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


Further Health Coverage Gains, Especially in Medicaid Expansion States

December 17, 2014 at 2:08 pm

The number of uninsured Americans fell by 6.8 million over the first two quarters of 2014, preliminary data from the Centers for Disease Control and Prevention’s (CDC) National Health Interview Survey show.  These are the most up-to-date government survey data on the early impacts of health reform’s major coverage expansions, which took effect in January.  And they show a widening coverage gap between states that have adopted health reform’s Medicaid expansion and other states.

Superseding earlier CDC estimates, the new figures that the CDC released yesterday include the second quarter of 2014, when enrollment surged in state Medicaid programs and health reform marketplaces.  Together, the two reports show consistent progress across the year in reducing the ranks of the uninsured.

Some 12.2 percent of Americans were uninsured in the first six months of 2014, the CDC data show, a 2.2 percentage-point decline from 2013 and the lowest rate since the CDC first collected these data in 1997.  The uninsured rate has fallen by nearly a quarter since peaking at 16.0 percent in 2010.

Coverage gains were greatest among the population groups that have been least likely to have coverage.  The uninsured rate for people in families between 100 and 200 percent of the poverty line plummeted from 29.3 percent to 24.1 percent between 2013 and the first half of 2014.  Adults under age 26, Latinos, African Americans, and people with less than a high school education also experienced disproportionate gains.

Coverage gains among non-elderly adults were nearly twice as large in states that have expanded Medicaid as in non-expansion states, widening the gap between the uninsured rates in the two groups of states from 4.3 percentage points to 6.1 percentage points.  (See graph.)  Several more states are considering adopting the expansion, which would lead to further coverage gains.

The new CDC figures are consistent with four independent surveys showing significant coverage gains in 2014, particularly among Medicaid expansion states.

While the CDC data were collected in January through June, private survey data from the Urban Institute show further coverage gains in the third quarter of 2014, while survey data from Gallup show coverage rates holding steady over this period.

Low-Income Adults Favor Medicaid Expansion, New Survey Shows

November 13, 2014 at 4:06 pm

Four-fifths of low-income adults surveyed in three southern states favor health reform’s Medicaid expansion, a new Harvard School of Public Health study finds.  The first quantitative analysis of potential enrollees’ views on Medicaid, the survey included residents of Kentucky (which has adopted the expansion), Texas (which hasn’t), and Arkansas (which has expanded under a waiver that allows it to enroll the expansion population in private marketplace coverage).

The survey was conducted in December 2013, during health reform’s first open enrollment period (and before implementation of the Medicaid expansion), to maximize the likelihood that respondents were familiar with the concepts in the survey.

Large majorities of respondents also said they believe that Medicaid’s quality of care, access to physicians, and affordability rival or outperform private coverage.

Roughly two of every three uninsured low-income adults surveyed in each state planned to apply either for Medicaid or subsidized marketplace coverage, the survey also found.

State policymakers should take into account this strong support for Medicaid among low-income adults as they debate whether to take up the expansion.  Twenty-three states (including Texas) haven’t expanded Medicaid.  In addition, Arkansas’ private-option expansion may not get the funding needed to continue, despite covering some 200,000 low-income Arkansans.

While the Harvard survey found that low-income adults value Medicaid highly and would enroll if eligible, it also found that many residents didn’t know whether their state has adopted the expansion.  So, achieving the full benefits of the expansion will require not just convincing more states to adopt it but also making more low-income eligible adults aware of it so they enroll.

Census Data Show Improved Health Coverage in 2013

September 22, 2014 at 4:36 pm

We’ve posted our full analysis of the Census Bureau’s new data on health coverage, which show that the share and number of Americans with health insurance improved slightly last year.  (Because the results are for 2013, they don’t reflect the coverage gains in 2014 resulting from health reform’s major coverage provisions, which took effect on January 1 — namely, the Medicaid expansion and subsidized marketplace coverage.)

