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Articles by Stan Dorn
The House Budget Resolution’s cuts to SNAP would be the largest in U.S. history
By Hannah Garelick, Policy Analyst, and Stan Dorn, Health Policy Director, UnidosUS If the pending House Budget Resolution passes and is implemented in Budget Reconciliation, the Supplemental Nutrition Assistance Program (SNAP), America’s most important anti-hunger program, would experience its largest cuts in history. People from all backgrounds would have their lives upended by the Budget Resolution’s SNAP cuts.
The House Budget Resolution’s Medicaid cuts would be the largest in U.S. history
By Stan Dorn, Director, Health Policy Project, UnidosUS If the pending House Budget Resolution passes and is implemented in Budget Reconciliation legislation, Medicaid would experience the largest cuts in its history. In fact, the current proposed cuts are larger than the combined total of cuts made by all previous legislation, in federal eight separate Budget Reconciliation bills.
ACA Metal-Tier Mispricing: Improving Affordability By Solving An Actuarial Mystery
It wasn’t supposed to be this way. In 2015, HHS’s Assistant Secretary for Planning and Evaluation (ASPE) described what would happen if the cost-sharing reductions (CSR) that silver-tier Marketplace plans give their low-income members were financed by premiums rather than separate federal payments.
How to win Latino voters: protect health care and lower health costs
With midterm elections in full swing, political pundits are highlighting the pivotal role Hispanic voters are likely to play — and for good reason. The National Association of Latino Elected and Appointed Officials (NALEO) projects that Hispanics will make up 1 in 10 voters nationally, with higher proportions in some key battleground states — roughly 1 in 5 voters in Arizona and Florida and 1 in 6 Nevada voters.
To Reduce Coverage Losses, CMS Should Revise Limits On How States Verify Medicaid Eligibility
On September 7, 2022, the Centers for Medicare and Medicaid Services (CMS) published proposed rules that would dramatically streamline eligibility determination, enrollment, and retention in Medicaid and the Children’s Health Insurance Program (CHIP).The proposed regulations reflect an effort by the Biden administration to ensure that people who are eligible can obtain and retain health coverage, free of needless paperwork burdens.
How New Mexico Dramatically Reduced Marketplace Deductibles At Zero Cost To The State
High deductibles, which can impose significant financial burdens and deter use of essential health care, are a longstanding problem for many consumers who buy their own insurance through the health insurance Marketplace. Earlier this year, New Mexico made significant progress in addressing that problem, when a quarter of all Marketplace participants shifted from relatively high-deductible bronze and silver plans to gold plans with much lower deductibles.
How New Mexico Dramatically Reduced Marketplace Deductibles At Zero Cost To The State
High deductibles, which can impose significant financial burdens and deter use of essential health care, are a longstanding problem for many consumers who buy their own insurance through the health insurance Marketplace. Earlier this year, New Mexico made significant progress in addressing that problem, when a quarter of all Marketplace participants shifted from relatively high-deductible bronze and silver plans to gold plans with much lower deductibles.
How to boost health insurance enrollment: Three practical steps that merit bipartisan support | AEI
The COVID-19 pandemic is exposing the vulnerability of working Americans to loss of their health insurance. Employer-sponsored insurance (ESI) is the primary source of coverage for US workers and their dependents, and when unemployment rises, so too does the uninsured rate. The recession gripping the nation has upended existing insurance arrangements for millions of working families.
Options for Designing a Public Option
State and federal policymakers are considering adding state-backed public options to the individual market in an effort to expand health coverage and improve affordability. Such options would be either publicly administered or privately administered using publicly-defined provider reimbursement rates. Earlier today, we released an analysis of what would happen if public options became available in the country's health insurance exchanges (sometimes termed, “marketplaces”).
Webinar: Health insurance auto-enrollment
Twitter Join the conversation on Twitter using #AutoEnrollment Before the COVID-19 pandemic, 30 million Americans were uninsured, but half of this population is eligible for insurance coverage through Medicaid or for financial assistance to buy coverage on the health insurance marketplace. Auto-enrollment is a method by which individuals are placed automatically into the health insurance coverage they are qualified for, and it has received support across the political spectrum.
Health care for veterans is on the chopping block
On July 9, exactly two months ago, three federal judges sitting in a New Orleans courtroom heard a lawsuit seeking to overturn the entire Affordable Care Act. The case was brought by Texas and 17 other states, with the Trump administration lending its support. On the other side were 20 states led by a mix of Democrats and Republicans.
