Awarded Grant
State Benchmarking, Healthcare Outcomes, and Implications for People with Disabilities (December 2016)
Principal Investigator: Kathleen Thomas, PhD, University of North Carolina Chapel Hill
The goal of this study is to improve the physical and economic health of people with disabilities using evidence on state insurance benchmarking strategies that support improved access and quality healthcare for people with disabilities. The researchers will use data from the Health Reform Monitoring Survey (HRMS), a nationally representative online survey of approximately 7,400 non-elderly adults that is designed to allow rapid cycle monitoring of changes in coverage, health care access, and affordability under the ACA to accomplish the following:
- Combine state benchmarking strategies for Medicaid, expansion coverage, marketplace, and employer-sponsored plans with the HRMS.
- Test the impact of ACA insurance benchmarking reforms on access to care and employment for people with disabilities.
Awarded Grant
The Effect of State Minimum Wage Laws on Medicaid Expansion Outcomes (December 2016)
Principal Investigator: Christine Eibner, PhD, RAND Corporation
The goal of this study is to inform state-level policy discussions around whether minimum wage changes could have unintended consequences for workers’ health insurance access and to enable state policymakers to begin thinking about potential solutions. Over the past several years, there has been significant policy action regarding state minimum wage laws—with the federal minimum wage increasing by 40 percent between 2007 and 2010, and 15 states increasing their minimum wages above the federal requirement between 2010 and 2015. Higher minimum wages may affect employer-sponsored insurance enrollment if employers respond to wage increases by reducing benefit generosity, increasing employee contributions, or eliminating insurance entirely. Using data from the Current Population Survey, the researchers will estimate whether state minimum wage changes that occurred since 2007 were associated with reduced employer-sponsored insurance enrollment, and whether this effect was modified by Medicaid expansion.
Publications
The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults
(2016, Report)
Do Minimum Wage Changes Affect Employer-Sponsored Insurance Coverage?
(June 2018, Presentation)
Awarded Grant
How Much Better is Medicaid than Marketplace Coverage at Easing the Burden of Out-of-Pocket Spending for Near-Poor Adults? (December 2016)
Principal Investigator: Frederic Blavin, PhD, The Urban Institute
The goal of this study is to inform expansion and non-expansion states of the effect of Medicaid expansion on out-of-pocket spending and the overall resources available to families. Using data from the 2014-2016 Current Population Survey Annual Social and Economic Supplement, the applicants will conduct a difference-in-differences analysis, using the 2014 Medicaid expansion as a natural experiment, to address the following research questions:
- Compared to marketplace coverage, what is the impact of the Medicaid expansion on reducing premium and non-premium out-of-pocket health spending among low-income adults with incomes between 100 and 138% FPL? In other words, among those in this income group, how much would out-of-pocket health spending in nonexpansion states change if states either expanded Medicaid or made Marketplace benefits and cost-sharing comparable with Medicaid?
- What is the impact of the Medicaid expansion on out-of-pocket health spending among adults with incomes below 100% FPL in expansion states, relative to similar adults in nonexpansion states without access to Medicaid or Marketplace subsidies?
- How do these changes in out-of-pocket spending affect the overall resources available to families?
Publications
Medicaid vs. Marketplace Coverage for Near-Poor Adults: Effects on Out-of-Pocket Spending and Coverage
(June 2018, Presentation)
"Medicaid Versus Marketplace Coverage for Near-Poor Adults: Effects On Out-Of-Pocket Spending"
(February 2018, Health Affairs)
Impact of Medicaid vs. Marketplace Coverage on Out-of-Pocket Spending for Near-Poor Adults
(December 2017, SHARE Webinar)
Medicaid vs. Marketplace Coverage for Near-Poor Adults: Impact on Out-of-Pocket Spending Burdens
(November 2017, Presentation)
Blog & News
Video: Angie Fertig Discusses SHARE-Funded Study of Pent-Up Demand among New Medicaid Enrollees
November 11, 2016:Dr. Angie Fertig, Research Investigator at Medica Research Institute (MRI), is featured in a new MRI Investigator Video in which she discusses her SHARE-funded analysis of pent-up demand among new Medicaid enrollees under the ACA. Check out the video below.
Additional information about this analysis can be found on Dr. Fertig's SHARE grantee page.
Angela Fertig PhD-2016 from Medica Research Institute on Vimeo.
Blog & News
SHARE Research at APPAM: A State Perspective on the Coverage, Access, & Cost Impacts of the ACA
November 02, 2016:The 2016 Fall Research Conference of the Association for Public Policy Analysis & Management (APPAM) begins tomorrow and runs through Friday in Washington, DC. The conference, which is mutli-displinary in nature, focuses on a range of current and emerging policy and management issues, including health policy. This year's conference theme is "The Role of Research in Making Government More Effective."
Findings from several SHARE-funded studies will be featured during the conference on a panel titled, "State-Level Impacts of the Affordable Care Act: Coverage, Access, and Costs." The panel includes four presentations that examine the effects of the federal Affordable Care Act (ACA) on a range of outcomes, including health insurance coverage, access to care, service utilization, and costs and affordability. In each study, the researchers examine outcomes as a function of state health policy decisions and attributes.
SHARE funded three of these four studies and organized this panel with a state policy lens in mind – recognizing that the impacts of the ACA hinge on individual state decisions and that the ACA, because of its federal scope, provides a unique opportunity to study state variation in a systematic way. The systematic nature of these analyses subsequently supports the generation of evidence that can meaningfully inform and facilitate federal and state policymaking and public management in the areas of health insurance coverage and insurance market regulation.
Click on the links below to learn more about the panel and/or the individual panel presentations.
Panel Details
State-Level Impacts of the Affordable Care Act: Coverage, Access, and Costs
Thursday, November 3, 2016, 1:15PM – 2:45PM
Room: Columbia 9 (Washington Hilton)
Chair: Sharon Long, Urban Institute
Discussants: Kathleen Call, State Health Access Data Assistance Center, and Lisa Dubay, Urban Institute
To Expand Medicaid or Not to Expand Medicaid? Effects of State ACA Medicaid Expansion Decisions on Coverage, Access, Utilization, and Health Status of Low-Income Adults
Speaker: Laura Wherry, University of California, Los Angeles
The Medicaid Expansion States: Effects of Medicaid Coverage on Access, Affordability, Utilization, and Health Status for Newly Eligible and Previously Eligible Adults*
Speaker: Michael Dworsky, RAND Corporation
Early Evidence on Employment Responses to the Affordable Care Act: Employer Coverage Offers*
Speaker: Jean Abraham, University of Minnesota
Specialty Drug Benefit Design and Patient Out-of-Pocket Costs in the ACA Health Insurance Exchanges*
Speaker: Erin Taylor, Pardee RAND Graduate School
*Research supported by SHARE funding