Census published data from both its Current Population Survey (CPS) and American Community Survey (ACS).  Although the CPS is the most widely used source of health coverage information, changes in its health coverage questions in 2013 — the result of a multi-year Census initiative to improve the reliability and accuracy of the survey’s health coverage estimates — mean the 2013 results can’t be compared to those for prior years.  Thus, for comparisons with earlier years, the ACS is the preferred data source this year.

The Census figures from the ACS show:

  • The share of Americans without health coverage fell slightly, from 14.8 percent in 2012 to 14.5 percent in 2013 (see chart).  The number of uninsured Americans also declined slightly, from 45.6 million in 2012 to 45.2 million in 2013.
  • The share of the population with private coverage remained stable at 65.0 percent in 2013 for the third consecutive year, while the share of the population with Medicaid or CHIP (Children’s Health Insurance Program) remained stable at 15.3 percent.
  • The share of the population enrolled in Medicare rose again in 2013 as another cohort of baby boomers aged into eligibility.
  • Some 14.1 percent of those living in states that have expanded Medicaid were uninsured in 2013, compared with 17.3 percent of residents of non-expansion states.  These results pre-date, and hence do not reflect, the coverage gains due to the Medicaid expansion.  This means that the coverage gap between expansion and non-expansion states will widen further in 2014.

 

Click here to read the full paper.

Coverage Gap Widening Between Medicaid Expansion States and Others

September 18, 2014 at 11:53 am

People in states that have adopted health reform’s Medicaid expansion had a lower uninsured rate in 2013 (before the expansion took effect) than people in non-expansion states — and non-expansion states are falling further behind in 2014, several recent government and independent surveys reveal.

Some 14.1 percent of the people in the 27 states (including Washington, D.C.) that have expanded Medicaid lacked health insurance in 2013, compared to 17.3 percent in the 24 non-expansion states, according to the Census Bureau’s American Community Survey (see chart).

Next year’s Census data, which will reflect the substantial coverage gains expected in expansion states in 2014 due to the expansion (which took effect January 1), should show a further widening of this coverage gap.

Results from several independent surveys — and this week from the Centers for Disease Control and Prevention (CDC), the first government survey data showing health reform’s early impacts — show that this is already happening.  For example, the Urban Institute’s Health Reform Monitoring Survey found that the uninsured rate for non-elderly adults in expansion states fell from 16.2 percent to 10.1 percent between the third quarter of 2013 and the second quarter of 2014, compared to a decline from 20.0 percent to 18.3 percent in non-expansion states.

Health reform’s Medicaid expansion creates a pathway to coverage for all non-elderly adults with incomes up to 138 percent of the poverty line, including, for the first time, low-income adults without children.  However, the 2012 Supreme Court decision upholding health reform made the expansion a state option.  States can opt in to the expansion at any time; the federal government will pick up all of the cost through 2016 and nearly all of the cost thereafter.

Census Data Show Continued Wide Disparities in Health Coverage

September 17, 2014 at 11:46 am

Certain groups of Americans continue to be uninsured at particularly high rates, the new Census Bureau data show.  African Americans and Hispanics, residents of the South and West, adults under age 35, and households with incomes under $50,000 had uninsured rates in 2013 well above the national average of 13.8 percent (see chart).  Hispanics’ 24.3 percent uninsured rate, for example, was nearly twice the national average.

These estimates, from the Current Population Survey (CPS), are the best source for comparing coverage rates among population groups in a single year but can’t be compared to CPS estimates from previous years because of changes to the CPS questions for 2013.  For health coverage trends over time, one should look instead to Census’ American Community Survey data, which we discussed yesterday.

Health reform’s major coverage expansions — the Medicaid expansion in many states to cover more low-income adults and the availability of subsidies for private marketplace coverage — will help reduce the disparities in health coverage among population groups.  But the expansions didn’t begin until 2014, so the new Census figures for 2013 don’t capture those coverage gains.  The Centers for Disease Control and Prevention released data yesterday covering the first quarter of 2014, and they show that the coverage gains in 2014 were greatest among some of the groups with the highest uninsured rates, including young adults, Latinos, and low-income households.