I explore one key determinant of Medicaid take-up, the benefit of access to care proxied by the Medicaid-to-Medicare primary care physician payment ratio. Using a unique dataset of Medicaid physician reimbursement rates and the American Community Survey of 2010 – 14, I find that a 10-percentage-point increase in the payment ratio of a 30-minute new patient office visit will increase Medicaid enrollment among uninsured adults in poverty by more than 150,000. In …

Medicaid Coverage Across The Income Distribution Under The Affordable Care Act, Charles J. Courtemanche, James Marton, Aaron Yelowitz

Institute for the Study of Free Enterprise Working Papers

This chapter examines trends in Medicaid enrollment across the income distribution after the ACA’s Medicaid expansion.Using data from the American Community Survey between 2012and 2017, we compare Medicaid coverage over time in 9 states that expanded Medicaid in 2014 with no previous expansion for able-bodied, working-age adults with 12 states that had not expanded Medicaid by 2019 and also had no previous expansion for such adults. A difference-in-differences model is used to formalize this comparison. Similar to many previous studies, we find that Medicaid coverage increased dramatically for income-eligible adults under 138% of the federal poverty level (FPL). In addition, …

Navigating The Michelle P. Waiver: A Narrative Examination Of The Impact Of Parent Care-Related Uncertainty And Decision Making For Children With Disabilities, Whittney Darnell

Whittney Darnell

Reexamining The Impact Of Medicaid Expansion In A Post-Affordable Care Act Environment From A Critical Race Perspective, Ty Price Dooley

Journal of Public Management & Social Policy

The passage of the Patient Protection and Affordable Care Act (ACA) in 2010 drastically transformed the health care system in the United States. This paper examines the factors influencing state decisions relative to Medicaid expansion in a post-ACA environment through the lens of Critical Race Theory. This study incorporates economic, geographic and health variables into a model of post-ACA-Medicaid decision-making by using logistic regression to examine State Medicaid expansion from 2010 to 2014. The size of the minority population in state, tobacco use and southern distinctiveness are significant predictors of decision making relative to Medicaid expansion. Findings support that racialized …

The Effects Of The Affordable Care Act Medicaid Expansion On Breast And Cervical Cancer Screening Rates On Low-Income Childless Women, Michelle Raissa Kobou Wafo

Economics

In 2010, the Obama administration passed the Patient Protection and Affordable Care Act (ACA) commonly known as Obamacare. However, it is in 2014 that several key parts of the ACA went into effect. Among those key parts is the Medicaid expansion program. States that chose to adopt the policy, expanded Medicaid access to everyone under 138 percent of the federal poverty line. This extension had the largest impact on childless adults who previously were not covered by the program. Moreover, ACA made it mandatory for all health plans (private and public) to include the ten essential health benefits in their …

Effects The 2014 Medicaid Expansion On Seat Belt Use: An Investigation Into Moral Hazard, Paul Pangburn

Economics

Under the Patient Protection and Affordable Care Act, signed into law by President Obama in 2010, health insurance coverage was expanded to 20 million previously uninsured people. Of these, 14.5 million were Medicaid eligible. Moral Hazard, a common research topic in insurance, is defined as when the private actions of an individual in a risk-sharing situation influence the probability of the outcome. There are two types of moral hazard, called ex-post moral hazard and ex-ante moral hazard. In the case of health insurance, ex-post moral hazard is when a health behavior changes after an individual becomes insured. Ex-ante moral hazard, …

The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd

Disability & Aging

This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.

Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.

Restricted Access And Delays To Hcv Treatment Among Medicaid Patients In Louisiana, Morris M. Kim, Keanan M. Mcgonigle

Journal of Health Disparities Research and Practice

Background: Many people living with chronic Hepatitis C Virus (HCV) have seen delays in accessing treatment or been denied entirely due to Medicaid restrictions requiring patients to meet certain criteria prior to receiving approval for medication pre-authorization.

Methods: This study identified a cohort of Medicaid-insured patients with chronic HCV infection within New Orleans, LA. Patient medical records were reviewed and information regarding HCV care was gathered. This study sought to determine the degree to which HCV care was delayed for this population and describe common reasons for prior-authorization denials for direct-acting antiviral (DAA) medications.

