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Medicaid DSH Cut Delayed

Cuts in Medicaid DSH payments to hospitals will be delayed for another month after Congress passed, and the president signed, a continuing resolution to fund the federal government through December 20. A cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states is mandated by the Affordable Care Act and has been delayed several times by Congress.  If implemented, Medicaid DSH allotments to the states would be slashed $4 billion in FY 2020 and then $8 billion a year through FY 2025. Cuts in allotments to the states would result in reductions of Medicaid DSH payments to DSH-eligible hospitals. Medicaid DSH payments are a vital tool for helping safety-net hospitals care for the low-income residents of their communities.  … Read More

Posted in Affordable Care Act, DSH hospitals, Federal Medicaid issues

Administration Shares Regulatory Priorities for 2020

The Trump administration’s health care regulatory priorities for 2020 have been outlined by the Office of Management and Budget in a newly released “Statement of Regulatory Priorities for Fiscal Year 2020.” The statement, an annual OMB document, organizes the priorities as follows: Facilitating patient-centered markets Fixing health care financing through protecting private insurance and Medicare Fixing health care financing through reforming the individual market Fixing health care financing through making the ACA and Medicaid fiscally sustainable Bringing value to health care through price and quality transparency Bringing value to health care through patient-centered health IT Bringing value to health care through deregulation, especially for coordinated care Bringing value to health care through tackling the high cost of prescription drugs Bringing … Read More

Posted in Affordable Care Act, Federal Medicaid issues, Medicare

Medicaid Expansion Brings Improvements to Expansion States

States that expanded their Medicaid programs under the Affordable Care Act have experienced fewer hospital admissions, shorter lengths of stays in the hospital, and lower hospital costs, according to a new Health Affairs study. Specifically, they experienced: a 3.1 percent decline in inpatient days a 3.5 percent decrease in discharges for conditions considered “ambulatory care-sensitive,” such as diabetes, chronic respiratory problems, and pneumonia a reduction of nearly three percent in hospital costs. Pennsylvania is one of those expansion states, and Medicaid expansion has greatly enhanced the ability of Pennsylvania safety-net hospitals to serve their communities. Learn more about how Medicaid expansion has improved the health of the population in states that expanded their Medicaid programs in the Health Affairs study … Read More

Posted in Affordable Care Act, Federal Medicaid issues, Pennsylvania safety-net hospitals

ACA May be Improving, Saving Lives

The insurance expansion made possible by the Affordable Care Act may be improving and even saving lives, some studies and anecdotal evidence suggest. While observers warn that it is difficult to attempt to render a final verdict on the reform law’s insurance expansion and its impact, various studies and observations point to encouraging developments.  Among them: High blood pressure is being detected at a higher rate now among people who bought insurance as a result of the ACA than it was prior to the law’s passage. Fewer 19-26 year-olds, now permitted to remain on their parents’ health insurance, are choosing not to see a doctor about their asthma because of the cost of seeking care. Women in Michigan report having … Read More

Posted in Affordable Care Act, Pennsylvania Medicaid policy

CMS Adopts Methodology for Medicaid DSH Cuts

Medicaid DSH money will be allocated among states based on a new methodology under a regulation adopted this week by the Centers for Medicare & Medicaid Services. But it is not clear when that new methodology may actually be used. Cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to states were mandated by the Affordable Care Act based on the expectation that the law would greatly reduced the number of uninsured Americans.  While this has been the case, the decline in the number of uninsured has not been as great as expected.  For this reason, Congress has on several occasions delayed the required Medicaid DSH cut. That cut is now scheduled to take effect next week, on October 1, … Read More

Posted in Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals

Millions Eligible for Health Insurance Remain Uninsured

More than 15 million Americans who are currently entitled to free or subsidized health insurance are currently uninsured. Among them are 11 million who are eligible for Medicaid but have not applied for benefits and 4.2 million who could afford insurance with the help of federal premium subsidies and either have decided not to take advantage of those subsidies or are unaware of the availability of such subsidies. In addition, another two million people would be eligible for Medicaid if their states expanded their Medicaid program as authorized by the Affordable Care Act. In light of such figures, it is not entirely surprising that the uninsured rate, according to the census bureau, rose last year for the first time since … Read More

Posted in Affordable Care Act

ACA Has Reduced Insurance Disparities

The Affordable Care Act is responsible for a major reduction in the disparity of insurance status among racial and ethnic minorities. According to a new Commonwealth Fund analysis, All U.S. racial and ethnic groups saw comparable, proportionate declines in uninsured rates…  However, because uninsured rates started off much higher among Hispanic and black non-Hispanic adults than among white non-Hispanic adults, the coverage gap between blacks and whites declined from 11.0 percentage points in 2013 to 5.3 percentage points in 2017. Likewise, the coverage gap between Hispanics and non-Hispanic whites dropped from 25.4 points to 16.6 points. Learn more about specific differences among racial and ethnic groups, differences based on residence in Medicaid expansion states and non-expansion states, and differences in … Read More

Posted in Affordable Care Act

ACA’s Medicaid Pay Bump Helped But Benefits Now Lost, Study Says

Health status and access to care improved for Medicaid patients when the Affordable Care Act mandated a temporary rate increase for physicians serving newly insured patients covered through that law’s Medicaid expansion. But when the mandate for increased physician payments ended and state Medicaid programs reverted to their previous, lower payments, many of those benefits were lost. Or so reports a new study from the National Bureau of Economic Research. According to the study, even a $10 rate increase improved access to care enough to reduce by 13 percent Medicaid recipients’ complaints about not being about to find a doctor.  Utilization also increased.  The temporary Medicaid pay increase has even been credited with improving school attendance and reducing chronic absenteeism. … Read More

Posted in Affordable Care Act

PA May Take Over Insurance Exchange

Pennsylvania may soon assume responsibility for providing a health insurance exchange for its residents. When the Affordable Care Act was adopted in 2010, states were given the option of establishing their own marketplaces for health insurance offered under the reform law or having their citizens use a federal exchange established for the same purpose.  Pennsylvania chose to have its residents use the federal exchange, but now, a law changing that is making its way through the state legislature. House Bill 3, with more than 80 sponsors from both parties, would direct the state to establish its own health insurance exchange and establish a Pennsylvania Health Insurance Exchange Fund to pay for it. After years of ceding this responsibility to the … Read More

Posted in Affordable Care Act

Medicaid Expansion Helps Pregnant Women and Their Babies

An intuitive assumption now has evidence to support it:  Medicaid expansion has improved the health of pregnant women and their babies. According to a new study from the Georgetown University Health Policy Institute’s Center for Children and Families, …states that expand Medicaid improve the health of women of childbearing age:  increasing access to preventive care, reducing adverse health outcomes before, during and after pregnancies, and reducing maternal mortality rates. Better health for women of childbearing age also means better health for their infants.  States that have expanded Medicaid under the Affordable Care Act saw a 50 percent greater reduction in infant mortality than non-expansion states. The report notes that the number of uninsured women of childbearing age in Pennsylvania fell … Read More

Posted in Affordable Care Act, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals
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