Some could have gaps in medical coverage under new law – latimes.com

Nationwide, income fluctuations are estimated to interrupt coverage for as many as 28 million people expected to bounce between Medicaid and the federally subsidized health insurance exchanges that states are working to create, according to an article in the journal Health Affairs. Among those most at risk are seasonal and hourly workers and young adults who lack coverage through their parents or jobs, experts said.

Patients who can’t see their doctors or get their medication will either avoid care or end up in publicly subsidized emergency rooms, pushing healthcare costs even higher, experts said. And insurance premiums will rise if young, healthy people get fed up with the transitions and opt out of health coverage altogether.

via Some could have gaps in medical coverage under new law – latimes.com.

Bill Bars Health-Care Cost Assistance for Immigrants – WSJ.com

Immigrant advocates are upset with a health-care provision of the immigration-overhaul legislation that could force certain immigrants to pay a fee for lacking insurance coverage while excluding them from financial help to buy it.The wrinkle could create the first class of Americans who would face the 2010 Affordable Care Acts penalties without having access to its main benefit. If passed into law, the immigration changes would apply to many of the 11 million immigrants living in the U.S. illegally who would have “provisional” status for a decade before becoming eligible for green cards.

via Bill Bars Health-Care Cost Assistance for Immigrants – WSJ.com.

A possible fix for that coming US doctor shortage? Disruptive innovation | AEIdeas

A Drudge headline right now highlights this medical math: 30 million Americans currently without health insurance will be getting coverage next year. But by 2020, there’s a projected shortage of 45,000 primary care physicians.

This seems like a big problem. But there is an obvious solution: Give more autonomy to nurse practioners. As this AARP blog post points out, “the American Association of Nurse Practitioners [have] 43,000 members who say they can offer basic care if state laws would just let them set up an independent practice without doctor supervision.”

Clayton Christensen argues that nurse practitioners working in retail clinics — such as those at Walmart, CVS and Target – can offer care as good as or better than what doctor’s offices provide — at about 40% lower cost.

via A possible fix for that coming US doctor shortage? Disruptive innovation | AEIdeas.

Health Insurance Coverage and Use of Family Planning Services among Current and Former Foster Youth: Implications of the Health Care Reform Law

This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population.

via Health Insurance Coverage and Use of Family Planning Services among Current and Former Foster Youth: Implications of the Health Care Reform Law.

The Affordable Care Act and Reproductive Health: Potential Gains and Serious Challenges

After nearly a century of failed or incomplete legislative efforts, the Patient Protection and Affordable Care Act (PPACA), enacted by Congress in March 2010, establishes the principle that every American is entitled to affordable and effective health insurance coverage regardless of income or health status. Although many aspects of the act have received broad attention, its impact on reproductive health has received considerably less scrutiny, except when debated through the specific lens of particularly polarized ideological concerns. If fully implemented as planned, the PPACA has the potential to improve reproductive health in the United States in at least three ways: increasing the number of women and men with insurance coverage; increasing the value of insurance coverage for addressing reproductive health needs; and improving access to reproductive health services and information more generally. Several PPACA provisions stand out as having particular importance for reproductive health, including Medicaid family planning expansions, standards for an essential health benefits package, expanded coverage for contraception and other clinical preventive services, and teen pregnancy prevention programs. All these potential gains, however, are threatened by political, economic, and logistical challenges to the PPACA and by flaws in the legislation itself.

via The Affordable Care Act and Reproductive Health: Potential Gains and Serious Challenges.

