Hospitals Benefiting From Medicaid Expansion, Report Finds

September 5, 2014 at 10:52 am

Hospitals in states that have expanded Medicaid as part of health reform are seeing a large drop in uninsured patients and higher-than-expected revenues, a new report from the PricewaterhouseCoopers (PwC) Health Research Institute finds.  It’s the latest evidence of the Medicaid expansion’s benefits for states, their businesses, and their residents.

Examining financial data for the first half of the year from the country’s three largest health care providers, PwC found a 47 percent drop in admissions of uninsured patients at affiliated hospitals in Medicaid expansion states.  This suggests a sizable drop in uncompensated care — consistent with a nationwide survey of hospitals by the Colorado Hospital Association after the first quarter of the year.  PwC also found that the rise in the share of patients with health coverage boosted providers’ revenues even more than they had anticipated.

Meanwhile, the Urban Institute projects that hospitals in the 23 states that have not yet expanded Medicaid (see map) will lose out on $157 billion in reimbursements between 2013 and 2022.

This PwC report is one of several indicators of the growing gap between states that have expanded Medicaid and those that haven’t.  The Medicaid expansion is driving large gains in health coverage, while states that haven’t expanded risk forgoing those gains as well as millions of dollars in savings.

Today’s Jobs Report in Pictures

September 5, 2014 at 9:39 am

Today’s disappointing jobs report, while perhaps only a temporary blip in an ongoing labor market recovery, is nevertheless a sober reminder of how devastating the Great Recession and subsequent prolonged jobs slump has been for American workers.  In particular, the share of the population with a job, which plunged to low levels not seen since the early 1980s, has since risen only modestly even though we now are more than five years into the recovery.  In addition, the share of the labor force that is working fewer hours than it would like remains elevated, and unusually high long-term unemployment persists.

Click here for my full statement with further analysis.

Share of population with a job remains near recession levels

Long-term unemployment

Monthly job growth

Job losses were particularly high

Unemployment rate

The EITC’s Far-Reaching Benefits

September 4, 2014 at 12:17 pm

The Earned Income Tax Credit (EITC) “may ultimately be judged one of the most successful labor market innovations in U.S. history,” says the University of California’s Hilary Hoynes in a new article, explaining that the EITC not only encourages work and reduces poverty but produces gains that extend into the next generation:

The effects of EITC extend well beyond simple income support and poverty reduction.  By increasing the income of poor families, it generates additional spending and hence “downstream” economic effects.  It leads to various improvements in the mental and physical health of mothers.  It brings about a reduction in low birth weight among infants. And it improves the performance of children on cognitive tests.  This burgeoning body of work suggests, then, that income support programs have benefits that extend well beyond an increase in cash flow for families in poverty.

We’ve highlighted findings by Hoynes, a leading researcher, and others on the benefits of the EITC and related income support, including a study suggesting that more adequate income during early childhood can lead to greater work effort later in life (see chart).

Policymakers can build on this proven success by expanding the tiny EITC for childless workers, as both President Obama and House Budget Committee Chairman Paul Ryan favor, and by making permanent key EITC and Child Tax Credit improvements set to expire in 2018.

New Study Shows Link Between Medicaid Coverage of Prenatal and Infant Care and Better Long-Term Health Outcomes

September 4, 2014 at 10:12 am

The benefits of good prenatal and infant care for a child’s development are well documented, so it makes sense that improving access to care by expanding Medicaid coverage to pregnant women and children would produce long-term gains.  A new study suggests that as well.

University of Michigan researchers examined the health in young adulthood of people born during the 1980s and early 1990s, when states significantly expanded Medicaid to cover more low-income pregnant women and children in response to new federal requirements and added state flexibility.  Building on a large body of research documenting the benefits of Medicaid, they found that people who were more likely to be eligible for Medicaid during their prenatal and infant stages had better health and fewer preventable hospitalizations as young adults than those who were less likely to be eligible for Medicaid.

Specifically, a ten-percentage-point increase in the share of women of childbearing age who were eligible for Medicaid was linked to the following positive outcomes for young adults (ages 19-33) born during the expansion:

  • lower body mass index and a 7 percent drop in the likelihood of obesity;
  • a nearly 2 percent decline in preventable hospitalizations overall and a 9 to 10 percent decline in preventable hospitalizations related to chronic conditions; and
  • an 8 to 10 percent drop in hospitalizations related to conditions that benefit from regular medical evaluations in early childhood, such as diabetes.

As noted, other studies have shown the health benefits of expanding Medicaid, but this study shows the link between Medicaid coverage and positive long-term health outcomes as well.  It’s one more reason why states that haven’t yet adopted health reform’s Medicaid expansion should get off the sidelines.

Two Policy Tools States Can Use to Build a Broader Recovery

September 3, 2014 at 3:35 pm

Low-wage workers need a boost.  In the last few years, their wages have fallen sharply and now are no different than they were 40 years ago, adjusted for inflation (see chart), leaving millions struggling to afford basics like decent housing in safe neighborhoods, nutritious food, reliable transportation, and quality child care.  As we detail in a new paper, states can use two effective policy tools to help working families and individuals meet their basic needs and pursue a path to financial stability:  state earned income tax credits (EITCs) and minimum wages.  The two work best when states strengthen them at the same time.

State EITCs and minimum wages help make work pay for families who earn low wages.  They increase income, widen the path out of poverty, and reduce income inequality.  They also help to build a stronger future economy because lifting family income for young, low-income children can result in improved learning and educational attainment and higher future earnings in adulthood.

While each policy is effective in its own right, state EITCs and minimum wages build upon each other’s effectiveness in boosting the prospects of low-wage working families.  State policymakers should improve them in tandem.  Here’s why:

  • State minimum wages and EITCs reach overlapping but different populations.  State EITCs primarily target low-income families with children and are available to working families earning more than three times a full-time minimum wage worker’s annual salary of $14,500.  The minimum wage goes to the very lowest-wage workers, regardless of factors like family income, family status, or age.
  • Increasing both at the same time provides added support to the working families who need it most.  Together, a minimum wage boost and a robust state EITC can move families beyond poverty and further down the road to economic security.  Also, a minimum wage increase provides the added benefit of increasing the EITC for some families.
  • The benefits of the two policies are timed differently.  An expanded minimum wage increases every paycheck, which helps with routine expenses, like food, monthly bills, and rent.  State EITCs are paid at tax time and can be used for larger, one-time expenses, like car repairs or a security deposit.
  • Improving both together allows the public and private sectors to share the cost of boosting incomes for those who work.  The EITC is a cost largely borne by state government, and by extension state taxpayers.  The state minimum wage is borne principally by the private sector, especially employers and consumers.  Improving both policies spreads the cost of making work pay more broadly than does either policy alone.

Many states have increased their minimum wage and a few states have enacted EITC improvements in 2014.  Three states — Maryland, Minnesota, and Rhode Island — and the District of Columbia have done both.  Other states also should look to advance the two policies at the same time to make the biggest impact for families most in need.

Click here to read the full paper.