Research Roundup: Medicaid Work Requirements; 340B Program; And Title X Funding
Each week, KHN compiles a selection of recently released health policy studies and briefs.
JAMA Internal Medicine:
Diversity Of Participants In The 340B Drug Pricing Program For US Hospitals
As of 2015, 41.8% of all nonprofit and public general acute-care hospitals participated in the 340B program. Although participating hospitals provided more uncompensated care and low-profit services to patients despite worse finances than nonparticipants, later participants—most hospitals—spent less of their budget on uncompensated care and were more financially stable compared with earlier participants. Our results should be interpreted as descriptive owing to unmeasured confounding, and some of our outcome measures may be reported with error.6Recent reimbursement reforms will likely have different effects across 340B participants. Targeting cuts might mitigate potential adverse effects on participants that provide a large amount of charitable medical care and operate at a substantial loss. (Nikpay, 5/21)
Urban Institute:
Changes To Title X Funding Could Affect Access To Health Care For Millions Of Women
Nearly one-third of these roughly 18.6 million women who had visited a clinic did so in the past three years (5.6 million women) and 13.8 percent have used a safety net family planning clinic in the past year (2.6 million women), but for most clinic users in our survey, it had been more than three years since their last visit. Low-income women were significantly more likely to have visited a clinic in the past year than high-income women (7.9 percent of women with family income at or below 138 percent of the federal poverty level versus 2.5 percent of women with family income at or above 400 percent of the federal poverty level; data not shown). Insured and uninsured women had similar rates of safety net family planning clinic visits in the past year (4.1 percent and 5.8 percent, respectively; data not shown). (Johnston and Shartzer, 5/23)
Urban Institute:
Medicaid Work Requirements In Arkansas
An estimated 269,000 nonelderly, nondisabled adults were enrolled in Arkansas’s Medicaid program in 2016. In 2018, when adults ages 19 to 29 are exempt from the work requirements, we estimate that 230,000 enrollees (86 percent of the enrollee group) would likely be exempt from the work requirements; 17,000 (6 percent) could be subject to work requirements and are working; and 22,000 (8 percent) could be subject to work requirements and are not working. (Gangopadhyaya, Kenney, Burton and Marks, 5/24)
Urban Institute:
The Implications Of Medicaid Expansion In The Remaining States: 2018 Update
Under the Affordable Care Act (ACA), states can expand Medicaid eligibility for nonelderly people up to 138 percent of the federal poverty level (FPL). As of March 2018, 31 states and the District of Columbia had expanded and 19 states had not. If the remaining 19 states were to fully implement a Medicaid expansion in 2019 and all else stayed the same, we estimate that between 4.3 and 4.7 million fewer people would be uninsured, Federal spending on health care would increase by between $32.1 billion and $37.8 billion, while state spending on Medicaid would increase by between $2.3 billion and $3.0 billion. This additional state spending would fully or largely be offset by savings in other areas. (Buettgens, 5/17)
JAMA Psychiatry:
Association Of State Laws Permitting Denial Of Services To Same-Sex Couples With Mental Distress In Sexual Minority Adults: A Difference-In-Difference-In-Differences Analysis
Of 109,089 participants, 4656 (4.8%; all percentages incorporate survey weights) identified as sexual minorities, 8,6141 (72.1%) were non-Hispanic white, and ages were uniformly distributed between 18 and 64 years. In 2014, 2038 of 16,637 heterosexual adults (12.6%) and 156 of 815 sexual minority adults (21.9%) in the 3 same-sex denial states reported mental distress. The proportion of sexual minority adults reporting mental distress increased by 10.1 percentage points.... Laws permitting denial of services to same-sex couples, which exist in 12 states and are under consideration by the US Supreme Court, are associated with a 46% increase in sexual minority adults experiencing mental distress. (Raifman, Moscoe and Austin et al, 5/23)
