Rural Health
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CMS Weighing Decision that Would Lead to Loss of Health Coverage for Thousands of Tennessee Families Living in Poverty
Tennessee, a state that has not accepted the option to expand Medicaid to more low-income adults, has become the fifth state to ask CMS to impose a work or community service reporting requirement on parents with incomes at or below 98% of the federal poverty level. South Carolina is next in the queue. If the…
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Lack of ACA Navigator Funding Leads to Consumer Confusion, Decreased Enrollment
Open Enrollment is over in most states, and enrollment numbers are down slightlyfrom 8.8 million plan selections on healthcare.gov for plan year 2018 to 8.4 million plan selections for plan year 2019. Navigators thought the 2018 Open Enrollment was challenging, after a slew of policy changes including massive Navigator grant funding cuts, shortened enrollment period, 90 percent cuts to federal…
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Oklahoma’s Medicaid Waiver Proposal Will Harm Its Most Vulnerable Families
Unfortunately, our series of reports looking at harmful state Medicaid work requirement rules targeting very poor parents is getting longer. Today we are releasing an updated look at Oklahoma’s proposal, which is currently up for public comment at the federal level. Six states now have active proposals – Mississippi, Alabama, and South Dakota have proposals…
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Medicaid Waiver Proposal For Oklahoma Medicaid Beneficiaries Would Harm Low-Income Families With Children
Introduction Through an amendment to its Section 1115 Medicaid demonstration waiver, Oklahoma is seeking federal permission to impose work reporting rules on very low-income parents and caregivers age 19-50 receiving health coverage through Medicaid. Parents of children below age six would be exempt. Under the proposal, which would be phased in, these beneficiaries would have…
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New Report Finds South Carolina’s Medicaid Waiver Would Leave Thousands of Poor Parents Uninsured
[Editor’s Note: On March 4, 2019 South Carolina posted a revised application for state public comment.] Just before the holidays, South Carolina posted its application for new work-related reporting rules for very low-income parents and caretaker relatives with incomes below 67 percent of the poverty line who are insured through Medicaid. Today we partnered with South Carolina…
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The Importance of Medicaid to Kentucky’s Rural Areas is Eye Popping
In 2017, we embarked on a new project with the Rural Health Research Program at the University of North Carolina Sheps Center for Health Services Research to examine the role of Medicaid in rural areas and small towns. In our first report, Medicaid is a Lifeline for Small Towns and Rural Communities, we highlighted the…
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New Policy Brief asks: “Why are Tennessee moms and babies dying at such a high rate?”
Tennessee Justice Center’s recent policy brief focuses on rising rates of infant and maternal mortality in Tennessee. When I saw the state’s dismal outcomes in the 2018 America’s Health Rankings Health of Women and Children report, I immediately wanted to learn why moms and babies were dying at higher and higher rates in Tennessee. According…
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Medicaid at the 2018 Ballot Box: What to Look For (Part 1)
Next Tuesday (as usual) I will be staying up late to see what happens in the midterm elections. But for the first time in more than twenty years of working on Medicaid there will be so much to watch out for that will directly affect Medicaid! Today I will start with the 17 states that…
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More Rural Hospitals Closing in States Refusing Medicaid Coverage Expansion
The University of North Carolina’s Rural Health Research Program tracks closures of rural hospitals across the country. From 2010 to the present there are six states with five or more rural hospital closures. Texas leads with a stunning 15 rural hospitals closed, followed closely by Tennessee (9 rural hospitals closed) and Georgia (7 rural hospitals…
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Rural Residents and Communities Have Much at Stake in Medicaid Expansion
Last year, working with our partners at the University of North Carolina’s Rural Health Project, we released a report that underscored the critical role that Medicaid plays in rural areas and small towns with populations below 50,000. This year Jack Hoadley, Mark Holmes and I took a look at how Medicaid expansion has impacted these same…
