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Journal Article
States may face higher spending in give-and-take of Medicare/Medicaid changes
Quigley, E. Matthew (2005-01)
Despite a markedly improved outlook for state finances, New Englands states still face significant fiscal pressures moving forward into the current and next fiscal years. Prominent among these challenges are two changes to the Medicaid and Medicare programs that could significantly increase state health care costs.
Fiscal Facts , Issue Win , Pages 1-5

Working Paper
Old, Frail, and Uninsured: Accounting for Puzzles in the U.S. Long-Term Care Insurance Market
Braun, R. Anton; Koreshkova, Tatyana; Kopecky, Karen A. (2017-03-01)
Half of U.S. 50-year-olds will experience a nursing home stay before they die, and one in ten will incur out-of-pocket long-term care expenses in excess of $200,000. Surprisingly, only about 10% of individuals over age 62 have private long-term care insurance (LTCI). This paper proposes a quantitative equilibrium optimal contracting model of the LTCI market that features screening along the extensive margin. Frail and/or poor risk groups are ordered a single contract of no insurance that we refer to as a rejection. According to our model, rejections are the main reason that LTCI take-up rates ...
FRB Atlanta Working Paper , Paper 2017-3

Working Paper
Missouri’s Medicaid Contraction and Consumer Financial Outcomes
Bailey, James; Blascak, Nathan; Mikhed, Vyacheslav (2020-11-02)
In July 2005, a set of cuts to Medicaid eligibility and coverage went into effect in the state of Missouri. These cuts resulted in the elimination of the Medical Assistance for Workers with Disabilities program, more stringent eligibility requirements, and less generous Medicaid coverage for those who retained their eligibility. Overall, these cuts removed about 100,000 Missourians from the program and reduced the value of the insurance for the remaining enrollees. Using data from the Medical Expenditure Panel Survey, we show how these cuts increased out-of-pocket medical spending for ...
Working Papers , Paper 20-42

Journal Article
Medicaid-the need for reform
Weil, Alan R.; Holahan, John (2007-10)
Recent administration proposals to address the rising cost of Medicaid will do little to contain costs or truly reform the program. The primary issues are the large differences among state Medicaid programs in coverage and benefits and the programs high and rising costs. In this paper, we describe and develop several options for Medicaid reform that would expand coverage, provide fiscal relief to states, shift responsibility for some or all of the cost of dual eligibles to the federal government, and eliminate or restructure the disproportionate share programs. A number of other issues are ...
Regional Economic Development , Issue Oct , Pages 12-21

Newsletter
Medicaid Expansion and the Affordable Care Act: A Fiscal Checkup
Wetmore, Sarah; Mattoon, Richard H. (2016)
On April 4, 2016, the Federal Reserve Bank of Chicago and the Civic Federation held a conference to examine how states are lowering the ranks of the uninsured under the Affordable Care Act (ACA)?by expanding Medicaid and through other strategies. The conference also looked at the ACA?s impact on delivering health care to traditionally underserved populations.
Chicago Fed Letter

Briefing
Medical Spending in Old Age
Jones, John Bailey; Romero, Jessica Sackett (2017-05)
Older Americans' health care spending is relevant to many policy questions. Recent research shows that spending varies considerably with income, as do funding sources for that spending. Overall, the government pays more for lower-income individuals than higher-income individuals, but Medicaid is not just a program for the young and the poor. It provides substantial benefits to older adults with higher incomes as well.
Richmond Fed Economic Brief , Issue May

Discussion Paper
Can Community Development Improve Health? Emerging Opportunities for Collaboration between the Health and Community Development Sectors
Fazili, Sameera (2017-12-01)
The two sectors of community development and health have long worked in the same neighborhoods, but they have not always worked together. This is starting to change, due in part to a growing recognition among health experts of the social, economic, and environmental factors that drive health outcomes. These social determinants of health have become the basis for new collaborations between community development and health professionals. This paper introduces professionals in both sectors to this emerging area of practice through a series of case studies of innovators in the southeastern United ...
FRB Atlanta Community and Economic Development Discussion Paper , Paper 2017-03

Working Paper
Medicaid Expansion and the Unemployed
http://fedora:8080/fcrepo/rest/objects/authors/; Buchmueller, Thomas C.; Valletta, Robert G. (2019-12-16)
We examine how a key provision of the Affordable Care Act—the expansion of Medicaid eligibility—affected health insurance coverage, access to care, and labor market transitions of unemployed workers. Comparing trends in states that implemented the Medicaid expansion to those that did not, we find that the ACA Medicaid expansion substantially increased insurance coverage and improved access to health care among unemployed workers. We then test whether this strengthening of the safety net affected transitions from unemployment to employment or out of the labor force. We find no meaningful ...
Working Paper Series , Paper 2019-29

Journal Article
Barriers to saving
Neuberger, Zoe; Orszag, Peter; Greenstein, Robert (2006-07)
When the poor succeed in building up a few assets, they often find themselves disqualified from badly needed government programs. Confusing rules about IRAs and 401(k)s plus conflicting state regulations make retirement saving particularly challenging.
Communities and Banking , Issue Sum , Pages 25-27

Working Paper
The Costs of Payment Uncertainty in Healthcare Markets
Gottlieb, Joshua D.; Shapiro, Adam Hale; Tebaldi, Pietro; Dunn, Abe (2020-04-13)
What does it cost healthcare providers to collect payment in the complex U.S. health insurance system? We study this question using rich data on repeated interactions between a large sample of physicians and many different payers, and investigate the consequences when these costs are high. Payment uncertainty is high and variable, with 19% of Medicaid visits not reimbursed after the first claim submission. In such cases, physicians either forgo substantial revenue or incur costs to collect payment. Using physician movers and practices that span state boundaries, we find that providers respond ...
Working Paper Series , Paper 2020-13

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