Understanding state variation in health insurance dynamics can help tailor enrollment strategies for ACA expansion

Health Affairs

Volumn 32, Issue 10, 2013, Pages 1832-1840

  Graves, John A ^a   Swartz, Katherine ^b  

^a VANDERBILT UNIVERSITY   (United States)

^b HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; FEMALE; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; INCIDENCE; MALE; MEDICAID; MEDICALLY UNINSURED; MEDICARE; PRIVATE HEALTH INSURANCE; PUBLIC HEALTH INSURANCE; RISK ASSESSMENT; UNITED STATES; GOVERNMENT; INSURANCE; MIDDLE AGED; STATISTICS AND NUMERICAL DATA; UTILIZATION; YOUNG ADULT;

ADULT; FEMALE; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MALE; MEDICALLY UNINSURED; MIDDLE AGED; PATIENT PROTECTION AND AFFORDABLE CARE ACT; STATE GOVERNMENT; UNITED STATES; YOUNG ADULT;

EID: 84885402378     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2013.0327     Document Type: Article

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21. To access the Appendix, click on the Appendix link in the box to the right of the article online.
22. By comparison, the 2008 SIPP reweighting approach used by CMS for Modified Adjusted Gross Income standard conversions uses 1,152 cells based on interactions between discrete categories of eight covariates (age, parent status, sex, race or ethnicity, total household income, and categories of unearned income). Another key difference is borrowing across state boundaries: CMS's ap-proach does not restrict borrowing, but our approach restricted borrowing to neighboring states and states with similar policies about eligibility for public programs. For more details, see Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Data sources for Modified Adjusted Gross Income (MAGI) conversions [Internet]. Washington (DC): ASPE; 2013 Feb [cited 2013 Sep 4]. (ASPE Issue Brief). Available from: http://aspe.hhs.gov/health/reports/2013/sipp/ib.cfm
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24. We identified states with similar public eligibility policies using a Medicaid generosity index that we constructed. We applied each state's 2012 public program income eligibility rules to a national sample of nonelderly adults from the 2008 SIPP.We then estimated and ranked states based on the percentage of this sample that would be eligible for coverage under each state's rules.We permitted cross-state borrowing among states that were within 2.5 percentage points above or below each other. Program eligibility rules were drawn from Kaiser Commission on Medicaid and the Uninsured. Where are states today? Medicaid and CHIP eligibility levels for children and non-disabled adults [Internet]. Washington (DC): KFF; 2013 Mar [cited 2013 Sep 4]. Available from: http://kaiserfamilyfoundation.files.wordpress.com/2013/04/7993-03.pdf
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