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House Bill 64 of the 131st General Assembly required the Ohio Department of Medicaid to provide a report evaluating the impact of Ohio's 2014 Medicaid expansion. Guided by the General Assembly's request, the Ohio Medicaid Group VIII Assessment examined how Medicaid expansion has affected new enrollees with respect to access and utilization of health care, physical and mental health status, financial distress/hardship, and employment. The phrase "Group VIII" refers to the section of the Social Security Act that sets requirements for Medicaid expansion eligibility and allowed most Ohioans age 19 through 64 with incomes at or below 138% of the federal poverty level (FPL) to become eligible for Medicaid.
Emerging Government Issues with Medicaid and Children's Health is an authoritative, insider's perspective on the strategic thinking behind reforming and improving the quality and access to health care for children across the United States. Featuring state health services officials and other children's health experts from across the country, this book provides a broad yet comprehensive overview of the role government officials and non-profits play in providing access to Medicaid benefits, as well as the obstacles faced by health care professionals in providing medical care to children and receiving insurance reimbursement for services provided. These leaders articulate the key points in the process of establishing Medicaid coverage for a child, from determining eligibility to detecting potential fraud, and discuss the strengths and weaknesses of the program as well as the reforms that could revolutionize the system. Additionally, the authors offer their predictions on future reform and share their advice for improving the communication channels between hospitals. Medicaid personnel, families, and social services departments. The different niches represented and the breadth of perspectives presented enable readers to get inside some of the great minds in children's health today, as these experts reveal the secrets and challenges behind ensuring that all of the nation's children receive the health care they deserve. Book jacket.
Background Child maltreatment impacts a large number of children and has negative consequences through adulthood. Only a few programs and policies that aim to prevent child physical abuse and neglect have proven to be consistently effective. Policies and programs that address some of the risk factors for physical abuse and neglect (e.g., poverty, limited parental access to physical and mental health care) have been proposed as a means to prevent child maltreatment indirectly. The recent Patient Protection and Affordable Care Act (ACA) Medicaid expansion has been associated with improved adult financial stability and access to physical and mental health care. By impacting these parental factors, the Medicaid expansion may have also impacted child physical abuse and neglect outcomes. Since Medicaid expansion did not happen in all states or at the same time, this allowed for a comparison not just of maltreatment outcomes within states that expanded Medicaid before and after the expansion occurred, but also for a comparison of the same maltreatment outcomes between states that did expand Medicaid and those that did not as part of a “natural experiment.” Objective Determine whether the ACA Medicaid expansion was associated with a decreased rate of child physical abuse and neglect. Methods We conducted an observational study using data from the National Child Abuse and Neglect Data System (NCANDS) Child Files to evaluate rates of reported abuse and neglect for children under the age of 6 years over a 7-year period, from 2010 through 2016. We also used data available through the Henry J. Kaiser Family Foundation to evaluate state-level changes in Medicaid coverage proportions for parents as a possible intermediate step in the association between Medicaid expansion policies and child maltreatment outcomes. A difference-in-difference analysis was conducted in which the change in rates of physical abuse and neglect before and after expansion of Medicaid in states where Medicaid expansion occurred were compared to the change in rates seen in states that did not expand Medicaid on or after January 1st 2014 controlling for several state-level measures including unemployment and teenage birth rates. Results Medicaid coverage for adults with dependent children increased after 2014 by 2.3% in the states that did not expand Medicaid and by 3.7% in the states that did. The states that did not expand Medicaid saw a decrease in the Medicaid eligibility cutoff for parents of 11 percentage points of the FPL whereas the states that did expand saw the eligibility cutoff increase by 36.9 percentage points of the FPL. The proportion of parents covered by Medicaid was found to increase annually (p=0.01) and was positively associated with Medicaid expansion status (p=0.04). When comparing the years 2013 and 2016, Medicaid expansion was found to be associated with a significant increase in %FPL Medicaid eligibility (p
A chief focus of The Patient Protection and Affordable Care Act (ACA) was addressing income-based disparities in access to care since uninsured individuals were more likely to be low-income prior to the ACA. The main vehicles for improving access are Medicaid Expansion and insurance "Marketplaces" (also known as the, "Health Insurance Exchanges - HIEs", or the "Exchanges"), which are platforms to purchase private insurance that meet essential benefit requirements. The impact that the ACA has had in reducing the number of low-income, uninsured individuals is incontrovertible, but less is known about how these gains in insurance coverage have translated to improvements in population health. Therefore, Aim 1 investigates the extent to which Medicaid Expansion and the Exchanges have improved health care access in low-income Ohioans by evaluating changes to self-reported measures of health care access. Aims 2 and 3 evaluate whether the improvements in healthcare access suggested in Aim 1 have translated to meaningful improvements in stage at diagnosis in four screening-amenable cancers (breast, cervical, colorectal, and lung cancer). Aim 2 focuses on the low-income, Medicaid-eligible Ohioans, while Aim 3 focuses on low-income privately insured Ohioans, including those with Marketplace insurance. During this time of rapid health systems evolution, these studies, which provide timely insight on the impact of the Marketplaces and Medicaid Expansion on both healthcare access and disease-specific outcomes, can help inform future policy efforts to improve population health.
"The Ohio Medicaid Group VIII Assessment (Group VIII Assessment) project examined how Medicaid expansion in Ohio has affected new enrollees with respect to access and utilization of health care, physical and mental health status, financial distress/hardship, and employment."--Page 1.
"The 2018 Ohio Medicaid Group VIII Assessment (Group VIII Assessment) study examined how the 2014 Medicaid expansion in Ohio impacts the Patient Protection and Affordable Care Act (ACA) associated Medicaid expansion enrollees with respect to access and utilization of health care, physical and mental health status, financial distress/hardship, and employment--the ACA health reform expansion legislation was passed by the 111th United States Congress and signed into law in March 2010. The 2018 Group VIII Assessment is a followup to the 2016 Ohio Medicaid Group VIII Assessment Statutory Report."--Page 1.