Thursday, April 23, 2015

Disparities among states show weaknesses and strengths of the Affordable Care Act

Four largest states have sharp disparities in access to healthcare



Californians and New Yorkers have better access to healthcare than Floridians and Texans, according to the study from the Commonwealth Fund, a New York foundation that studies health systems domestically and around the world.


The data may reveal the strengths and weaknesses of the Affordable Care Act, or at least the pathways the law affords the states.  The suggestion is that access to medical care and perhaps even ability to pay medical bills is affected by whether a state has expanded insurance coverage under the law.


·         Residents of Florida and Texas, which have resisted expanding insurance coverage through the health law, reported more problems getting needed care than residents of California and New York, which both guarantee coverage to their residents.


·         Floridians and Texans were also significantly more likely to struggle with medical bills and to report that they had medical debt.


·         More than 40% of residents of Florida and Texas reported that they did not go to the doctor when they were sick, didn't fill a prescription, didn't see a needed specialist or skipped a recommended test or treatment in the previous year.


·         The same proportion reported they had been unable to pay a medical bill, had been contacted by a collection agency over a medical bill, had had to change their way of life to pay bills or had medical debt.


"Health policy decisions made by state leaders matter," the study's authors conclude, warning: "Coverage gaps are leaving millions uninsured and without access to affordable coverage."


Some states have expanded Medicaid with federal aid made available by the law; other states — all led by either Republican governors or legislatures, or both — have turned down the assistance, citing concerns about Medicaid's effectiveness and cost.


States that fully implemented the law saw a 4.8 percentage-point improvement in the share of adults with insurance from 2013 to 2014, according to a recent Gallup poll. That was nearly twice the rate of states that have not fully implemented the law.


Just 31% of Californians and 30% of New Yorkers reported the same access problems as found in Florida and Texas. Even fewer said they had the same struggles with medical bills.


What is the situation in your state?  What are you seeing at registration or the back end of the revenue cycle?


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