100 days in Michigan: U-M team releases new analysis of state’s Medicaid expansion
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In an article in the
In its first 100 days, the authors write, the plan enrolled 327,912 people with incomes below or just above the poverty level – beating projections for its entire first year. Almost 80 percent of them hadn't been enrolled in other state health programs for the poor. And 36 percent of those enrolled in the first two months had used their insurance to visit a doctor or clinic by the end of the fourth month.
The implementation and rollout of the Healthy Michigan Plan, which expanded
Led by
For instance, will the state save enough money from the effects of the new coverage to offset its required future spending to support the Healthy Michigan Plan when federal funding is scaled back in 2017? Will the 16 percent of early enrollees who had incomes just above the federal poverty level participate in healthy behaviors that can reduce their premiums? And will the state's health providers be able to handle the additional demand for services from new enrollees who were previously uninsured?
He and his co-authors propose a national effort to link states, universities and research groups to perform such evaluations, and inform policymakers' future decisions about health care reform.
"For other states that more recently decided to expand
"A lot of low-income adults stand to benefit, so we need to look fully at expansion's impact in every state where it's occurring, and the impact in states that choose not to expand," he says.
The researchers describe many of the factors that may have helped
Although the expansion received state and federal approvals in late 2013, the enrollment period did not begin until
The massive media coverage of initial problems with the national enrollment site, and the mandate for most Americans to get insurance or pay a tax penalty, may have worked in
The time between enactment and enrollment for
Some of the distinctive components of the Healthy Michigan Plan, and permitted under a waiver granted by the
According to the new paper, the population enrolling in the new plans resembles in some ways the population that has traditionally enrolled in
But where traditional
"Gridlock in
In addition to Ayanian, the paper's authors are
Reference: NEJM, 371;17, DOI: 10.1056/NEJMp1409600
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