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Blog & News
Now Available on State Health Compare: Updated Data on Five Measures of Social Determinants of Health and Three Measures of Youth Health Behaviors
August 01, 2018:SHADAC has updated eight measures in State Health Compare. The updated measures include:
- Unemployment Rate
This measure is now available for all states from 2000 through 2017. - Smoke-Free Campuses
The measure is an indication of whether a state has enacted laws to ensure smoke-free campuses and can be broken down by type of school campus—i.e., public vs. private and k-12 vs. college. This measure is now available for all states from 2000 through 2017. - Cigarette Tax Rates
This measure indicates the rate of state excise tax per pack of cigarettes and is now available for all states from 2000 through 2016. - Public Health Funding
This measure captures per-capita state-provided public health funding in each state and is now available for all states from 2005 through 2016. Read SHADAC’s recent issue brief on this measure. - Child Vaccinations
This measure indicates the percent of children ages 19-35 months who received all recommended vaccines and is now available for all states from 2000 through 2016. - High School Obesity
This measure indicates the prevalence of obesity (>95th percentile for BMI) among high school students. It is now available for all states from 2001 through 2017. - High School Smoking
This measure indicates the percent of high school students who smoked at least one cigarette in the past 30 days. It is now available for all states from 2001 through 2017. - High School Physical Activity
This measure indicates the percent of high school students who did not meet the recommendations for 60 minutes of physical activity per day in five of the last seven days. It is now available for all states from 2001 through 2017.
Explore these updated estimates on State Health Compare.
Data Sources
The State Health Compare estimates for unemployment rates come from the Bureau of Labor Statistics; the smoke free campuses and state cigarette tax rates come from the Centers for Disease Control’s (CDC) State Tobacco Activities Tracking and Evaluation (STATE) System; the public health funding measure comes from Trust for America’s Health; the child vaccinations measure comes from the CDC’s National Immunization Survey; and the measures of high school obesity, smoking, and physical activity come from the CDC’s Youth Risk Behavior Surveillance System (YRBSS).
Blog & News
SHARE Panel at 7th Annual ASHEcon
July 30, 2018:
The 2018 Conference of the American Society of Health Conomists (ASHEcon) will take place from June 10th to June 13th at Emory University in Atlanta, with this year's theme being "Economics and Public Health."
An ASHEcon panel featuring findings from recent SHARE-funded research projects is scheduled for Monday, June 11th, from 10:00 a.m. to 11:30 a.m. in the Azalea Room of the Emory Conference Center Hotel. Panel details are below.
Panel: Medicaid Eligibility Thresholds and Minimum Wage Laws: The Impact of State Policy Decisions on Health Insurance Coverage, Out-of-Pocket Spending, and Access to Care
Chair: Andrew Mulcahy (RAND Corporation)
Paper: Medicaid vs. Marketplace Coverage for Near-Poor Adults: Effects on Out-of-Pocket Spending and Coverage
Presenting Author: Fredric Blavin (Urban Institute)
Discussant: Andrew Mulcahy (RAND Corporation)
Paper: The Impact of Changes in Medicaid Eligibility Thresholds on Duration of Health Insurance Coverage and Access to Health Care
Presenting Author: Heather Dahlen (University of Minnesota)
Discussant: Marguerite Burns (University of Wisconsin - Madison)
Paper: Do Minimum Wage Changes Affect Employer-Sponsored Insurance Coverage?
Presenting Author: Christine Eibner (RAND Corporation)
Discussant: Thomas Buchmueller (University of Michigan)
Publication
Affordable Care Act Impact in Kentucky: Increasing Access, Reducing Disparities
The American Journal of Public Health (AJPH) has just released a SHADAC-authored article, “Affordable Care Act in Kentucky: Increasing Access, Reducing Disparities.” The piece was co-authored by SHADAC Director Lynn A. Blewett along with SHADAC researchers Colin Planalp and Giovann Alarcón. The authors used data from the American Community Survey (ACS) to examine changes in uninsurance and uninsurance disparities by race/ethnicity in Kentucky since the state’s implementation of the Affordable Care Act (ACA).
