Financial Burden of Medical Spending by State and the Implications of the 2014 Medicaid Expansions

This study is the first to offer a detailed look at medical spending burden levels, defined as total family medical out-of-pocket spending as a proportion of income, for each state. It further investigates which states have greater shares of individuals with high burden levels and no Medicaid coverage, but would be Medicaid eligible under the 2014 rules of the Affordable Care Act should their state choose to participate in the expansion. This work suggests which states have the largest populations likely to benefit, in terms of lowering medical spending burden, from participating in the 2014 adult Medicaid expansions

Monitoring the Impact of Health Reform on Americans 50-64: Medicaid Expansion and Marketplace Implementation Increased Health Coverage

This survey shows that the share of 50- to 64-year-olds without health insurance fell between December 2013 and March 2014. In states that expanded their Medicaid programs, a greater share of previously uninsured adults gained coverage, particularly among groups that have traditionally faced barriers to obtaining it. The survey also found that the newly insured differed in key ways from those who reported being insured for all of the past 12 months. On average, more were low income, and more reported that they had had trouble paying medical bills. This paper is part of a series that looks at the experience of 50- to 64-year-olds during the first open enrollment period of the Affordable Care Act (ACA)

Monitoring the Impact of Health Care Reforms on Americans 50-64: Awareness and Coverage Expectations

This survey found widespread awareness among Americans ages 50 to 64 about the new health insurance Marketplace that had been created by the Affordable Care Act (ACA). Those with the most to gain from the ACA -- the uninsured and those with nongroup (individual) insurance -- expressed the greatest interest in using the Marketplace to learn about new coverage options. Most of those already insured expected to keep their same source of coverage in 2014, whereas the uninsured had mixed expectations. This paper is part of a series that looks at the experiences of 50- to 64-year-olds during the ACA's first open enrollment period

Monitoring the Impact of Health Reform on Americans 50-64: Use of Insurance Marketplaces

This survey found that 9 out of 10 Americans ages 50 to 64 were aware of the new health insurance Marketplace that had been created by the Affordable Care Act (ACA). The survey found that, despite widespread awareness of the Marketplace among this age group, relatively few who knew about the Marketplace were interested in using it to acquire new coverage. The survey also found that 50- to 64-year-olds' use of the Marketplace varied widely by health insurance status and income. This paper is part of a series that looks at the experiences of 50- to 64-year-olds during the ACA's first open enrollment period

Estimates of the Potential Insurance Value of Disability Insurance for Individuals with Mental Health Impairments

Working PaperSince the mid-1980s there has been dramatic growth in the number and fraction of DI and SSI beneficiaries with mental illness. With longer life expectancies and younger ages of disability onset than beneficiaries with physical impairments, their growth exerts added fiscal pressure on the programs. While not specifically focused on mental illness, fears of an increase in the duration (and thus prevalence) of disability claims that may result from this demographic shift have generated calls to tighten eligibility rules again. Using data from the Health and Retirement Study linked to SSA administrative records, we created statistically matched control groups of non-beneficiaries with severe mental illness. We then estimated the earnings, income, and health insurance coverage among rejected DI/SSI applicants with mental illness who have characteristics comparable to persons awarded benefits on the basis of mental impairments. We found that even after controlling for health and demographic characteristics, DI beneficiaries were substantially worse off than rejected applicants in terms of wealth and income. While these rejected applicants with mental illness were worse off than those with physical impairments, our findings suggests that the programs successfully select applicants with the greatest income needs, and that retrenchment could result in significant hardship.Social Security Administrationhttp://deepblue.lib.umich.edu/bitstream/2027.42/99525/1/wp283.pd

The Expanding Role of Managed Care in the Medicaid Program

States increasingly use managed care for Medicaid enrollees, yet evidence of its impact on health care outcomes is mixed. This research studies county-level Medicaid managed care (MMC) penetration and health care outcomes among nonelderly disabled and nondisabled enrollees. Results for nondisabled adults show that increased penetration is associated with increased probability of an emergency department visit, difficulty seeing a specialist, and unmet need for prescription drugs, and is not associated with reduced expenditures. We find no association between penetration and health care outcomes for disabled adults. This suggests that the primary gains from MMC may be administrative simplicity and budget predictability for states rather than reduced expenditures or improved access for individuals

ACRL 2021 Environmental Scan

Every other year, the ACRL Research Planning and Review Committee provides a scan of higher education, detailing the current environment and its anticipated impact on libraries. While this year\u27s Environmental Scan is no different in terms of scope, we are now facing challenges to higher education on a scale not seen in decades. Across the globe, the COVID-19 pandemic has disrupted the lives and livelihoods of millions of people, and in the United States, this disruption has been compounded by the eruption of protests surrounding civil rights and other social justice issues. While the 2021 Environmental Scan covers developments over the last two years (2019 and 2020), the events of 2020 are anticipated to have lasting repercussions, and, while not the primary focus, are a common thread throughout the document