Are adults benefiting from state coverage expansions?

Health Affairs

Volumn 25, Issue 2, 2006, Pages

  Long, Sharon K ^a   Zuckerman, Stephen ^a   Graves, John A ^a  

^a URBAN INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; CHILD; CHILD HEALTH CARE; COMPARATIVE STUDY; ECONOMICS; FEMALE; HEALTH CARE PLANNING; HUMAN; INSURANCE; MALE; MEDICAID; ORGANIZATION AND MANAGEMENT; PATIENT; REVIEW; STATISTICS; UNITED STATES;

ADULT; CALIFORNIA; CHILD; CHILD HEALTH SERVICES; ELIGIBILITY DETERMINATION; FEMALE; HUMANS; INSURANCE COVERAGE; MALE; MASSACHUSETTS; MEDICAID; MEDICALLY UNINSURED; NEW JERSEY; STATE HEALTH PLANS; UNITED STATES; WISCONSIN;

EID: 33645687819     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.25.w1     Document Type: Review

References (19)

1. L. Dubay, J. Haley, and G. Kenney, "Children's Eligibility for Medicaid and SCHIP: A View from 2000," Assessing the New Federalism Policy Brief no. B-41, March 2002, http://www.urban.org/UploadedPDF/310435.pdf (accessed 3 January 2006).
2. G. Kenney, J. Haley, and A. Tebay, "Children's Insurance Coverage and Service Use Improve," Snapshots of America's Families 3, no. 1, July 2003, http://www.urban.org/UploadedPDF/310816_snapshots3_nol.pdf (accessed 3 January 2006).
3. S. Zuckerman, "Gains in Public Health Insurance Offset Reductions in Employer Coverage among Adults," Snapshots of America's Families 3, no. 8, September 2003, http://www.urban.org/UploadedPDF/310850_snapshots3_no8.pdf (accessed 3 January 2006).
4. See, for example, J.B. Mitchell et al., "Impact of the Oregon Health Plan on Access and Satisfaction of Adults with Low Income," Health Services Research 37, no. 1 (2002): 33-42;
5. L. Moreno and S.D. Hoag, "Covering the Uninsured through TennCare: Does It Make a Difference?" Health Affairs 20, no. 1 (2001): 231-239;
6. R. Kronick and T. Gilmer, "Insuring Low-Income Adults: Does Public Coverage Crowd Out Private?" Health Affairs 21, no. 1 (2002): 225-239;
7. and S.K. Long and S. Zuckerman, "MassHealth Succeeds in Expanding Coverage for Adults," Inquiry 41, no. 3 (2004): 268-279.
8. The technical appendix is available online at http://content. healthaffairs.org/cgi/content/full/hlthaff.25.W1/DC2.
9. J.W. Wooldridge, Econometric Analysis of Cross Section and Panel Data (Cambridge, Mass.: MIT Press, 2002).
10. The lower bound for the income band for the near-eligible group in a state is set at the income level that captures 99 percent of those predicted to be eligible under the rules in place in that state. The near-eligible parents comparison group constitutes a 175-percentage-point band above that income cutoff. Sensitivity analyses using different income bands and income cutoff points yielded results similar to those reported here. For New Jersey, we included both eligible and near-eligible childless adults because the state expanded coverage temporarily to some low-income childless adults. We excluded the childless adults who would have been eligible for that expansion from the comparison group. Because Massachusetts expanded coverage to both parents and childless adults, there is no model 2 comparison group in that state.
11. Since Massachusetts implemented MassHealth in 1997, it is both a study state and, for the period 1999-2002, a comparison state for other study states. The states included in the cross-state comparison groups for each of the study states were as follows. California: FL, KY, LA, MS, NM, NV, OR, TN, TX, and WV; New Jersey. AL, AR, CO, GA, ID, IL, IN, KS, MA, MI, MT, NC, NE, PA, SC, VA, and WY; Wisconsin: AR, DE, HI, IA, IL, KS, MA, MD, MI, NE, NH, PA, VA, and WY; Massachusetts: DE, GA, IA, MI, NC, PA, SC, and WY.
12. Institute of Medicine, Coverage Matters: Insurance and Health Care (Washington: National Academies Press, 2001);
13. and R.M. Andersen, "Revisiting the Behavioral Model and Access to Care: Does It Matter?" Journal of Heath and Social Behavior 36, no. 1 (1995): 1-10.
14. Data comparable to those in Exhibit 2 for the comparison groups are available in the online technical appendix as Exhibit A.2; see Note 5.
15. G. Davidson, L. Blewett, and K.T. Call, "Public Program Crowd-Out of Private Coverage: What Are the Issues?" Research Synthesis Report no. 5, June 2004, http://www.rwjf.org/publications/synthesis/reports_and_briefs/pdf/ no5_researchreport.pdf (accessed 3 January 2006).
16. An exhibit similar to Exhibit 3 that summarizes changes in coverage for the comparison groups during the study period is available in the online technical appendix as Exhibit A.3; see Note 5.
17. S. Silow-Carroll and T. Alteras, "Massachusetts: A Case Study in Childless Adult Coverage" (Washington: Henry J. Kaiser Family Foundation, August 2004).
18. Kronick and Gilmer, "Insuring Low-Income Adults."
19. P. Fronstin, "Uninsured Rose in 2002 as Number of Americans with Employment-based Health Benefits Declined," EBRI Notes 24, no. 11 (2003), http://www.ebri.org/pdf/notespdf/1103notes.pdf (accessed 27 December 2005).