Key Findings: Kentucky’s Uninsured
The authors found that Kentucky’s uninsurance rate for all ages declined significantly between 2013 and 2015, from 14.4% to 6.1%. Among racial/ethnic groups, the largest decline in the uninsurance was experienced by Blacks (from 16.7% uninsured in 2013 to 5.5% in 2015), although uninsurance rates among the state’s White and Hispanic populations also declined significantly (from 13.3% to 5.3% and from 34.5% to 24.2%, respectively). Only the uninsurance rate for Asians remained statistically unchanged between 2013 and 2015.
Key Findings: Disparities
In Kentucky in 2015, coverage disparities among Blacks were eliminated. In 2013, Blacks were overrepresented among the uninsured, accounting for 8.9% of the state’s uninsured while representing a smaller 7.7% of the state’s population. But in 2015, Blacks represented 7.1% of the state’s uninsured, which was not significantly different from their overall proportion of the population in 2015 (7.8%). However, Whites did continue to experience favorable disparities in 2015, being underrepresented among the uninsured, at 74.2%, compared with their share of the population, at 85.4%. Moreover, Kentucky’s Hispanic/Latino population remained overrepresented among the state’s uninsured in 2015, making up 13.0% of the state’s uninsured but only 3.3% of the state’s total population. Asians were also overrepresented among the uninsured in 2015, representing 2.8% of the uninsured but just 1.4% of the population.
Read the full American Journal of Public Health article to learn more about study methods and findings, as well as the role of health policy in reducing disparities.
Blog & News
SHADAC Research in American Journal of Public Health: ACA Led to Increased Health Insurance Access, Reduced Disparities in Kentucky
May 30, 2018:The American Journal of Public Health (AJPH) has just released a SHADAC-authored article, “Affordable Care Act in Kentucky: Increasing Access, Reducing Disparities.” The piece was co-authored by SHADAC Director Lynn A. Blewett along with SHADAC researchers Colin Planalp and Giovann Alarcón. The authors used data from the American Community Survey (ACS) to examine changes in uninsurance and uninsurance disparities by race/ethnicity in Kentucky since the state’s implementation of the Affordable Care Act (ACA).
Key Findings: Kentucky’s Uninsured
The authors found that Kentucky’s uninsurance rate for all ages declined significantly between 2013 and 2015, from 14.4% to 6.1%. Among racial/ethnic groups, the largest decline in the uninsurance was experienced by Blacks (from 16.7% uninsured in 2013 to 5.5% in 2015), although uninsurance rates among the state’s White and Hispanic populations also declined significantly (from 13.3% to 5.3% and from 34.5% to 24.2%, respectively). Only the uninsurance rate for Asians remained statistically unchanged between 2013 and 2015.
Key Findings: Disparities
In Kentucky in 2015, coverage disparities among Blacks were eliminated. In 2013, Blacks were overrepresented among the uninsured, accounting for 8.9% of the state’s uninsured while representing a smaller 7.7% of the state’s population. But in 2015, Blacks represented 7.1% of the state’s uninsured, which was not significantly different from their overall proportion of the population in 2015 (7.8%). However, Whites did continue to experience favorable disparities in 2015, being underrepresented among the uninsured, at 74.2%, compared with their share of the population, at 85.4%. Moreover, Kentucky’s Hispanic/Latino population remained overrepresented among the state’s uninsured in 2015, making up 13.0% of the state’s uninsured but only 3.3% of the state’s total population. Asians were also overrepresented among the uninsured in 2015, representing 2.8% of the uninsured but just 1.4% of the population.
Read the full American Journal of Public Health article to learn more about study methods and findings, as well as the role of health policy in reducing disparities.