Results: For this population of Medicaid-insured …

The Effect Of The Affordable Care Act's Medicaid Eligibility Expansion On Labor Supply, Shannon Hebert

Senior Theses and Projects

Medicaid is a program that uses funds from the states and federal government to provide healthcare coverage to millions of Americans. A key goal of the 2010 Affordable Care Act (ACA) was to expand Medicaid eligibility to include all adults with income below 138 percent of the federal poverty level. Unintended labor supply consequences may arise due to this eligibility expansion. This paper seeks to determine what the effect of the ACA’s Medicaid eligibility expansion on labor supply is.

In 2012, the Supreme Court ruled to make the expansion optional for states. As a result, many states chose not to …

Medicaid Work Requirements: State-Based Innovation Or Punitive Policymaking?, Diane Sherwin

Honors Theses

In March 2017, officials appointed to the Center for Medicare and Medicaid Services by President Donald Trump signaled to state governments their intent to support states who would choose to utilize Medicaid’s Section 1115 waiver provision to alter their state’s Medicaid program by introducing a work requirement. As of October 1, 2018, 13 states have heeded this signal and proposed a work requirement component for their Medicaid programs. The purpose of this paper is to determine if Medicaid work requirements are an innovative policy approach to improve independence among Medicaid enrollees, or if these requirements are a punitive, partisan approach …

The Shadows Of Life: Medicaid's Failure Of Health Care's Moral Test, Barak D. Richman, Kushal T. Kadakia, Shivani A. Shah

Faculty Scholarship

North Carolina Medicaid covers one-fifth of the state’s population and makes up approximately one-third of the budget. Yet the state has experienced increasing costs and worsening health outcomes over the past decade, while socioeconomic disparities persist among communities. In this article, the authors explore the factors that influence these trends and provide a series of policy lessons to inform the state’s current reform efforts following the recent approval of North Carolina’s Section 1115 waiver by the Centers for Medicare and Medicaid Services. The authors used health, social, and financial data from the state Department of Health and Human Services, the …

Threats To Medicaid And Health Equity Intersections, Mary Crossley

Articles

2017 was a tumultuous year politically in the United States on many fronts, but perhaps none more so than health care. For enrollees in the Medicaid program, it was a “year of living precariously.” Long-promised Republican efforts to repeal the Affordable Care Act also took aim at Medicaid, with proposals to fundamentally restructure the program and drastically cut its federal funding. These proposals provoked pushback from multiple fronts, including formal opposition from groups representing people with disabilities and people of color and individual protesters. Opposition by these groups should not have surprised the proponents of “reforming” Medicaid. Both people of …

Everybody’S Working (But The Weakened): An Assessment Of Medicaid Work Requirements And Their Administrative Burdens, Samuel Misleh

MPA/MPP/MPFM Capstone Projects

Although Medicaid work requirements are currently halted in both Arkansas and Kentucky, this analysis utilizes the data available to make an assessment and estimate of what Kentucky’s Medicaid enrollment will look like if work requirements similar to those Arkansas had are ever implemented. The relative severity of the administrative burden of such requirements provide a tool for comparison, and a difference-in-differences analysis of the change in Medicaid enrollment between Arkansas and West Virginia, a state that has not implemented and currently has no plans to implement Medicaid work requirements, provide the bases for this estimate. After coding the work requirements …

Does Medicaid Increase Emergency Room Use: Evidence From Oregon Health Program?, Md Fourkan

Electronic Theses and Dissertations

This thesis paper strives to identify the relationship between Medicaid expansion and Emergency Department use. I use a Monte Carlo simulation for demonstrating the endogeneity problem and a copula model using the Oregon Health Program (OHP) data to show the previous literature has exaggerated the causal relation between Medicaid expansion and Emergency Department use. This paper can be divided into two parts. First, it tries to focus on the under-identification of multiple endogenous variables problem in typical econometrics papers, where researchers correct for a single endogenous variable but intentionally or unintentionally ignore the endogeneity of one or more other independent …

Navigating The Michelle P. Waiver: A Narrative Examination Of The Impact Of Parent Caregiver-Related Uncertainty And Decision Making For Children With Disabilities, Whittney H. Darnell

Theses and Dissertations--Communication

The Michelle P. Waiver (MPW) is the primary means of health insurance for more than 10,000 people in the state of Kentucky. The waiver is especially popular among families with young children with disabilities because it is robust in its benefit offerings and also one of the few Medicaid resources that does not include parental income as a qualifying factor in eligibility. Through the waiver, children receive a medical card as well as additional coverage for medical expenses that fall beyond the scope of traditional health insurance. For these young children to gain access to the comprehensive offerings of the …