Health and Disability

Health And Work Status Of Medicaid Expansion Adults

Data from the 2015 National Health Interview Survey illustrate that most healthy Medicaid expansion beneficiaries are working or pursuing economic opportunities. Half (48 percent) of adults covered by the Medicaid expansion are permanently disabled, have serious physical or mental limitations—-caused by conditions like cancer, stroke, heart disease, cognitive or mental health disorders, arthritis, pregnancy, or diabetes—-or are in fair or poor health. Low-wage jobs are often physically demanding, precluding those with limitations from employment. Of the other half, who might be viewed as “able-bodied,” 62 percent are already working or in school and 12 percent are looking for work; only 25 percent are not currently working or in school. (More information about the analyses is at the end of this brief.)

Only 13 percent of adults covered by Medicaid’s expansion are able-bodied and not working, in school, or seeking work. Of that small group, three-quarters report they are not working in order to care for family members and the rest report other reasons, like being laid off. A much higher share of overall American adults are unemployed or not in the labor force (28 percent), according to 2015 Census data. Medicaid expansion enrollees are more likely to be working or looking for work than the general public, unless they are burdened by ill health or the needs of their families. Moreover, Medicaid expansions could make it easier for beneficiaries to find work, as reported in Ohio.

Many people suffer from pain when they fly but that may soon be a thing of the past. A new study from Aalborg University may have discovered the mechanisms responsible, opening the door to developing a cure.

A getaway to the southern sunshine should be a treat but according to a study done at Aalborg University last year, for one out of twelve people a flight means a severe headache. Now, the same research group is the first in the world to investigate the cause of the problem, and they have a preliminary explanation.

"The major changes in cabin pressure at take-off and landing may cause tissue damage and inflammation in the sinuses. This releases the substance PGE2, which can make the blood vessels in the brain expand and thus cause head pain," says Master's student Sebastian Bao Dinh Bui.

Torben Petersen and Sebastian Bao Dinh Bui conducted the study as part of their studies in Medicine with Industrial Specialization (MedIS) at Aalborg University along with their supervisor, Parisa Gazerani, Associate Professor. The group's results have just been published in The Journal of Headache and Pain.

House Republicans released on Monday a plan to undo Obamacare that will likely leave millions more Americans uninsured.

After significant internal division about the path forward on Obamacare, lawmakers unveiled two bills that, taken together, would repeal and replace President Obama’s signature health care reform law. House committees are expected to hold votes on the bills as early as this week.

Here’s what you need to know about the legislation, and what it says about the House GOP’s plan for the future of health insurance in America:

It includes massive cuts to Medicaid, the program that provides coverage for millions of low-income Americans.

The proposed replacement bill includes big cuts to Medicaid, the government program that provides coverage for low-income Americans.

It would phase out the Medicaid expansion under Obamacare, which extended coverage to more than 11 million low-income people, beginning in 2020. It would also restructure the way the entire program is funded — offering states a lump sum to administer Medicaid coverage rather than providing however much funding states need to cover the pool of Medicaid eligible residents — putting the future of Medicaid in jeopardy.

It defunds Planned Parenthood and eliminates abortion coverage.

The GOP’s replacement proposal includes two major provisions aimed at eroding access to reproductive health care.

One would bar Planned Parenthood from using federal funding toward its family planning services, which would prevent the women’s health organization from providing birth control and mammograms to 2.5 million current patients who are covered through Medicaid. The other would prevent Americans from using their tax credits to help pay for plans that include coverage for elective abortion services — essentially, singling out abortion care as a service that won’t be covered like other medical procedures and forcing low-income people to bear the full out-of-pocket cost of ending a pregnancy.

It includes a big tax break for insurance companies that pay their CEOs more than $500,000 per year.

One provision in the House GOP’s proposed Obamacare replacement plan would essentially incentivize major corporations to overpay their top executives — offering a tax break to insurers that pay CEOs more than half a million dollars per year.

A significant portion of the bill is devoted to ensuring lottery winners don’t have access to Medicaid.