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Health Insurance Coverage in Small Towns and Rural America: The Role of Medicaid Expansion
Introduction Medicaid has been a key factor in lowering the percentage of Americans who lack health insurance. Nationally, the uninsured rate for all Americans under the age of 65 (adults and children) fell dramatically between 2010 and 2016 from 18.2 percent to 10.4 percent, rising slightly to 10.7 percent in 2017. Expansion of Medicaid coverage…
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Public Comments are Virtually Unanimous Against Mississippi’s Harmful Medicaid Proposal
Last month, federal CMS reopened the public comment period on Mississippi’s proposed Section 1115 Medicaid work requirements waiver at the same time as Kentucky’s comment period was reopened. Mississippi’s proposal has not garnered as much attention as Kentucky’s, which as regular readers of SayAhhh! know, is currently on hold due to a federal court decision.…
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Louisiana Report: 2016 Medicaid Expansion Cut Adult Uninsured Rate in Half, Reduced Coverage Disparities, Benefited Rural and Urban Areas
A new report from the Louisiana Department of Health, the 2017 Louisiana Health Insurance Survey, shows multiple positive effects from Louisiana’s recent Medicaid expansion – and continuing overall satisfaction with Medicaid and other coverage. While the report focused on adult coverage, it also noted that Louisiana retains its remarkable success at reducing the uninsured rate…
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Medicaid Expansion: The Facts Are In
With 34 states (including DC) now expanding Medicaid since 2014 and 17 states still refusing expansion, the ability for researchers to compare patient experiences in these disparate two groups of states has resulted in literally hundreds of high-quality studies – a “natural experiment” created by the Supreme Court’s decision to make the expansion optional. A…
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Analysis of Ohio’s report on Medicaid expansion
On Tuesday, August 21, the Ohio Department of Medicaid (ODM) released the second “assessment” of the Medicaid expansion as a follow-up to the first, General Assembly required, assessment from 2016. In this document the ODM found the following: EMPLOYMENT Employment for enrollees went up 15%, meaning 1 in 2 expansion enrollees are working The most common reason for…
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Summary of Mississippi’s Revised Section 1115 Medicaid Waiver Proposal
Overview: A revised version of Mississippi’s Section 1115 waiver proposal, which seeks to condition Medicaid eligibility on compliance with a work/community engagement requirement for very low-income parents/caregivers, has been re-opened by the federal government for public comment. Comments on the waiver, known as the “Mississippi Workforce Training Initiative,” are due by August 18, 2018. The…
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Oklahoma’s Proposed Work Rule Would Harm Mothers and Children
Oklahoma has one of the highest uninsured rates for children in the nation, and the state will likely make matters worse if it gets a green light from CMS to go through with a plan to impose more red tape requirements on poor parents. Oklahoma is seeking approval to amend its Section 1115 demonstration waiver…
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Proposed Fix to Harmful Medicaid Waivers Impacting Very Poor Parents in Alabama and Mississippi is no Fix at All
Both Alabama and Mississippi have submitted Medicaid Section 1115 waiver proposals that would impose work/community engagement requirements rules on poor parents and caregivers. Because these states have not expanded Medicaid under the Affordable Care Act and have some of them most restrictive eligibility limits in the nation, most people facing loss of health coverage due…
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Perry County to Tuscaloosa: A 70-Minute Drive for Rural Women Seeking Obstetrics Care
I have driven the 57 miles from Perry County, Alabama to Tuscaloosa many times, with long stretches of bumpy road that is marred by stop lights as you get closer to the city. All in all it’s about a 70-minute drive, a 70-minute drive residents of Perry County have to make if they need to…
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Update: State Data on Health Coverage in Small Towns and Rural Areas, 2015/16
The state-specific downloads in the table below show county-level data on Medicaid coverage and uninsurance for the time periods 2008/09 and 2015/16. Uninsurance rates for seniors are not presented because they are so low. Delaware, Massachusetts, New Jersey, Rhode Island, and the District of Columbia are excluded because less than 2 percent of their residents live in counties…
