Impact of Children’s Health Insurance Bene fit on Labor Supply: Evidence from Newly Arrived Immigrants in the United States by Keshar M. Ghimire :: SSRN

June 24, 2017

This paper exploits the State Children’s Health Insurance Program of the United States to investigate impact of a publicly funded health insurance benefit for children on work behavior of adult men and women. Drawing data from the Annual Social and Economic Supplement of the Current Population Survey and employing a triple- difference identification strategy, I find that public health insurance benefit for children decreases labor supply of women but increases that of men. Estimates suggest that, on average, labor force participation rate of women decreased by 7.4 percentage points while that of men increased by 5.5 percentage points as their families became eligible for State Children’s Health Insurance Program. The findings are supported by a number of robustness checks and a falsification exercise.

Source: Impact of Children’s Health Insurance Bene fit on Labor Supply: Evidence from Newly Arrived Immigrants in the United States by Keshar M. Ghimire :: SSRN


The Impact of Recent Mental Health Changes on Employment: New Evidence from Longitudinal Data by Sophie Mitra, Kristine Jones :: SSRN

June 24, 2017

This study uses longitudinal data and four different measures of mental health to tease out the impact of psychiatric disorder onsets and recoveries on employment outcomes. Results suggest that developing a mental health problem leads to a significant increase in the probability of transitioning to non-employment, while a recovery increases the probability of return to work among the not employed with a mental health problem. No consistent effect was found on hours worked and earnings. Research and policy attention is needed with respect to early interventions such as job retention programmes to help workers with mental health problems remain employed as well as interventions that may lead to recovery and return to work. More research is needed especially with data and models that can differentiate between the effects of mental health onsets and recoveries on employment exit and return to work transitions.

Source: The Impact of Recent Mental Health Changes on Employment: New Evidence from Longitudinal Data by Sophie Mitra, Kristine Jones :: SSRN


MACPAC | Comparing Section 1332 and Section 1115 Waiver Authorities

June 19, 2017

As discussed above, states cannot combine savings under Section 1115 and Section 1332 waivers into a single budget-deficit neutrality test. This clarification, along with the further definition of the guardrails, has been characterized by some as limiting states’ flexibility under the statute. As such, it is not clear how many states will pursue Section 1332 waivers and whether any of the reforms will lead to changes in Medicaid or CHIP. Furthermore, given the timing of their implementation (January 2017), the change in
administration at the federal level may alter the parameters in which states can seek these waivers.

Full text: https://www.macpac.gov/wp-content/uploads/2016/08/Comparing-Section-1332-and-Section-1115-Waiver-Authorities.pdf


Nevada’s Governor Vetoes ‘Medicaid for All’ Insurance Plan – WSJ

June 19, 2017

Nevada’s Republican governor vetoed a bill late Friday that would have created the nation’s first “Medicaid for all” insurance offering, a plan that drew widespread attention as states brace for changes in the federal Affordable Care Act.

The bill would have allowed any state resident to buy into Medicaid, the federal-state program for people with low incomes or disabilities. The idea, which its Democratic sponsor said would have created a guaranteed health coverage option that was affordable, has drawn the interest of other liberal-leaning states as congress works to repeal major portions of the Affordable Care Act, including the law’s Medicaid expansion.

Source: Nevada’s Governor Vetoes ‘Medicaid for All’ Insurance Plan – WSJ


Kansas Should Avoid The Medicaid Expansion Trap

February 9, 2017

The ApothecaryInsights into health care and entitlement reform. Opinions expressed by Forbes Contributors are their own.Josh Archambault, ContributorPauseUnmuteCurrent Time 0:28/Duration Time 0:30Loaded: 0%Progress: 0% FullscreenThe Kansas legislature has wisely rejected ObamaCare’s Medicaid expansion year after year. As a result, policymakers have protected taxpayers and the truly vulnerable from costly enrollment overruns. But now, despite a rapidly shifting health care landscape, special interest groups are once again ramping up pressure on state lawmakers to expand ObamaCare to a new class of able-bodied, mostly childless adults. Thanks to the prudence of Governor Sam Brownback and legislative leaders, Kansas is now in a position to learn from the mistakes of other states that bought into Washington’s false promises of flexibility and “free money.” They’ve also created a welfare reform model for the nation that they should build on, not diminish.

Source: Kansas Should Avoid The Medicaid Expansion Trap


Growth in Federal Spending on Medicaid Continues – AAF

February 6, 2017

The newly released Medicaid Actuarial Report states that total Medicaid outlays in the 2015 fiscal year amounted to $553.8 billion, increasing 11.6 percent between 2014 and 2015—the fastest growth in more than a decade. This is largely due to the ACA’s Medicaid eligibility expansion as expenditures for this population have been higher than expected. Adults previously eligible for the program had annual per enrollee costs of $4,580, $4,695 and $4,986 in the years 2013, 2014, and 2015, respectively, while expenditures for newly eligible adults were $5,511 (12 percent higher than other adults) in 2014 and $6,356 (28 percent higher) in 2015.

Source: Growth in Federal Spending on Medicaid Continues – AAF


The Effect of State Medicaid Expansions on Prescription Drug Use: Evidence from the Affordable Care Act by Ausmita Ghosh, Kosali Ilayperuma Simon, Benjamin Sommers :: SSRN

February 1, 2017

This study provides a national analysis of how the 2014 Affordable Care Act (ACA) Medicaid expansions have affected aggregate prescription drug utilization. Given the prominent role of prescription medications in the management of chronic conditions, as well as the high prevalence of unmet health care needs in the population newly eligible for Medicaid, the use of prescription drugs represents an important measure of the ACA’s policy impact. Prescription drug utilization also provides insights into whether insurance expansions have increased access to physicians, since obtaining these medications requires interaction with a health care provider.

We use 2013-2015 data from a large, nationally representative, all-payer pharmacy transactions database to examine effects on overall prescription medication utilization as well as effects within specific drug classes.

Using a differences-in-differences (DD) regression framework, we find that within the first 15 months of expansion, Medicaid-paid prescription utilization increased by 19 percent in expansion states relative to states that did not expand; this works out to approximately seven additional prescriptions per year per newly enrolled beneficiary. The greatest increases in Medicaid prescriptions occurred among diabetes medications, which increased by 24 percent. Other classes of medication that experienced relatively large increases include contraceptives (22 percent) and cardiovascular drugs (21 percent), while several classes more consistent with acute conditions such as allergies and infections experienced significantly smaller increases. As a placebo test, we examine Medicare-paid prescriptions and find no evidence of a post-ACA effect. Both expansion and non-expansion states followed statistically similar trends in Medicaid prescription utilization in the pre-policy era, offering support for our DD approach.

We did not observe reductions in uninsured or privately insured prescriptions, suggesting that increased utilization under Medicaid did not substitute for other forms of payment. Within expansion states, increases in prescription drug utilization were larger in geographical areas with higher uninsured rates prior to the ACA. Finally, we find some suggestive evidence that increases in prescription drug utilization were greater in areas with larger Hispanic and black populations.

Source: The Effect of State Medicaid Expansions on Prescription Drug Use: Evidence from the Affordable Care Act by Ausmita Ghosh, Kosali Ilayperuma Simon, Benjamin Sommers :: SSRN