Insurance Expansion In Massachusetts Did Not Reduce Access Among Previously Insured Medicare Patients

Critics of Massachusetts’s health reform, a model for the Affordable Care Act, have argued that insurance expansion probably had a negative spillover effect leading to worse outcomes among already insured patients, such as vulnerable Medicare patients. Using Medicare data from 2004 to 2009, we examined trends in preventable hospitalizations for conditions such as uncontrolled hypertension and diabetes—markers of access to effective primary care—in Massachusetts compared to control states. We found that after Massachusetts’s health reform, preventable hospitalization rates for Medicare patients actually decreased more in Massachusetts than in control states (a reduction of 101 admissions per 100,000 patients per quarter compared to a reduction of 83 admissions). Therefore, we found no evidence that Massachusetts’s insurance expansion had a deleterious spillover effect on preventable hospitalizations among the previously insured. Our findings should offer some reassurance that it is possible to expand access to uninsured Americans without negatively affecting important clinical outcomes for those who are already insured.

via Insurance Expansion In Massachusetts Did Not Reduce Access Among Previously Insured Medicare Patients.

The Story Behind the Biggest Mistake in Obamacare

The main purpose of the Affordable Care Act (ACA) was to provide health insurance for most of the tens of millions of Americans who don’t currently have any coverage. But after an impossible-to-predict move from the Supreme Court seemed to gut the law’s ability to do that, millions of people will instead get coverage through a drafting error that was never supposed to become law.

via The Story Behind the Biggest Mistake in Obamacare.

Here Comes The Boom: CMS Slashes Medicare Advantage; ‘Disarray For Many Seniors’ – Forbes

Though Democrats denied it during the 2012 campaign, Obamacare cut Medicare by $716 billion in order to partially fund $1.9 trillion in new entitlement spending over the next ten years. A big chunk of those Medicare cuts came from the market-oriented Medicare Advantage program. Cleverly, the Obama administration postponed the Medicare Advantage cuts until after the election, so as to persuade seniors that everything would be just fine. But the election is over. On Friday, the administration announced that it would be significantly reducing funding for the popular program. Obama’s proposal, according to one analyst, “would turn almost every plan in the industry unprofitable.”

via Here Comes The Boom: CMS Slashes Medicare Advantage; ‘Disarray For Many Seniors’ – Forbes.

Pay Plan Could Limit Children’s Dental Coverage Under Law – WSJ.com

The 2010 health law provides dental coverage for lower-income children, some of whom don’t get their teeth checked regularly. But some people in the dental business say the number signing up for new plans may be lower than hoped, because people are likely to have to pay for the benefit separately.

Rules on pediatric dental plans and many other aspects of the Affordable Care Act are due as soon as this week. The law, meant to bring health coverage to some 30 million currently uninsured Americans, moves into higher gear this fall, when people will be able to buy coverage …

via Pay Plan Could Limit Children’s Dental Coverage Under Law – WSJ.com.

Young Adulthood, Dependent Coverage, and Health: The Immediate Effects of the Patient Protection and Affordable Care Act on the Well-Being of 19-25 Year Olds by Daniel Carlson, Ben Kail, Jamie Lynch, Marlaina Dreher :: SSRN

Objectives: This study examines the health impact of the Patient Protection and Affordable Care Act (ACA) dependent coverage provision for U.S. young adults ages 19-25.

Methods: Multinomial logistic and OLS regression are used to examine changes in health coverage across three time periods (Pre-Great Recession; Great Recession/Pre-ACA; Post-ACA) and the mediating effect of dependent coverage on the association between period and self-reported health. Data come from the Current Population Survey – March Supplement for the years 2007 to 2012.

Results: Young adults were more likely to have dependent coverage in the post-ACA period compared to previous years. Young adults reported poorer health during the Great Recession/pre-ACA period compared to the years preceding and following it. Dependent health coverage was positively associated with self-reported health and accounted for a substantial portion of health differences between young adults in the pre- and post-ACA periods. No such mediating effect was found for the pre-Great Recession period relative to the pre-ACA/Great Recession period.

Conclusion: The ACA expanded access to dependent health insurance coverage for young adults, ameliorating some of the negative health consequences of the Great Recession.

via Young Adulthood, Dependent Coverage, and Health: The Immediate Effects of the Patient Protection and Affordable Care Act on the Well-Being of 19-25 Year Olds by Daniel Carlson, Ben Kail, Jamie Lynch, Marlaina Dreher :: SSRN.