WorldCat Identities

Sommers, Benjamin D.

Overview
Works: 17 works in 37 publications in 1 language and 262 library holdings
Genres: Academic theses 
Roles: Author, Contributor, Other
Classifications: H11, 617.5
Publication Timeline
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Most widely held works by Benjamin D Sommers
The effect of state Medicaid expansions on prescription drug use : evidence from the Affordable Care Act by Ausmita Ghosh( )

6 editions published in 2017 in English and held by 88 WorldCat member libraries worldwide

This study provides a national analysis of how the 2014 Affordable Care Act (ACA) Medicaid expansions have affected aggregate prescription drug utilization. Given the prominent role of prescription medications in the management of chronic conditions, as well as the high prevalence of unmet health care needs in the population newly eligible for Medicaid, the use of prescription drugs represents an important measure of the ACA's policy impact. Prescription drug utilization also provides insights into whether insurance expansions have increased access to physicians, since obtaining these medications requires interaction with a health care provider. We use 2013-2015 data from a large, nationally representative, all-payer pharmacy transactions database to examine effects on overall prescription medication utilization as well as effects within specific drug classes. Using a differences-in-differences (DD) regression framework, we find that within the first 15 months of expansion, Medicaid-paid prescription utilization increased by 19 percent in expansion states relative to states that did not expand; this works out to approximately seven additional prescriptions per year per newly enrolled beneficiary. The greatest increases in Medicaid prescriptions occurred among diabetes medications, which increased by 24 percent. Other classes of medication that experienced relatively large increases include contraceptives (22 percent) and cardiovascular drugs (21 percent), while several classes more consistent with acute conditions such as allergies and infections experienced significantly smaller increases. As a placebo test, we examine Medicare-paid prescriptions and find no evidence of a post-ACA effect. Both expansion and non-expansion states followed statistically similar trends in Medicaid prescription utilization in the pre-policy era, offering support for our DD approach. We did not observe reductions in uninsured or privately insured prescriptions, suggesting that increased utilization under Medicaid did not substitute for other forms of payment. Within expansion states, increases in prescription drug utilization were larger in geographical areas with higher uninsured rates prior to the ACA. Finally, we find some suggestive evidence that increases in prescription drug utilization were greater in areas with larger Hispanic and black populations
The Affordable Care Act's effects on patients, providers, and the economy : what we've learned so far by Jonathan Gruber( )

7 editions published in 2019 in English and held by 63 WorldCat member libraries worldwide

As we approach the tenth anniversary of the passage of the Affordable Care Act, it is important to reflect on what has been learned about the impacts of this major reform. In this paper we review the literature on the impacts of the ACA on patients, providers and the economy. We find strong evidence that the ACA's provisions have increased insurance coverage. There is also a clearly positive effect on access to and consumption of health care, with suggestive but more limited evidence on improved health outcomes. There is no evidence of significant reductions in provider access, changes in labor supply, or increased budgetary pressures on state governments, and the law's total federal cost through 2018 has been less than predicted. We conclude by describing key policy implications and future areas for research
Fiscal federalism and the budget impacts of the Affordable Care Act's Medicaid expansion by Jonathan Gruber( )

5 editions published in 2020 in English and held by 60 WorldCat member libraries worldwide

Medicaid's federal-state matching system of financing is the nation's largest example of fiscal federalism. Using generous federal subsidies, the Affordable Care Act incentivized states to expand Medicaid, which became a state option in the aftermath of a 2012 Supreme Court ruling. As of early 2020, 14 states had not yet expanded, with concerns over state budgetary effects described as a key barrier. We use an event-study approach to analyze state budget data from 2010-2018 and assess the effects of state Medicaid expansion decisions. We find that Medicaid expansion increased total spending in expansion states by 6% to 9%, compared to non-expansion states. By source of funds, federal spending via the states increased by 10% in the first year of Medicaid expansion, rising to 27% in 2018. Changes in spending from state funding were modest and non-significant, with less than a 1% change from baseline annually in the most recent years, 2017 and 2018. Meanwhile, we find no evidence that increased Medicaid spending from expansion produced any reductions in spending on education, corrections, transportation, or public assistance. Changes in Medicaid spending tracked closely with the baseline pre-ACA (2013) uninsured rate in each states, with expansion leading to roughly $2680 in added annual spending per uninsured adult. As a result, we estimate states that didn't expand Medicaid passed up $43 billion in federally-subsidized program funds in 2018. Finally, state projections in the aggregate were reasonably accurate, with expansion states projecting average Medicaid spending from 2014-2018 within 2 percent of the actual amounts, and in fact overestimating Medicaid spending in most years
Premium subsidies, the mandate, and Medicaid expansion : coverage effects of the Affordable Care Act by Molly Frean( )

