Showing Tag: "medicaid" (Show all posts)

Growth in Missouri Medicaid 3.5% since ACA began

Posted by Timothy McBride on Wednesday, May 6, 2015, In : Missouri 
As others who follow trends in Missouri Medicaid enrollment know, Missouri is a state that has shown sluggish growth in Medicaid enrollment over the last year, even while other states have seen significant growth -- including states that have also not expanded Medicaid (experiencing the so-called "Woodwork" effect).  In fact, for several months, the growth in Medicaid in Missouri was flat or negative, and Missouri had one of the slowest rates of growth in Medicaid in the country.

It appears fr...
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Backlog facing Missouri Medicaid nearly erased

Posted by Timothy McBride on Wednesday, May 6, 2015, In : Missouri 

There is good news for Missouri’s Medicaid program.  In the last few months, the program (called MOHealthNET in Missouri) has really turned the corner on a challenge the program faced in the recent year – a backlog in processing applications to the program.  However, in the last 4-5 months, concerted efforts by state workers, working hard with many around the state has led to a huge drop in the backlog.

As this figure shows, the number of days it is taking for an applicant to Medicaid to...


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Missouri Medicaid enrollment dropping

Posted by Timothy McBride on Monday, September 1, 2014, In : Missouri 

An article in today’s St. Louis Post-Dispatch points to a serious issue facing Missouri’s Medicaid program.  As the article points out, enrollment in the Medicaid program (called MOHealthNET in Missouri) has been dropping in the state for several months.  As reported by the Centers for Medicare and Medicaid Services (CMS) in their latest reports, with data through July, Medicaid enrollment is down -4.4% in Missouri since last year (from about 866,000 to about 830,000). This is the second ...


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Here is something about the response to the Health Reform (the Affordable Care Act) I don't get...

Posted by Timothy McBride on Saturday, June 28, 2014, In : ACA 
So here is something that has perplexed me for a long time, watching the (largely successful) rollout of health reform (the Affordable Care Act).

For months now, many very bright people (pundits, reporters, Legislators) have been fixated on one part of the Affordable Care Act (ACA)'s rollout and using it as a ruler to measure the law's success: the number of people enrolled in the MARKETPLACES -- whether the law would reach the target of roughly 8 million people enrolled in the "Marketplaces" ...
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Job Layoffs in Health Care Sector Continue to Plague Missouri

Posted by Timothy McBride on Sunday, June 22, 2014, In : ACA 
Missouri continues to be plagued by job layoffs in the health care sector.  Though it is admittedly hard to track these job layoffs specifically without exact details (reports I have on these are based on press reports which are notoriously lacking in detail, for good reasons) -- and it could be that some of the job layoffs have not been reported at all publicly, this post will be based on what I have been able to find in the news over the period April 2013 to June 2014.

Over that period as th...
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Missouri's Medicaid eligibility determinations continue to drop, April 2014

Posted by Timothy McBride on Thursday, June 5, 2014, In : Missouri 

A new report out from CMS indicates that applications for Medicaid in Missouri continued to drop in April, relative to March, from 829,585 to 806,639, a drop of -2.8%.  This means Missouri remains an outlier, with a drop of -4.7% in Medicaid determinations since before the open enrollment period started for the Affordable Care Act (ACA) as the report shows -- the drop in Missouri is the second lowest in the country, second only to Wyoming since before the open enrollment period.

As I reported ...

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Missouri's Medicaid Enrollment Dropping, And Unemployment Declines do not Explain the Drop

Posted by Timothy McBride on Sunday, June 1, 2014, In : Missouri 

A recent release from the Center on Medicare and Medicaid Services shows that across the U.S. Medicaid enrollment grew by 5.8 million from right before the open enrollment period (July-September 2013) to March 2014, a growth rate of almost 10%.  However, as would be expected most of this growth occurred in states that chose to expand Medicaid coverage.  Nevertheless, even the remaining states have experienced growth of over 640 thousand (or about 2.6%).

However, the report highlights a perplex...


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The Great Lamping-Silvey debate continues (this time on Twitter!)

Posted by Timothy McBride on Saturday, May 24, 2014, In : Missouri 
Those of us in Missouri, and who follow the Medicaid expansion debate closely, know that a couple key turning points that happened (in public at least) were when, first, a handful of Republican Senators (led by Sen. John Lamping) took to the floor right after their Spring break and declared their solid opposition to the Medicaid expansion, and vowed to fight this even to the point of filibusters. Shortly after that, one of Sen. Lamping's colleagues, Sen. Ryan. Silvey took to the floor and eng...
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Crunch Time: Is it time for Gov. Nixon to behave like Gov. Brewer?

Posted by Timothy McBride on Monday, April 28, 2014, In : Missouri 
So there is less than three weeks left in the Legislative session. The Missouri Legislature has yet to give Governor Jay Nixon the leading initiative he has asked for the last two years, much to his credit. As a result, the state is losing billions of dollars, losing thousands of jobs, and low-income people still don't have the coverage they need.

Maybe it is time for Gov. Nixon (who after all has always had a huge positive popularity rating) to adopt the strategy that Republican Gov. Jan Brew...
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Perplexing State Policy Decision: Tax Cut Yes, Medicaid Expansion: No?

Posted by Timothy McBride on Thursday, April 17, 2014, In : Missouri 

Today (April 16th, 2014), the state of Missouri Legislature passed a $620 million tax cut with an annual price tag.

What is rather flabber-gasting about this decision is that this Legislature has been dragging its heels for two years on another decision: to expand Medicaid to about 300,000 low-income uninsured Missourians.  By recent reports, the legislation working its way through the Legislature is not as likely to pass.

Now someone needs to explain to this economist why:

  • the Legislature would...

