Medicaid is a long-term source of insurance for low-income families | Daily News Byte

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1. In this cohort study, more than half of all Medicaid beneficiaries in 2011 were still enrolled nine years later.

2. Both short-term and long-term health insurance stability rates were higher among people with disabilities, who may depend on regular care programs.

Level of evidence rating: 2 (good)

Study overview: The Medicaid program was designed as a low-cost, temporary insurance solution for millions of low-income and marginalized Americans. Recent policy changes at the state level and poor economic circumstances have increased reliance on and stability of Medicaid coverage. This cohort study used enrollment data for Michigan Medicaid beneficiaries between 2011 and 2020 to study short- and long-term enrollment trends in the programs. Fixed cohort and newly enrolled cohort are defined as Medicaid beneficiaries enrolled as of January 1, 2011 and those newly enrolled between 2011 and 2020. More than half of the fixed cohort is also enrolled in 2020, with the most stable demographic among people with disabilities. One quarter of the fixed cohort was enrolled continuously in the same period. In the newly enrolled cohort, 37% remained enrolled in 2020. About three-quarters of all users were enrolled for at least two years. However, this trend dropped to 54% after 2015, which coincided with the Medicaid expansion of the Patient Protection and Affordable Care Act of 2014, which suggested that Medicaid continue to serve people who need the program only temporarily. As a limitation, this analysis included only one state’s Medicaid program and could not differentiate between mortality and exclusion. These deviations may reduce generalizability to other states or misrepresent the stability of the program.

Click to read the study in AIM

In-Depth [retrospective cohort]: In this retrospective cohort study, Michigan Medicaid beneficiary enrollment data between January 1, 2011 and June 30, 2020 were used to study short-term and long-term program enrollment trends. Fixed cohort and newly enrolled cohort are defined as Medicaid beneficiaries enrolled as of January 1, 2011 and those newly enrolled between February 1, 2011 and June 1, 2020. In the fixed cohort, 54.8% of the 1,228,050 Medicaid beneficiaries were also enrolled nine years later in January 2020. Only 25.6% of the fixed cohort were continuously enrolled over the entire nine-year period. On average, individuals in the fixed cohort were enrolled for 76.3 months. The most stable and least stable demographics were persons with and without disabilities. In the newly enrolled cohort, 37.2% remained enrolled nine years after joining the Medicaid program. The two-year coverage stability rate was 67% to 72% for new enrollees between 2011 and 2014. This rate dropped to below 60% after 2015, which coincided with the 2014 Patient Protection and Affordable Care Act Medicaid expansion . study, the Medicaid program is a long-term source of insurance. New policies and Medicaid infrastructure development to improve coverage stability would help make the program more robust and user-friendly.

Picture: PD

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