Featured Issues

Suddenly, Progress on Children’s Health Coverage Reverses

For many years, the rate of uninsured children in the United States has been declining thanks to bipartisan efforts to extend coverage through Medicaid and the Children’s Health Insurance Program. But in 2017, approximately 276,000 more children became uninsured, leading to a total of 3.9 million uninsured children nationwide. The rate for children age 18 and younger went up from 4.7 percent in 2016 to 5 percent in 2017,

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More Rural States Vote to Expand Medicaid

The Affordable Care Act (ACA) allows states to expand Medicaid access to childless adults whose incomes are below 138 percent of the federal poverty level. In the last two years, multiple attempts in Congress to repeal the ACA would have also ended expanded Medicaid. Where it has been adopted, expanded Medicaid has bolstered finances at rural hospital. The majority of recent rural hospital closures – about 90 since 2010 – have occurred in non-expansion states.

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Study: Without Medicaid expansion, poor skip care

Among the report’s findings: Nearly 20 percent of low-income people in states that did not expand Medicaid said they passed up needed medical care in the past 12 months because they couldn’t afford it. That compared to 9.4 percent in states that expanded the program. And about 8 percent of those in states that did not expand Medicaid reported they either skipped medication doses to save money or took less medication than prescribed. That compared to about 5 percent in states that expanded.

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Bringing Value to Iowa’s Medicaid Program

A fundamental flaw of Iowa’s current Medicaid managed care arrangement is its failure to provide value. After closely reviewing current research and examining effective Medicaid solutions from other states, Iowa’s hospitals believe there is a better way, a “Third Way” that puts Medicaid back under state control and evolves the program beyond the volume-based fee-for-service model – a way that creates and sustains value at a level that is simply impossible under the profit-driven private managed care organizations.

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Rural Areas Benefit from Medicaid Expansion

“Expanding Medicaid has had a very positive impact on small towns and rural communities,” said Georgetown University researcher Joan Alker. “Improved coverage rates typically translate to a more stable health care system and help rural areas and small towns maintain availability of health care providers in areas where shortages are all too common. Access to rural health providers is especially important to women of child-bearing age and those with chronic conditions.”

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