Tag Archives: Medicaid

NBER working paper: Medicaid expansion leads to fewer high school dropouts

5 Jun

Moi blogs about education issues so the reader could be perplexed sometimes because moi often writes about other things like nutrition, families, and personal responsibility issues. Why? The reader might ask? Children will have the most success in school if they are ready to learn. Ready to learn includes proper nutrition for a healthy body and the optimum situation for children is a healthy family. Many of society’s problems would be lessened if the goal was a healthy child in a healthy family. There is a lot of economic stress in the country now because of unemployment and underemployment. Children feel the stress of their parents and they worry about how stable their family and living situation is.

The best way to eliminate poverty is job creation, job growth, and job retention. The Asian Development Bank has the best concise synopsis of the link between Education and Poverty For a good article about education and poverty which has a good bibliography, go to Poverty and Education, Overview
http://www.adb.org/documents/assessing-development-impact-breaking-cycle-poverty-through-education There will not be a good quality of life for most citizens without a strong education system. One of the major contributors to poverty in third world nations is limited access to education opportunities. Without continued sustained investment in education in this state, we are the next third world country.

Shadee Ashtari reported in the Huffington Post article, Medicaid Expansion Leads To Fewer High School Dropouts And More College Graduates: Study:

Amid the ongoing debate over 24 states’ refusal to expand Medicaid eligibility under the Affordable Care Act, a recent report by the National Bureau of Economic Research has found that expanding health insurance coverage for low-income children resulted in fewer high school dropouts, higher college attendance rates and a better likelihood of attaining a bachelor’s degree.
Cornell and Harvard researchers examined the effects of Medicaid expansion among eligible children in the 1980s and 1990s in states that broadened their public insurance programs and concluded “better health is one of the mechanisms driving our results by showing that Medicaid eligibility when young translated into better teen health.” Better health, in turn, led to substantial long-term educational benefits.
According to the working paper, published in May, states that increased childhood Medicaid eligibility by 10 percent reduced high school dropout rates by 5.2 percent and increased college attendance and BA attainment by 1.1 percent and 3.2 percent, respectively.
After examining two decades of Medicaid eligibility expansion in various states, the authors argued that in addition to immediately improving children’s health statuses, public health expansion renders long-term benefits by working to reduce “inequality and higher economic growth that stems from the creation of a more skilled workforce.”
The researchers attributed the outcomes to two plausible explanations. First, children with health insurance benefited from healthier lifestyles -– they missed less school due to illness, were less likely to engage in risky sexual activity, had lower likelihoods of obesity and fewer mental health problems.
Indirectly, the authors explained that by spending less money on health care, low-income families eligible for Medicaid were able to shift a greater share of their resources toward helping their children succeed in school.
As of 2013, roughly 10 percent of children in the U.S. — or 7.9 million — remain uninsured. About 70 percent of them are eligible for coverage under Medicaid or the Children’s Health Insurance Program. Under the Affordable Care Act, that number is estimated to decrease by 40 percent. http://www.huffingtonpost.com/2014/06/05/medicaid-children-education_n_5455335.html?utm_hp_ref=education&ir=Education

Citation:

The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions
Sarah Cohodes, Samuel Kleiner, Michael F. Lovenheim, Daniel Grossman
NBER Working Paper No. 20178
Issued in May 2014
NBER Program(s): CH ED HC PE
Public health insurance programs comprise a large share of federal and state government expenditure, and these programs are due to be expanded as part of the 2010 Affordable Care Act. Despite a large literature on the effects of these programs on health care utilization and health outcomes, little prior work has examined the long-term effects of these programs and resultant health improvements on important outcomes, such as educational attainment. We contribute to filling this gap in the literature by examining the effects of the public insurance expansions among children in the 1980s and 1990s on their future educational attainment. Our findings indicate that expanding health insurance coverage for low-income children has large effects on high school completion, college attendance and college completion. These estimates are robust to only using federal Medicaid expansions, and they are mostly due to expansions that occur when the children are older (i.e., not newborns). We present suggestive evidence that better health is one of the mechanisms driving our results by showing that Medicaid eligibility when young translated into better teen health. Overall, our results indicate that the long-run benefits of public health insurance are substantial.

