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The Advantages and Disadvantages of Medicaid Expansion: Florida versus Alaska
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The Advantages and Disadvantages of Medicaid Expansion: Florida Versus Alaska
Kelly Rechele Green
Jacksonville University
DIVING DEEPER
DIVING DEEPER
Objectives: Learner will be able to
- Discuss the advantages of Medicaid expansion.
- Discuss trends in inpatient stays for different payers.
- Discuss the difference between states in regards to insurance coverage availability.
Florida
Florida Trends
Opted Out of Medicaid Expansion in 2014. This resulted in 400,000 of the population ineligible for Medicaid in 2018 (Garfield et al., 2020). This includes families with and without children. Subsides were offered but still left insurance coverage out of reach for some.
KEY
RESULTS
KEY RESULTS
x
Regardless of payer, the inpatient stays remained fairly constant over a 12 year period even after the affordable care act became law.
www.hcup-us.ahrq.gov/faststats/statepayer
Medicare
Inpatient stays increase in the beginning of the year and then steadily decreased.
Self pay/no coverage
Inpatient stays remained the same 2005-2018.
Medicaid
Medicaid inpatient stays remained steady.
y
Alaska
Alaska Trends
Opted in to the Medicaid Expansion more than a year after the Affordable Care Act was enacted. This allowed more than 23 percent of the population to be covered. This includes Alaska natives and American Indian population.
www.kff.org/statefacts
KEY
RESULTS
KEY RESULTS
x
Medicare
Inpatient stays varied with the expansion of Medicaid except for Medicare, which stayed steady. Medicaid stays increased substantially with the passage of Medicaid Expansion while self pay and no insurance substantially decreased due to the availability of insurance coverage to cover the cost of medical care.
www.hcup-us.ahrq.gov/faststats/statepayer
Inpatient stays remained fairly steady over the last three years. since the expansion in 2015.
Self pay/no coverage
Inpatient stays decreased by more than 3000 in one year.
Medicaid
Medicaid inpatient stays increased significantly by 2000 over one year.
y
TIMELINE
Affordable Care Act
Target Date for Medicaid
Expansion
Alaska Opts In
Florida Opts Out
2014
January
September 2015
TIMELINE
www.kff.org
Medicaid Expansion
According to Mazurenko (2018), Medicaid has improved quality of care and service use with increases of coverage. This is turn improved outcomes. Federal funding, thought to be limited on payment for coverage, was one of the reasons that Florida opted out of the expansion. On the other hand, Alaska saw the benefit of coverage for the majority of people falling in the middle gap for those unable to afford insurance but had too much income for medicaid.
www.kff.org
State Trends
State Inpatient Trends
Without insurance coverage, the majority of the population cannot afford preventative healthcare and will delay treatment until too late before seeking care in emergency rooms and hospitals. Had insurance been made available prior the admission rate would be lower.
Payers
There was no recorded data for 2014. The percentage of uninsured increased one third more than the year of the expansion.
Alaska had no recorded data for 2014
Diabetic Inpatient Stays 2014-2016 by Payers
There is very little variability in Florida due to the lack of Medicaid expansion
References
HCUP Fast Stats - HCUP-US Home Page. (n.d.). Retrieved June 13, 2020, from https://www.hcup-us.ahrq.gov/faststats/StatePayerServlet?state1=IL&type1=SL02&combo1=s&state2=&type2=PY00&combo2=s&expansionInfoState=hide&dataTablesState=hide&definitionsState=hide&exportState=hide
Mazurenko, O., Balio, C. P., Agarwal, R., Carroll, A. E., & Menachemi, N.
(2018). The Effects Of Medicaid Expansion Under The ACA: A Systematic Review. Health Affairs, 37(6), 944-950. doi:10.1377/hlthaff.2017.1491
Garfield, R., Orgera, K., & Damico, A. (n.d.). The Coverage Gap: Uninsured Poor
in States that Do ... Retrieved June 14, 2020, from https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/
Alaska state facts. (n.d.). Retrieved June 14, 2020, from http://www.kff.org/