One of the most bizarre inclusions in the legislation is a provision that would prevent lottery winners from being able to remain covered by the Medicaid program. The 66-page document spends seven of those pagesdetailing this policy change.

Eric Pusey has to bite his tongue when customers at his pharmacy cough up co-payments far higher than the cost of their low-cost generic drugs, thinking their insurance is getting them a good deal.

Pusey’s contracts with drug-benefit managers at his Medicap Pharmacy in Olyphant, Pennsylvania, bar him from volunteering the fact that for many cheap, generic medicines, co-pays sometimes are more expensive than if patients simply pay out of pocket and bypass insurance. The extra money -- what the industry calls a clawback -- ends up with the benefit companies. Pusey tells customers only if they ask.

“Some of them get fired up,” he said. “Some of them get angry at the whole system. Some of them don’t even believe that what we’re telling them is accurate.”

When B. Paul Turpin was admitted to a Tennessee hospital in January, the biggest concern was whether the 69-year-old endocrinologist would survive. But as he battled a life-threatening infection, Turpin developed terrifying hallucinations, including one in which he was performing on a stage soaked with blood. Doctors tried to quell his delusions with increasingly large doses of sedatives, which only made him more disoriented.

Nearly five months later, Turpin’s infection has been routed, but his life is upended. Delirious and too weak to go home after his hospital discharge, he spent months in a rehab center, where he fell twice, once hitting his head. Until recently he did not remember where he lived and believed he had been in a car wreck. “I tell him it’s more like a train wreck,” said his wife, Marylou Turpin.

“They kept telling me in the hospital, ‘Everybody does this,’ and that his confusion would disappear,” she said. Instead, her once astute husband has had great difficulty “getting past the scramble.”

Turpin’s experience illustrates the consequences of delirium, a sudden disruption of consciousness and cognition marked by vivid hallucinations, delusions and an inability to focus that affects 7 million hospitalized Americans annually. The disorder can occur at any age — it has been seen in preschoolers — but disproportionately affects people older than 65 and is often misdiagnosed as dementia. While delirium and dementia can coexist, they are distinctly different illnesses. Dementia develops gradually and worsens progressively, while delirium occurs suddenly and typically fluctuates during the course of a day. Some patients with delirium are agitated and combative, while others are lethargic and inattentive.

With key leaders in Congress proposing major changes to Medicaid financing through the adoption of a block grant or per capita caps, Manatt has prepared a new toolkit for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network to help states and others assess the potential implications of proposals to cap federal Medicaid funding. The toolkit provides state-by-state data on Medicaid enrollment and expenditure trends—factors that are central to establishing the amount each state would be allocated under various capped funding proposals—as well as a detailed memo describing how each data point might be used by an individual state. The primary purpose of the toolkit is to assist individual states in evaluating how they might fare, but, as discussed in this article, the state-by-state data also illustrate some of the key challenges that Congress would face in capping and allocating federal Medicaid funds.

Chronic pain sufferers and those taking mental health meds would rather turn to cannabis instead of their prescribed opioid medication, according to new research by the University of British Columbia and University of Victoria. "This study is one of the first to track medical cannabis use under the new system of licensed producers, meaning that all participants had physician authorization to access cannabis in addition to their prescription medicines," says UBC Assoc. Prof. Zach Walsh, co-author of the study.

The study tracked more than 250 patients with prescribed medical cannabis - people treated for conditions such as chronic pain, mental health and gastrointestinal issues. Overall, 63 per cent of respondents reported using cannabis instead of their prescription drugs, which included opioids (to treat pain), benzodiazepines (sedatives) and anti-depressants.

Study lead Philippe Lucas is vice-president of Patient Research and Access at Tilray, a federally authorized medical cannabis production and research company, and a graduate fellow at the University of Victoria Centre for Addictions Research of BC. Lucas suggests the main reasons for the switch to cannabis from prescribed meds is due to reduced side effects, better symptom management and a feeling that cannabis is safer than prescription drugs.

Walsh goes on to suggest cannabis may have an important role to play in addressing the problematic use of pharmaceutical medications such as opioids.