6 editions published in 2016 in English and held by 34 WorldCat member libraries worldwide

Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. We provide the first comprehensive assessment of these provisions' effects, using the 2012-2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time. Overall, our model explains 60% of the coverage gains in 2014-2015. We find that coverage was moderately responsive to price subsidies, with larger gains in state-based insurance exchanges than the federal exchange. The individual mandate's exemptions and penalties had little impact on coverage rates. The law increased Medicaid among individuals gaining eligibility under the ACA and among previously-eligible populations ("woodwork effect") even in non-expansion states, with essentially no crowd-out of private insurance. Overall, exchange premium subsidies produced 40% of the coverage gains explained by our ACA policy measures, and Medicaid the other 60%, of which 1/2 occurred among previously-eligible individuals
The Policy Argument for Healthcare Workforce Diversity by Michael O Mensah( )

1 edition published in 2016 in English and held by 2 WorldCat member libraries worldwide

The Impact of Medicaid Expansion on Continuous Enrollment: a Two-State Analysis by Sarah Gordon( )

1 edition published in 2019 in English and held by 2 WorldCat member libraries worldwide

A Death in Primary Care by Benjamin D Sommers( )

1 edition published in 2010 in English and held by 2 WorldCat member libraries worldwide

The ACA's 65th Birthday Challenge: Moving from Medicaid to Medicare by Chima D Ndumele( )

1 edition published in 2015 in English and held by 2 WorldCat member libraries worldwide

Universal health coverage for US veterans: a goal within reach( )

1 edition published in 2015 in English and held by 1 WorldCat member library worldwide

Two studies in health services research : the effect of clinical encounters on Medicaid retention, and using patient preferences to guide prostate cancer treatment by Benjamin D Sommers( )

1 edition published in 2007 in English and held by 1 WorldCat member library worldwide

Impact of ACA Insurance Coverage Expansion on Perforated Appendix Rates Among Young Adults( )

1 edition published in 2016 in English and held by 1 WorldCat member library worldwide

Abstract : Background: The 2010 Dependent Coverage Provision (DCP) of the Affordable Care Act allowed young adults to remain on their parents' health insurance plans until age 26 years. Although the provision improved coverage and survey-reported access to care, little is known regarding its impact on timely access for acute conditions. This study aims to assess changes in insurance coverage and perforation rates among young adults with acute appendicitis--an established metric for population-level health care access--after the DCP. Methods: The National Inpatient Sample and difference-in-differences linear regression were used to assess prepolicy/postpolicy changes for policy-eligible young adults (aged 19-25 y) compared with a slightly older, policy-ineligible comparator group (aged 26-34 y). Results: After adjustment for covariates, 19-25 year olds experienced a 3.6-percentage point decline in the uninsured rate after the DCP (baseline 22.5%), compared with 26-34 year olds (P <0.001). This coincided with a 1.4-percentage point relative decline in perforated appendix rate for 19-25 year olds (baseline 17.5%), compared with 26-34 year olds (P =0.023). All subgroups showed significant reductions in uninsured rates; however, statistically significant reductions in perforation rates were limited to racial/ethnic minorities, patients from lower-income communities, and patients presenting to urban teaching hospitals. Conclusions: Reductions in uninsured rates among young adults after the DCP were associated with significant reductions in perforated appendix rates relative to a comparator group, suggesting that insurance expansion could lead to fewer delays in seeking and accessing care for acute conditions. Greater relative declines in perforation rates among the most at-risk subpopulations hold important implications for the use of coverage expansion to mitigate existing disparities in access to care. Abstract : Supplemental Digital Content is available in the text
Beyond Health Insurance: Remaining Disparities in US Health Care in the Post-ACA Era( )