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Uninsured in States with State-Based Marketplaces Twice as Likely to Obtain Coverage

Posted by Timothy McBride on Thursday, March 20, 2014, In : ACA 

·  ·    The ACA left the important decision of whether to create a state-based marketplace or not up to the states, and the Supreme Court gave states the option to expand Medicaid or not.  

Fifteen states (representing about one-third of the uninsured in the U.S.) have chosen to create state-based marketplaces, 10 states are using the federally-facilitated marketplaces (FFM) but are expanding Medicaid, while the remaining 26 states have chosen to use the federally-facilitated marketplace and...


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Additional comment on Patrick Ishmael's commentary

Posted by Timothy McBride on Saturday, March 8, 2014, In : ACA 

Earlier I commented on Patrick Ishmael's comments on Medicaid in Missouri posted on Forbes website.  In my previous comments I dealt with several of the issues he raises in that commentary, except the last one.  At the end of his piece he makes this comment:

"Keep in mind that this enrollment conversation doesn’t even touch on the abysmal Medicaid health outcome record that Avik Roy, Michael Cannon and others have talked about for years. That’s no small matter. Combine the outcomes problem...


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Response to Forbes/Show-Me Take on Missouri Medicaid Situation

Posted by Timothy McBride on Saturday, March 8, 2014, In : Missouri 
Given that we are in the middle of the implementation of the Affordable Care Act (ACA), and a full verdict on what is happening will not really be known for a short while, it is a prudent idea to wait before making definitive comments on what is happening out in the field.  The reality is that the "data" on the implementation of the ACA is still coming in, and none of us can be 100% sure at this point what is happening.  

However, a commentary by Patrick Ishmael (of Missouri's Show-Me Institut...
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A Tale of Three Markets: How ACA implementation by state is affecting the uninsured's ability to obtain coverage

Posted by Timothy McBride on Monday, December 2, 2013, In : ACA 

After passage of the ACA, and the decision by the Supreme Court, states have faced important implementation decisions that will profoundly affect the effectiveness of health reform in reaching the previously uninsured.   As the Affordable Care Act (ACA) is being implemented, it is becoming clear that the experience for those trying to obtain health insurance coverage is influenced by two major decisions made by the states: whether the state chose to operate their own state-based marketplace, ...


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Why is media minimizing impact of ACA?

Posted by Timothy McBride on Friday, November 29, 2013, In : ACA 
Persistent reports on the impact of the rollout of the new insurance options for 2014 under the Affordable Care Act (ACA) have fixated on the enrollments in the new Marketplaces, where private plans are being offered. 

Why is it that the media is not reporting widely the TOTAL number of previously uninsured who are obtaining coverage through all sources, including the marketplace plans as well as Medicaid coverage?

The recent updates from Kaiser show that over 741,000 people are now enrolled, a...
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Enrollment in ACA starting to accelerate?

Posted by Timothy McBride on Wednesday, November 20, 2013, In : ACA 
As is being reported in some media outlets, in November the enrollment in the Affordable Care Act (ACA) may be accelerating.  

This is being shown by preliminary data reported by the Kaiser Family Foundation, which is tracking state enrollment where it can get regular updates from the states.

In the three states where Kaiser has new updates since the administration released the nationwide report (of enrollment through November 2), there is a 28% increase in enrollment of 36,641 persons.  It bre...
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About 75% of new Medicaid enrollment in states expanding Medicaid

Posted by Timothy McBride on Tuesday, November 19, 2013, In : ACA 
Based on the report published last week, about three-quarters (74.2%, or 293,984 people) of the new enrollment in Medicaid (from October 1 to November 2) occurred in the 26 states (including D.C.).  This means that the remaining increase in enrollment -- 25.8%, or 102,277 people -- has occurred in the 25 states that have not expanded Medicaid so far.

This may not seem like a surprise, because perhaps some might ask: of course the new enrollment is occurring mostly in the states that expanded M...
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Politics will leave some uninsured

Posted by Timothy McBride on Monday, November 11, 2013, In : ACA 
It is worth remembering that because of policy and political decisions many of the uninsured will not have access to the options for coverage available under the Affordable Coverage Act (ACA).  At least two major groups are important:

Thus about 14 million (see Table here) are not ev...

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Missouri Obamacare Myths #2: Medicaid Expansion Costs Money

Posted by Timothy McBride on Monday, March 18, 2013, In : Missouri 
Earlier I described the proposal by Missouri Governor Jay Nixon to expand the Medicaid (MOHealthNet) program in Missouri to cover about 260,000 persons in 2014, according to the state's estimates [ http://dss.mo.gov/mhd/oversight/pdf/130129-healthcare-expansion.pdf ].

It has often been said in response to this proposal that expansion of Medicaid would not be affordable to Missouri.  For example, Rep. Jay Barnes said "Missouri taxpayers cannot afford a straight Medicaid expansion." [ http://www...

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Short-Term Deficits vs. Long-Term Deficits

Posted by Timothy McBride on Tuesday, March 5, 2013, In : Deficits 
Do people like Joe Scarborough really NOT understand the difference between short-term deficits and long-term deficits?  Apparently not.  [  http://www.huffingtonpost.com/2013/03/05/joe-scarborough-paul-krugman-charlie-rose_n_2810389.html?utm_hp_ref=business&ir=Business ]  The brain should be able to carry two thoughts at once, but maybe not in Washington DC.

In the short- and medium-run, deficits are falling, and rather fast.  The deficit as a percent of GDP is falling from a high of 10.1% of...
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About Me


Timothy McBride Timothy D. McBride, Ph.D. is a Professor at the Brown School, Washington University in St. Louis. Here you can find musings on health policy and other issues. Opinions are my own, and not those of my employer. Contact: mcbridetd@gmail.com