Leading the Way?: Maine's Initial Experience in Expanding Coverage Through Dirigo Health Reforms

Examines interim indicators -- enrollment of the previously uninsured, responses from small firms and the working poor, and the impact on costs -- of Maine's progress in providing affordable health insurance through the Dirigo Health program

Aiming High: Foundation Support for State Advocates Brings Universal Children’s Health Coverage Within Reach

To help close the children’s health insurance coverage gap in the United States, in 2011 the Atlantic Philanthropies created the Kids- Well Campaign. KidsWell’s theory of change posits that if advocates could leverage new funding and coverage opportunities created by the Patient Protection and Affordable Care Act, they could expand the number of children with health insurance coverage. This article presents the major results of the KidsWell evaluation, which found substantial progress in achieving KidsWell interim policy changes and coverage outcomes. But advocates still have a full agenda, which means grantees and funders need to redouble efforts to educate the larger field about the type of advocacy that can legally be supported by funders, the gains in children’s coverage achieved in part with such support, and what remains at stake for children’s coverage. While other funders may not be able to make investments comparable to Atlantic’s, advocacy networks and capacities have already been built and valuable knowledge has been gained through the KidsWell effort. Funders could target future investment to states and activities needing a short-term boost to exploit windows of political opportunity or to fight threats to children’s coverage. Such support is still needed to continue momentum toward universal health insurance coverage for all children

Medicaids Role in Improving the Social Determinants of Health: Opportunities for States

In an environment of uncertainty surrounding the future of Medicaid policy and funding, addressing the social determinants of health to improve the health status of Medicaid beneficiaries could be dismissed as an unaffordable luxury. But there is a strong business case for state Medicaid programs to address the social determinants of health as a key strategy for providing cost-effective, efficient care. By partnering with state and local agencies to address the social determinants of health, state Medicaid leaders may enhance their ability to control costs and strengthen the program's financial sustainability over the long term.This policy brief explains how state Medicaid agencies and managed care organizations can address the social determinants of health (SDH). It reviews the evidence demonstrating a link between health status and SDH, summarizes the business case for Medicaid to support interventions aimed at addressing SDH, describes current opportunities—and limitations—for using Medicaid as a lever to address SDH, and discusses new prospects for state policymakers to tackle SDH in the current environment