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Medicaid Opportunities & Challenges Task Force May 13, 2013 Jeff Bechtel, Senior Consultant Summary of Research Findings – Economic, Health, & Personal.

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Presentation on theme: "Medicaid Opportunities & Challenges Task Force May 13, 2013 Jeff Bechtel, Senior Consultant Summary of Research Findings – Economic, Health, & Personal."— Presentation transcript:

1 Medicaid Opportunities & Challenges Task Force May 13, 2013 Jeff Bechtel, Senior Consultant Summary of Research Findings – Economic, Health, & Personal Financial Impacts of Medicaid Expansion

2 Economic Impacts of Expansion Health Impacts of Expansion Personal Financial Impacts New Findings – Oregon Medicaid Expansion Study Presentation Overview 2

3 Research has shown that federal Medicaid dollars spur economic activity within a state beyond the initial investment. The Kaiser Family Foundation issued a report that reviewed 29 state-level studies of Medicaid’s economic impact. Kaiser Family Foundation, The Role of Medicaid in State Economies: A Look at the Research (Jan. 2009); Numerous studies have been released by various entities estimating the number of jobs that would be created in specific states as a result of Medicaid Expansion. Examples: Missouri Hospital Association: 22,000 Missouri jobs from 2014 to Source: University of Missouri School of Medicine, Department of Health Management and Informatics, and Dobson DaVanzo & Associates, LLC, The Economic Impacts of Medicaid Expansion on Missouri (November 2012); df df Economic Impacts of Expansion – “Multiplier Effect” 3

4 University of Florida: 54,000 permanent Florida jobs over the next decade. Source: Alan W. Hodges and Mohammad Rahmani, Economic Impacts of the Patient Protection and Affordable Care Act in Florida, University of Florida, Food & Resource Economics Department (November 5, 2012); Economic-Impact-of-the-ACA-in-Florida pdfhttp://www.fha.org/reports_resources/files/RPT- Economic-Impact-of-the-ACA-in-Florida pdf The Hilltop Institute, a non-partisan health research organization in Baltimore: Nearly 27,000 new jobs in all sectors of Maryland’s economy by Source: S.H. Fakhraei, Maryland Health Care Reform Simulation Model: Detailed Analysis and Methodology, The Hilltop Institute (July 2012); del-July2012.pdf del-July2012.pdf Economic Impacts of Expansion ̶ Jobs (cont’d) 4

5 Research has shown that the expansion of Medicaid may reduce death rates. By comparing three states that substantially expanded adult Medicaid eligibility since 2000 (NY, MA, AZ) with neighboring states without expansions, researchers concluded that mortality rates have been reduced significantly. Source: Benjamin D. Sommers, M.D., Ph.D. et al., Mortality and Access to Care Among Adults After Medicaid Expansions, N. Eng. J. Med. (July 25, 2012). Economic Impacts of Expansion – Mortality Rates 5

6 A large body of research shows that: Medicaid increases access to care and lowers financial barriers to care. On key measures on access to preventive and primary care, children in Medicaid and CHIP fare as well as children with private insurance, but adults face more difficulty. Medicaid restricts cost-sharing, lowering financial barriers to access. Source: Medicaid: A Primer. Kaiser Commission on Medicaid and the Uninsured, June 2013; (summary of research findings, page 20).http://www.kff.org/medicaid/7334.cfm Economic Impacts of Expansion – Access to Care 6

7 In addition, the financial security brought about by the Medicaid Expansion may also lead to reductions in bankruptcies. Medical debt factors into fully 62% of all bankruptcies. Source: David Himmelstein et al., Medical Bankruptcy in the United States, 2007: Results of a National Study, 122 J. of Am. Med. 741 (August 2009). An analysis of Oregon’s Medicaid expansion to uninsured adults found that insurance coverage reduces by 40% the probability that people report having to borrow money or skip payments on other bills because of Medical expenses, and decreases by 25% the probability that they will have unpaid medical bills sent to a collection agency. Source: Katherine Baicker, Ph.D. & Amy Finkelstein, Ph.D., The Effects of Medicaid Coverage-Learning from the Oregon Experiment, 365 N. Eng. J. Med. (August 25, 2011). Personal Financial Impact – Financial Hardship 7

8 New research findings were published on Wednesday, May 1, 2013 in the New England Journal of Medicine. The research uses data from Oregon, where the state held a lottery among low- income adults in 2008 for a limited Medicaid expansion. Of the 90,000 people who applied, 10,000 ultimately gained coverage. The lottery gave researchers a unique opportunity to conduct the first randomized experiment on Medicaid coverage. The analysis is based on 12,229 people – 6,387 of whom gained coverage. The first study of the Oregon lottery population, published in 2011 found that new Medicaid enrollees tended to self-report better health after gaining coverage. Catastrophic out-of-pocket spending was virtually eliminated. Oregon Medicaid Expansion Study – Background 8

9 The new paper published on May 2, 2013 delved into greater details on how patients used the healthcare system and whether their health improved as a result. The Study found that, compared to people who did not receive Medicaid coverage: People with Medicaid used more health care services - more doctor visits, more medications and more tests. People with Medicaid spent more money on health care overall. People with Medicaid were less likely to go bankrupt due to health care expenditures. People with Medicaid had less depression and overall, had better health-related quality of life. People with Medicaid did not have meaningful improvements in their hypertension, cholesterol, diabetes, or other measures of overall health. Oregon Medicaid Expansion Study – Findings 9

10 Lead study author Katherine Baicker: “You might very well expect changes to accrue over a long time period. That being said, one might have hoped that these particular conditions were amenable to treatment in the time frame we studied.” Opponents of Medicaid expansion: “This throws up a huge stop sign in front of the Medicaid expansion. The benefits are highly questionable.” - Cato Institute health policy director Michael Cannon. Proponents of Medicaid Expansion: The Medicaid program had a significant impact on reducing financial hardship and improving mental health outcomes. Oregon Medicaid Expansion Study – Observations 10

11 Discussion 11

12 Questions? Sellers Dorsey sellersdorsey.com Jeff Bechtel Senior Consultant Sellers Dorsey


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