The NBER Bulletin on Aging and Health provides summaries of publications like this. You can sign up to receive the NBER Bulletin on Aging and Health by email.
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The increased rate of poverty has profound implications if this society believes that ALL children have the right to a good basic education. Moi blogs about education issues so the reader could be perplexed sometimes because moi often writes about other things like nutrition, families, and personal responsibility issues. Why? The reader might ask? Because children will have the most success in school if they are ready to learn. Ready to learn includes proper nutrition for a healthy body and the optimum situation for children is a healthy family. Many of societies’ problems would be lessened if the goal was a healthy child in a healthy family.

Related:

Hard times are disrupting families https://drwilda.com/2011/12/11/hard-times-are-disrupting-families/

3rd world America: The link between poverty and education https://drwilda.com/2011/11/20/3rd-world-america-the-link-between-poverty-and-education/

3rd world America: Money changes everything https://drwilda.com/2012/02/11/3rd-world-america-money-changes-everything/

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Possible unintended consequences of the U.S. Supreme Court’s ‘Obamacare’ ruling

12 Jul

Mark Walsh has an intriguing Education Week about the aftermath of the U.S. Supreme Court’s “Obamacare” decision and its possible impact on education. In Ed. Law Challenges Loom After Health-Care Ruling, Walsh writes:

Legal analysts say that part of the U.S. Supreme Court decision on the federal health-care law will encourage states to challenge education laws and other federal aid programs and legislation passed under Congress’ spending power, a pivotal aspect of the historic ruling.

The justices ruled 5-4 to uphold a key provision of the Affordable Care Act—the requirement that individuals purchase a health-insurance policy with at least a minimum level of coverage—as a valid exercise under Congress’ taxing power. But the court effectively ruled 7-2 that the states could not be threatened with the loss of their existing Medicaid funding if they refused to participate in the law’s expansion of the federal health-care program for the poor.

That portion of the June 28 decision in National Federation of Independent Business v. SebeliusRequires Adobe Acrobat Reader (Case No. 11-393) could open the door to lawsuits over the spending strings attached to federal programs—or even the conditions for securing federal waivers under the No Child Left Behind Act, some commentators say….

Mr. Bagenstos of the University of Michigan noted that some federal education laws, such as the ESEA, have relatively frequent reauthorizations and revisions, leading to uncertainty about when conditions are first imposed. And other federal laws that come with conditions on the states, such as Title IX, are not grant programs per se but anti-discrimination statutes.

The rules aren’t tied to any particular funds” under such statutes, he said.

Mr. Bagenstos does not believe that the state challenges he predicts ultimately will be successful. But the Medicaid ruling could alter the dynamics of state-federal relations over such things as federal waivers for the No Child Left Behind Act, he said.

A state could say, ‘Look, if our waiver gets denied, we’re going to court,’ ” Mr. Bagenstos said.

Do I think these arguments are going to be successful in the courts? Ultimately, no,” he added. “But these are arguments that are going to take a while to work their way through the courts.”http://www.edweek.org/ew/articles/2012/07/12/36scotus.h31.html?tkn=PPTFLaYDB9dQxlfFlrIbQ3taERAkJIQPVmNa&intc=es

The possible reason for concern about education law suits is the portion of the Supreme Court’s majority opinion which deals with the possible coercive aspects of Medicaid expansion.

