On May 18, 2016, the Department of Health and Human Services (HHS) published a final rule to implement Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination in health coverage and care based on race, color, national origin, age or disability, and, for the first time sex. This Issue Brief provides a technical summary of Section 1557 and the final rule and highlights new protections and provisions included in the law and rule. Notably, Section 1557 is the first federal civil rights law to prohibit discrimination on the basis of sex in health care. Moreover, the proposed rule extends the definition of sex discrimination to include discrimination on the basis of gender identity. In addition, the final rule establishes regulations related to the provision of language assistance services based on long-standing HHS policy guidance.
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The number of rural hospital closures has increased significantly in recent years. This trend is expected to continue, raising questions about the impact the closures will have on rural communities’ access to health care services. To investigate the factors that contribute to rural hospital closures and the impact those closures have on access to health care in rural communities, the Kaiser Commission on Medicaid and the Uninsured and the Urban Institute conducted case studies of three hospital closures that took place in 2015: Mercy Hospital in Independence, Kansas; Parkway Regional Hospital in Fulton, Kentucky; and Marlboro Park Hospital in Bennettsville, South Carolina. Two of these hospitals were in states that did not adopt the Medicaid coverage expansion under the Affordable Care Act (ACA) (Kansas and South Carolina), while one of the hospitals was located in a Medicaid expansion state (Kentucky).
Oral contraceptives are now the most widely used form of contraception and are also commonly used to manage other health conditions. In the U.S., the daily oral contraceptive pills have traditionally only been available with a prescription, but current legislative and advocacy efforts in some states have focused on broadening access to oral contraceptives by eliminating the requirement that women first have an in-person clinical visit. This factsheet provides an overview of oral contraception, discusses private insurance and Medicaid coverage, and reviews emerging strategies to promote and expand women’s access to oral contraceptives.
A Comprehensive Review of Research Finds That the ACA Medicaid Expansion Has Reduced the Uninsured Rate and Increased Access to Care in Expansion States
Multiple studies find that the Affordable Care Act’s Medicaid expansion has increased coverage, with enrollment exceeding expectations in some states, while producing budget savings for states and reductions in uncompensated care costs for hospitals, according to a Kaiser Family Foundation review of 61 studies and policy reports. The literature review provides…
Research on the effects of Medicaid expansions under the Affordable Care Act (ACA) can help increase understanding of how the ACA has impacted coverage; access to care, utilization, and health outcomes; and various economic outcomes, including state budgets, the payer mix for hospitals and clinics, and the employment and labor market. These findings also may inform ongoing debates surrounding the Medicaid expansion. This brief reviews and summarizes findings from a total of 61 studies of the impact of state Medicaid expansions under the ACA.
On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.
This chartpack provides data on demographics, health access and utilization, health status and outcomes, and health coverage by race and ethnicity to provide greater insight into the current status of disparities. Where data are available, it examines measures by six groups: White, Asian, Hispanic, Black, American Indian and Alaska Native, and Native Hawaiian and Other Pacific Islander.
Connecting the Justice-Involved Population to Medicaid Coverage and Care: Findings from Three States
This brief provides an overview of initiatives to connect the justice-involved population to Medicaid coverage and care in the community in three states—Arizona, Connecticut, and Massachusetts—based on interviews with key stakeholders. These states are leading efforts in these areas and provide key lessons about how to coordinate across health care and corrections and the potential of such initiatives to better link individuals to the physical and behavioral services they need. Each of the case study states is connecting individuals to coverage at multiple points within the justice system. The study states also connect individuals to care in the community as they are released from jail or prison. Stakeholders and data indicate that these approaches have increased coverage, facilitated access to care, and contributed to administrative efficiencies and state savings. However, more data and time are needed to examine the effects on health and criminal justice outcomes, including recidivism rates.
Employer- and union-sponsored retiree health benefits have served as an important source of supplemental coverage for people on Medicare, but over time, this coverage has been eroding. This Data Note draws upon five national surveys to document the decline in retirement health insurance coverage, and discusses the implications for seniors and retiring Boomers.
Web Briefing – Serving the Homeless Community: New Findings on the Impact of the ACA Medicaid Expansion
On Tuesday, April 26, 2016, KFF presented a web briefing to examine new findings about how the Medicaid expansion has affected patients who are homeless, as well as the providers who care for them. The briefing addressed changes in insurance coverage, revenues and costs among Health Care for the Homeless (HCH) projects, a subset of community health centers that serve individuals who are homeless, in both expansion and non-expansion states, as well as examined experiences in health centers that serve a broad low-income population.