More About Matt Broaddus

Matt Broaddus

Broaddus joined the Center in December 1999 and is a Research Analyst in the Health Division.

Full bio and recent public appearances | Research archive at CBPP.org


Expanding Health Coverage Provides Financial Protection Too, Study Shows

February 25, 2014 at 1:39 pm

The comprehensive health reform that Massachusetts enacted in 2006 improved residents’ financial well-being, likely by protecting them from high out-of-pocket medical costs (among other things), according to recent research from the Federal Reserve Bank of Chicago.  Combined with previous research, these findings suggest that the federal Affordable Care Act (ACA) will not only give people better access to quality health care but also help them avoid financial hardship.

As the share of Massachusetts residents with health coverage rose by about 7 percentage points, residents’ credit scores improved, personal debt fell 22 percent on average, and the likelihood of bankruptcy fell 18 percent, after controlling for other personal and macroeconomic factors.  The positive financial effects of health coverage were especially pronounced among residents who had lower credit scores prior to health reform, though residents across the income spectrum benefited.

Using a rich database of credit report information, the Federal Reserve analysts evaluated a wider array of direct financial outcomes than has previous research.  They evaluated the impact on financial outcomes of each percentage-point increase in the share of the population with health coverage.  Since Massachusetts had one of the country’s highest rates of health coverage before enacting health reform, the Federal Reserve analysis suggests that the ACA’s major coverage expansions would have even greater financial benefits in states with lower health coverage rates.

The Massachusetts results reinforce findings from the landmark Oregon health insurance experiment, which found that uninsured adults who gained Medicaid coverage not only had better access to health care than adults who remained on a waiting list for Medicaid but also were less likely to borrow money or leave other bills unpaid to cover medical expenses.

CHIP’s Start: Lessons for Early Enrollment Under Health Reform

November 12, 2013 at 3:45 pm

The Administration is expected to issue estimates this week of enrollment since October 1 in health reform’s Medicaid expansion and its new health insurance marketplaces — and some media have already reported that the numbers did not meet Administration expectations.  But, as we’ve learned by examining the early experience with the Children’s Health Insurance Program (CHIP), early enrollment numbers aren’t a reliable indicator of health reform’s long-term performance.

CHIP — now recognized as an undeniable success — started slowly, too.  When the program started in fiscal year 1998, only eight states began enrolling low-income children in the first quarter.  By the end of that year, only 29 states operated CHIP programs and more than half of the 665,000 children enrolled came from just three states where most of the enrollment involved children transferred to CHIP from their pre-CHIP, state-funded children’s health programs.

But, by the end of fiscal year 2000, all 50 states and the District of Columbia had used CHIP to expand health insurance coverage to more low-income children, and enrollment had reached 3.3 million children.  Growing steadily ever since, CHIP now provides health insurance coverage to 8.1 million children.

The Congressional Budget Office (CBO) has estimated that health reform’s coverage expansions will eventually lead to 12 million to 13 million more people enrolled in Medicaid (and CHIP) and to about 20 million people enrolled in subsidized marketplace coverage.  But, these results will be achieved over time.  For example, steady-state enrollment won’t come in Medicaid until 2015 and in the marketplaces until 2017, CBO estimates (see chart).  (The coverage gains will be larger than this if most or all states ultimately adopt health reform’s Medicaid expansion for low-income non-elderly adults.)

Similar to states’ experiences with CHIP, it will likely take several years — as well as sustained, cooperative efforts by states, the federal government, and stakeholders — to maximize that enrollment.  (An analysis from First Focus similarly concludes that CHIP’s early years show that it likely will take considerable time for health reform to achieve major coverage gains.)

We can’t measure health reform’s success solely on the first month or first few months of enrollment numbers — or even on all of 2014 — just as CHIP couldn’t be judged based on its first year’s modest enrollment.  Rather, as with CHIP, it will take several years of experience to accurately evaluate health reform’s coverage expansions.

Click here to read the full paper.

Medicaid Coverage Doesn’t Discourage Employment, New Study Shows

October 28, 2013 at 12:05 pm

A new National Bureau of Economic Research (NBER) report refutes the claim by some opponents of health reform’s Medicaid expansion that enrolling in Medicaid discourages people from working.

The report strengthens the case for states to adopt the Medicaid expansion, a choice that more states are making.  It also corrects one of the many myths surrounding Medicaid; our recent short paper corrects five others.

The report uses data from the Oregon Health Study, a landmark, ongoing study of the state’s Medicaid program that allows researchers to compare low-income adults selected in a lottery to enroll in a Medicaid expansion to those who remained on a waiting list.

Researchers found no statistically significant difference between the two groups either in the share that had earnings (slightly more than half for both groups) or in the amount of earnings.

The researchers also found that Medicaid enrollment boosted participation in SNAP (formerly food stamps) among eligible people.