'Cadillac tax' on generous health plans may be headed to congressional junkyard
The 'Cadillac tax,' an enacted but not yet implemented part of the Affordable Care Act, is a 40 percent tax on the most generous employer-provided health insurance plans — those that cost more than $11,200 per year for an individual policy or $30,150 for family coverage. Andrew Harrer | Bloomberg Creative | Getty Images The politics of health care are changing. And one of the most controversial parts of the Affordable Care Act — the so-called "Cadillac tax" — may be about to change with it.
Texas vs. United States: What's at stake for Veterans
State and federal opponents of the Affordable Care Act (ACA) have filed a lawsuit asking the courts to throw out the entire ACA, based on Congress’s 2017 decision to eliminate the tax penalty for people who are uninsured. On July 9, 2019, the case came before the Fifth Circuit Court of Appeals, which could issue its ruling at any time. The lawsuit may eventually reach the U.S. Supreme Court.
Maryland’s Easy Enrollment Health Program
Broad bipartisan majorities in the Maryland Senate and House, by margins of 46-0 and 120-9, have approved legislation to establish a simple and seamless system for obtaining health coverage. Under the bill, an uninsured Marylander can start the enrollment process by simply checking a box on their state income tax return. That single step will let the state’s health care exchange determine eligibility for free or low-cost health insurance, based on information in the tax return.
How Have Workers Fared Under the ACA?
Whether the coverage provisions under the Affordable Care Act (ACA) would lead to adverse labor market consequences in the form of reduced employment, hours worked, or earnings has been the subject of substantial debate and analysis. This brief assesses whether coverage gains from 2010 to 2016 were associated with changes in labor market outcomes across occupations.
Do they think we’ll forget?
When a member of Congress held a town hall after voting to repeal the Affordable Care Act (ACA), the outrage of a constituent whose wife had survived cancer went viral: “You came after my wife! You came after my kids! There was a horrible bill, from a horrible group of people. They said if we get sick, it’s our fault. It’s completely immoral. I will not forgive.
Improving the Affordability of Coverage through the Basic Health Program in Minnesota and New York - Issue Brief
The Basic Health Program (BHP) gives states the option of providing state-administered coverage in lieu of coverage through health insurance marketplaces to certain individuals with incomes at or below 200% of the federal poverty level (FPL).
Under the Guise of “Health Insurance Stabilization,” Congress Should Not Axe Financial Help for Low-Wage Families
In negotiations over stabilizing the individual health insurance market, lawmakers are considering slashing federal health care assistance for low- and moderate-income consumers by more than $27 billion a year.
Funding CSR Payments in the Health Insurance Stabilization Package Could Harm Low- and Middle-Income Consumers
Families USA strongly supports bipartisan efforts to give consumers affordable health insurance in the individual market. A successful stabilization bill would enhance affordability and access by raising advance premium tax credits (APTCs), funding reinsurance, financing outreach and enrollment assistance, and stopping proposed regulations that would let short-term plans and association health plans (AHPs) substantially undermine the individual market.
Strategies for Connecting Justice-Involved Populations to Health Coverage and Care
This guide presents an array of strategies for connecting justice-involved people to Medicaid coverage and physical and behavioral health care services. Designed to address the specific health care needs unique to justice-involved people, the guide provides a comprehensive road map for state and local justice and health care officials aspiring to more efficiently enroll justice-involved people in Medicaid or other health care coverage and help them obtain coordinated care in the community.
Expert advice for the corporate titans taking on health care
An announcement Jan. 30 by three of the nation’s corporate titans – Amazon, Berkshire Hathaway, and JPMorgan Chase & Co. – that they are joining forces to address the high costs of employee health care has stirred the health policy pot. It immediately sent shock waves through the health sector of the stock market and reinvigorated talk about health care technology, value, and quality.
Assessing the Promise and Risks of Income-Based Third-Party Payment Programs
With roughly 20 million Americans gaining coverage under the Affordable Care Act (ACA), the United States has made enormous progress in reducing the number of uninsured.1 Nevertheless, 28.6 million people remained without health coverage in 2016,2 of whom an estimated 62 percent qualified for Medicaid or marketplace coverage.3 As of June 2015, only 35 percent of consumers eligible for advance premium tax credits — which lower monthly health insurance payments — had enrolled in marketplace...