Health Reform GPS has an excellent summary of the case in Summary of the U.S. Supreme Court decision in the case of National Federation of Independent Businesses et al. v. Sebelius, Secretary of Health and Human Services, et al.. Here is the portion of the case Walsh writes about:

The Constitution simply does not give Congress the authority to require the States to regulate. That is true whether Congress directly commands a State to regulate or indirectly coerces a State to adopt a federal regulatory system as its own.” Majority, p. 47-48. “When, for example, such conditions take the form of threats to terminate other significant independent grants, the conditions are properly viewed as a means of pressuring the States to accept policy changes.” Majority, p. 50. Furthermore, the Medicaid expansion “accomplishes a shift in kind, not merely degree. The original program was designed to cover medical services for four particular categories of the needy: the disabled, the blind, the elderly, and needy families with dependent children. Under the Affordable Care Act, Medicaid is transformed into a program to meet the health care needs of the entire nonelderly population with income below 133 percent of the poverty level. It is no longer a program to care for the neediest among us, but rather an element of a comprehensive national plan to provide universal health insurance coverage.” Majority, p. 53-54. However, “nothing in our opinion precludes Congress from offering funds under the Affordable Care Act to expand the availability of health care, and requiring that States accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding.” Majority, p. 55. http://healthreformgps.org/resources/summary-of-the-u-s-supreme-court-decision-in-the-case-of-national-federation-of-independent-businesses-et-al-v-sebelius-secretary-of-health-and-human-services-et-al/

It is important to understand the U.S. Legal system in order to understand why there might be unintended consequences from the court’s decision.

Mark F. Radcliffe and Diane Brinson of DLA Piper LLP (US) have written an excellent Findlaw article, The U.S. Legal System. The portion about the U.S. Supreme Court explains the role of precedent.

Supreme Court Review

There are two ways to get a case reviewed by the U.S. Supreme Court: by appeal and by certiorari . The losers in certain types of cases – for example, cases involving claims that state statutes are unconstitutional – have a right to appeal to the Supreme Court.

For most cases, though, there is no right of appeal to the Supreme Court. However, a party who has lost a case at the federal Court of Appeals level can file a petition for certiorari with the Supreme Court. A petition for certiorari is a document explaining why the Supreme Court should review a case. If the Supreme Court grants certiorari , the appeal proceeds. If the Court denies it, the Court of Appeals’ decision stands.

Thousands of petitions for certiorari are filed each year and most are denied. The Supreme Court is likely to grant certiorari on a case only if the case involves a matter of national interest or the Court believes that it must decide the case to resolve conflicts among the Circuit Courts and create uniformity in federal law.

Precedent

An appellate court’s decision on an issue is binding on lower courts in the appellate court’s jurisdiction. Thus, an appellate court’s decisions are “precedent” that the lower courts in the appellate court’s jurisdiction must follow (apply).

Example: In Effects Associates, Inc. v. Cohen , the United States Court of Appeals for the Ninth Circuit held that the grant of a nonexclusive copyright license can be implied from the copyright owner’s conduct. This decision is binding on the federal district courts located in the Ninth Circuit. Those courts are not free to decide that a nonexclusive copyright license cannot be implied from conduct.

A lower court’s decision is not binding on a higher court. In fact, appellate courts frequently reverse decisions made by trial courts to correct the trial courts’ “mistakes of law.”

Because the United States Supreme Court is the “highest court in the land,” the Supreme Court’s decisions are binding on all courts in the United States. http://library.findlaw.com/1999/Jan/1/241487.html

The litigation may just be beginning.

Related:

Online symposium: The Bar Review version of NFIB v. Sebelius http://www.scotusblog.com/2012/07/online-symposium-the-bar-review-version-of-nfib-v-sebelius/

The Roberts Court and the Role of Precedent                               http://www.npr.org/templates/story/story.php?storyId=11688820

The Nature and Timing of the U.S. Supreme Court’s Interpretation of Precedent                                                                            http://www.bsos.umd.edu/gvpt/CITE-IT/Documents/Hansford%20etal%202002%20Nature%20and%20Timing%20of%20t%20US%20Supreme%20Court.pdf

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