The increased SNAP participation reflected helpful state practices to coordinate program enrollment as well as enrollees’ greater awareness of SNAP because of their experience with Medicaid.

The report’s findings add to the other positive outcomes associated with Medicaid enrollment that previous research using the Oregon Health Study has identified.  Low-income adults enrolled in Oregon’s Medicaid expansion are more likely than the uninsured to receive preventive care, and they experience far less financial hardship from out-of-pocket health costs.

New Census Bureau Data Show More Young Adults Have Health Insurance Coverage Due to Health Reform

September 20, 2013 at 3:07 pm

The Census Bureau released its annual American Community Survey (ACS) this week, confirming that more young adults were insured in 2012.  (Earlier in the week, Census released its more well-known Current Population Survey (CPS), which found that the uninsured rate among young adults fell again in 2012, but not on a statistically significant basis.  The ACS’ larger sample size makes its health insurance data more robust than what’s reported through the CPS.)

The share of 18- to 24-year-olds without health insurance coverage declined from 25.8 percent in 2011 to 24.3 percent in 2012, according to the ACS data.  This marked the second consecutive year that the uninsured rate for this group has fallen, now down 5.2 percentage points since 2010 (see chart).

These coverage gains are due to growth in private coverage among young adults primarily resulting from a provision of health reform (the Affordable Care Act, or ACA) that allows adult children to stay on their parents’ private insurance plans until they turn 26.  The share of 18- to 24-year-olds with private coverage increased to 63.2 percent in 2012, up from 61.6 percent in 2011 and 58 percent in 2010.

These findings amplify a growing body of research on the positive coverage effects of the young-adult provision.  A Commonwealth Fund survey found that 6.6 million adults aged 19 through 25 who either joined or stayed on their parents’ insurance plans between November 2010 and November 2011 could not have done so without the health reform provision.  Similarly, analyses by the Centers for Disease Control and Prevention, the National Bureau of Economic Research, and the Kaiser Family Foundation show significant coverage gains among young adults since 2010.  Other studies from the Commonwealth Fund and the RAND Corporation have found that health insurance coverage protects young adults with health concerns against financial hardship.

The increase in coverage among 18- to-24-year-olds means that they’re no longer the age group most likely to be uninsured.  That dubious distinction now belongs to 25- to 34-year olds, 27.3 percent of whom were uninsured in 2012.  However, the uninsured rate for this group — as well as other non-elderly adults — should fall considerably in 2014, when health reform’s major coverage expansions take effect.

Where Is Health Reform in the New Census Bureau Health Data?

September 17, 2013 at 4:13 pm

Today’s Census Bureau health insurance coverage data do not reveal much about the impact of health reform.  That’s because the Census data reflect the number of people with and without health insurance coverage in 2012, but health reform’s major coverage expansion provisions will not take effect until 2014.  But, anyone examining the Census data should keep the following in mind:

  • Health reform has increased coverage among young adults. While the share of 19- to 25-year-olds without health insurance coverage remained unchanged between 2011 and 2012, it has fallen by 4.2 percentage points since 2009 (see chart).  Under health reform, adult children have been able to enroll in their parents’ health insurance plan up to their 26th birthday since September 2010.  This provision was likely the biggest reason for the drop in uninsured young adults.

  • Health reform required states to maintain their Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment procedures (through 2019 for children and until 2014 for adults). That allowed the overall share of people with Medicaid and CHIP to hold steady between 2011 and 2012.  Along with gains in private coverage in 2012, stable Medicaid and CHIP coverage helped cut the rate of children without health insurance coverage in 2012 to 8.9 percent, a historically low mark.  Medicaid and CHIP enrollment for adults has also increased, but not by enough to compensate for reductions in private coverage between 1999 and 2012; the uninsured rate rose more than 25 percent among non-elderly adults over that period.
  • Health reform can address regional inequities in health insurance coverage. The South remains the region with the greatest share of uninsured people, at 18.6 percent.  Most of the states in this region, however, don’t plan to take up health reform’s Medicaid expansion to low-income adults, even though the federal government will pick up the vast majority of the cost.  More Southern states opting for the expansion would produce large coverage gains.
  • Health reform can fill the coverage gaps that exist today for those without access to employer-based coverage or who are unemployed. Employer-based coverage remains the primary source of coverage in the United States.  Indeed, 54.9 percent of Americans had employer-based coverage in 2012.  But, the uninsured rates among those working only part-time (27.7 percent) and those without a job (25.8 percent) are much higher than the overall uninsured rate.  Health reform’s new health insurance exchanges (also known as marketplaces) and premium subsidies to purchase exchange plans will offer these individuals quality, affordable health insurance coverage irrespective of their employment circumstances.

We’ll take a closer look at the Census findings in a report tomorrow.