Another hidden ACA attack
After a decade of fruitlessly besieging the city of Troy, the Greeks seemed to sail away for home, leaving behind a gift. “What lovely sculpture,” exclaimed the Trojans. “The Greeks may return, but for now, they have obviously stepped aside from battle. Just look at this beautiful wooden horse!” Troy soon learned to its sorrow that Greek warriors were hiding in the belly of the beast. The gift acclaimed as a sign of peace turned out to be a vehicle for waging further war.
Senate Health Care Legislation Would Grant HHS Unprecedented Power Over States
In an earlier Health Affairs Blog post, we described several provisions in the Senate’s Better Care Reconciliation Act (BCRA) that would grant the U.S. Department of Health and Human Services (HHS) largely unchecked authority to make decisions that could significantly affect state budgets.
Workers Gaining Health Insurance Coverage Under the ACA
One major aim of the Patient Protection and Affordable Care Act (ACA) was to increase health insurance coverage. This brief highlights the ACA’s impact on insurance coverage in working families. Using data from the American Community Survey and the Current Population Survey, we examine changes in total coverage for workers and their family members from 2010 to 2015, by occupation type and state.
In Senate Health Care Bill, A Few Hidden Surprises
A low-income person, eligible for Medicaid but not enrolled, is hit by a car or a bullet. Gravely injured, she arrives at the hospital unconscious. Thanks to expert, intensive care that lasts for days or weeks, she gradually recovers. Eventually, her health improves to the point where she can complete the paperwork needed to apply for Medicaid.
Louisiana Deductibles Skyrocket under the Senate Bill to “Repeal and Replace” the Affordable Care Act
Opponents of the Affordable Care Act (ACA) complain about high deductibles, but the Senate health care repeal bill would dramatically increase deductibles, rather than lower them. In Louisiana, 149,145 consumers in the state’s marketplace—more than four out of every five marketplace enrollees (81%)–would see their per person deductibles rise from an average of $1,039 to $6,000—a 477% increase.
More Than Cost Savings
A popular benefit of the pay for success (PFS) model is its potential to finance programs that, if successful, will save governments more than they cost. But in practice, this limits the number of programs eligible for PFS. It also incorrectly assumes that most governments place little value on the non-fiscal benefits.
Beyond Cashable Savings
A popular benefit of the pay for success (PFS) model is its potential to finance programs that, if successful, will save governments more than they cost. But in practice, this limits the number of programs eligible for PFS. It also incorrectly assumes that most governments place little value on the non-fiscal benefits.
The Cost of Not Expanding Medicaid: An Updated Analysis
The 19 states that have not yet expanded Medicaid could reduce the number of uninsured by 4.3 million to 5.2 million people while claiming $7.14-$7.75 in federal dollars for each state dollar invested to finance expansion. Expanding Medicaid in these states would increase federal funding by $595.8 billion to $664.8 billion from 2018-2027, while raising state Medicaid costs by $82.5 billion to $90.8 billion. Residents would save between $84.1 billion and $90.7 billion..
The Cost to States of Not Expanding Medicaid
We analyze the 19 states that have not expanded Medicaid. From 2017 to 2026, expansion in these states would increase nominal state costs by less than $60 billion while increasing federal funding by more than $400 billion. Each new state dollar would draw down between $7 and $8 in additional federal dollars. We were not able to estimate offsetting state revenue gains and full state cost savings.
Helping Special Enrollment Periods Work under the Affordable Care Act
On June 17, 2016, CMS began requiring consumers to document eligibility for special enrollment periods (SEPs). Some evidence suggests the need for verification. However, requesting documentation is likely to reduce enrollment by eligible people, given past experience with similar policies. It may be more effective to seek consumer documentation only if the Marketplace cannot quickly verify eligibility with existing data systems or phone calls.
The Effects of the Medicaid Expansion on State Budgets: An Early Look in Select States
The Effects of the Medicaid Expansion on State Budgets: An Early Look in Select States As enacted, the Affordable Care Act (ACA) broadened Medicaid’s role, making it the foundation of coverage for nearly all low-income Americans with incomes up to 138 percent of the federal poverty level (FPL) ($16,242 per year for an individual in 2015). However, the Supreme Court ruling on the ACA effectively made the decision to implement the Medicaid expansion an option for states.
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