Blog & News
SHARE Results from Sara McMenamin in American Journal of Preventive Medicine: ACA Improved and Expanded Medicaid Coverage of Smoking Cessation Treatment
May 15, 2018:According to a new article in the American Journal of Preventive Medicine, the Affordable Care Act (ACA) improved and expanded state Medicaid coverage of effective smoking cessation treatment, although many programs are not fully compliant with the law.
The analysis, which is based on a SHARE-funded study led by Dr. Sara McMenamin (University of California, San Diego), examined data collected from 50 State Medicaid programs and the District of Columbia using a 12-question web-based survey. The survey assessed each program’s smoking-cessation coverage and its compliance with the four sections of the ACA (i.e., Sections 4107, 4106, 2502, and 2001) that address the expansion of Medicaid coverage for smoking-cessation treatments to bring coverage into alignment with recommendations from the U.S. Preventive Services Task Force (USFSTF). The authors also examined benefits language documents from each state as well as state plan amendments.
Key Findings
- Section 4107 of the ACA: Smoking-Cessation Coverage for Pregnant Women
Section 4107 of the ACA requires coverage of smoking-cessation treatments for pregnant women, including all seven forms of pharmacotherapy and individual and group counseling. Sixteen states adding this comprehensive coverage post-ACA, bringing the total number of states offering ACA-compliant smoking-cessation coverage for pregnant women to 28 (i.e., 55% of states). Taken separately, coverage for pharmacotherapy increased from 26 states covering all seven drugs for pregnant women in 2009 to 47 states in 2017. Coverage for smoking-cessation counseling lagged coverage for pharmacotherapy, with coverage for both face-to-face group and individual counseling for pregnant women increasing from 16 states in 2009 to 28 states in 2017. Of note, the four states that offered no coverage for cessation services for pregnant women in 2009 added at least some coverage by 2017, such that all 51 Medicaid programs offered coverage for at least some pharmacotherapy and counseling treatments to pregnant Medicaid enrollees.
- Section 4106 of the ACA: Coverage of USPSTF-Recommended Preventive Services without Cost-Sharing
Section 4106 of the ACA offers a 1% increase in the Federal Medical Assistance Percentage (FMAP) if Medicaid programs fully cover USPSTF-recommended preventive services, including all effective smoking-cessation treatments, and remove cost-sharing. In all, 15 Medicaid programs have submitted a state plan amendment to implement Section 4106, and nine of these report smoking-cessation coverage in alignment with Section 4106. Prior to the ACA, only one Medicaid program provided smoking-cessation coverage in alignment with Section 4106.
- Section 2502 of the ACA: Smoking-Cessation Pharmacotherapy May Not Be Excluded from Medicaid Formularies
Section 2502 of the ACA prohibits states from excluding any FDA-approved pharmacotherapy from their Medicaid formularies. The number of Medicaid programs covering all recommended pharmacotherapy increased from 26 in 2009 to 48 in 2017.
- Section 2001 of the ACA: Coverage of Preventive Services, Including Smoking Cessation, under Medicaid Expansion
Section 2001 of the ACA requires Medicaid programs in expansion states to cover all USPSTF-recommended preventive services, including smoking cessation, without cost-sharing or prior authorization requirements. In all, 23 of the 32 expanded Medicaid programs covered all recommended smoking-cessation treatments for their Medicaid expansion population. However, two programs were not covering all the recommended pharmacotherapy, and nine were not covering both individual and group counseling. Additionally, four still required cost-sharing for their covered treatments, and 21 have prior authorization requirements for some or all of their covered smoking-cessation treatments.
Conclusion
Medicaid programs have made considerable progress in expanding coverage for smoking-cessation treatments for enrollees since the passage of the ACA. However, the four sections of the ACA that address smoking-cessation treatments have not been fully realized, and the authors note that additional guidance and clarification from the Centers for Medicare and Medicaid Services (CMS) may be needed regarding these sections in order to achieve full compliance with the law.
Read the full American Journal of Preventive Medicine article.
