Under the Affordable Care Act (ACA), states can expand Medicaid eligibility for nonelderly adults with incomes up to 138 percent of the federal poverty level (FPL). As of May 2016, 19 states had not expanded Medicaid. Based on reported Medicaid and marketplace data, we estimate that in 2017, even without the Medicaid expansion, the major coverage provisions of the ACA will have reduced the numb...

Physician acceptance of new Medicaid patients has shown to be lower than acceptance of new Medicare patients or new privately insured patients. Acceptance of new Medicaid patients also has shown to be lower in states with lower Medicaid payment rates to physicians. Using the 2013 National Electronic Health Records Survey (NEHRS), this report summarizes physician acceptance of new patients with ...

This technical assistance (TA) brief discusses strategies for accessing vital records for quality measurement and improvement efforts related to maternal and infant health care in Medicaid and the Children’s Health Insurance Program (CHIP). The brief also gives guidance and describes resources available to states for linking vital records and Medicaid/CHIP data to increase states’ capacity to r...

M edicaid (Title XIX of the Social Security Act) was designed to provide medical and dental care for children in low socioeconomic groups. Access to dental care for children covered by Medicaid, however, has not been entirely successful due to lack of participation by dental providers. 1, 2 Low reimbursement rates have been reported by providers to be a major factor in Medicaid nonparticipation...

In 2006, Florida's Medicaid reform required some Medicaid consumers to enroll in health plans that differed in terms of cost-sharing requirements and benefit limitations. In focus groups we found enthusiasm among Medicaid consumers for having choices among health plans; however, enthusiasm did not translate into comparison shopping for health plans. Survey findings suggested that Medicaid consu...

On this 35th anniversary of the enactment of Medicaid, it is important to reflect on the program's role in the U.S. health care system. The Medicaid program is the third largest source of health insurance in the United States-after employer-based coverage and Medicare. The significance of Medicaid's role in providing health insurance cannot be overstated. As the largest in the Federal safety ne...

Medicaid, the nation’s main public health insurance program for low-income people, now covers over 65 million Americans – more than 1 in every 5 – at least some time during the year. The program’s beneficiaries include many of the most disadvantaged individuals and families in the U.S. in terms of poverty, poor health, and disability. The Affordable Care Act (ACA) provided for a broad expansion...

This article assesses the participation and the financial performance of licensed health maintenance organization (HMOs) in the Medicaid market. The study found that participation by Medicaid Dominant plans has more than doubled from 11 percent in 1992 to 23 percent in 1998 while Medicaid membership in Commercial Dominant plans declined from 71 percent in 1994 to 51 percent in 1998. Both partic...

OBJECTIVE To evaluate the effectiveness of increased primary care access created by North Carolina's Medicaid managed care plan, Carolina Access (CA), in reducing unnecessary emergency department (ED) use in Guilford County. METHODS Emergency department records of pediatric visits before and after the implementation of CA were analyzed. Variables included patient age, International Classifica...