1 edition published in 2017 in English and held by 1 WorldCat member library worldwide

Immigration, Pregnancy, and Heath Insurance( )

1 edition published in 2017 in English and held by 1 WorldCat member library worldwide

On the Outskirts of National Health Reform: A Comparative Assessment of Health Insurance and Access to Care in Puerto Rico and the United States( )

1 edition published in 2015 in English and held by 1 WorldCat member library worldwide

Abstract Policy Points: Puerto Rico is the United States' largest territory, home to nearly 4 million American citizens, yet it has remained largely on the outskirts of US health policy, including the Affordable Care Act (ACA). We analyzed national survey data from 2011 to 2012 and found that despite its far poorer population, Puerto Rico outperforms the mainland United States on several measures of health care coverage and access to care. While the ACA significantly increases federal resources in Puerto Rico, ongoing federal restrictions on Medicaid funding and premium tax credits in Puerto Rico pose substantial health policy challenges in the territory. Context Puerto Rico is the United States' largest territory, home to nearly 4 million American citizens. Yet it has remained largely on the outskirts of US health policy, including the Affordable Care Act (ACA). This article presents an overview of Puerto Rico's health care system and a comparative analysis of coverage and access to care in Puerto Rico and the mainland United States. Methods We analyzed 2011-2012 data from the Behavioral Risk Factor Surveillance System, and 2012 data from the American Community Survey and its counterpart, the Puerto Rico Community Survey. Among adults 18 and older, we examined health insurance coverage; access measures, such as having a usual source of care and cost-related delays in care; self-reported health; and the receipt of recommended preventive services, such as cancer screening and glucose testing. We used multivariate regression models to compare Puerto Rico and the mainland United States, adjusted for age, income, race/ethnicity, and other demographic variables. Findings Uninsured rates were significantly lower in Puerto Rico (unadjusted 7.4% versus 15.0%, adjusted difference: −12.0%, p < 0.001). Medicaid was far more common in Puerto Rico. Puerto Rican residents were more likely than those in the mainland United States to have a usual source of care and to have had a checkup within the past year, and fewer experienced cost-related delays in care. Screening rates for diabetes, mammograms, and Pap smears were comparable or better in Puerto Rico, while colonoscopy rates were lower. Self-reported health was slightly worse, but obesity and smoking rates were lower. Conclusions Despite its far poorer population, Puerto Rico outperforms the mainland United States on several measures of coverage and access. Congressional policies capping federal Medicaid funds to the territory, however, have contributed to major budgetary challenges. While the ACA has significantly increased federal resources in Puerto Rico, ongoing restrictions on Medicaid funding and premium tax credits are posing substantial health policy challenges in the territory
Fifty-four million additional Americans are receiving preventive services coverage without cost-sharing under the Affordable Care Act by Benjamin D Sommers( )

1 edition published in 2012 in English and held by 1 WorldCat member library worldwide

Medicaid expansion in Texas : what's at stake? by Benjamin D Sommers( )

1 edition published in 2016 in English and held by 1 WorldCat member library worldwide

Texas is one of nearly 20 states yet to expand its Medicaid program under the Affordable Care Act (ACA), and is home to the largest number of uninsured Americans of any state in the country. For many of the state's 5 million uninsured, this decision has left them without an option for affordable health insurance. A comparison with other Southern states that have expanded Medicaid shows how this decision has left many low-income Texans less able to afford their medical bills, to pay for needed prescription drugs, and to obtain regular care for chronic conditions. These problems have been compounded by the state opposition to outreach and enrollment assistance for many Texans who are eligible for coverage under the ACA. Ongoing efforts from stakeholders and consumer groups to persuade state leaders to expand coverage have significant implications for the well-being of millions of low-income adults in Texas
Seventy-one million additional Americans are receiving preventive services coverage without cost-sharing under the Affordable Care Act by Laura Skopec( )

1 edition published in 2013 in English and held by 1 WorldCat member library worldwide

The Affordable Care Act ensures that most insurance plans (so-called 'non-grandfathered' plans) provide coverage for and eliminate cost-sharing on certain recommended preventive health services, beginning on or after September 23, 2010. This includes services such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, flu shots for all children and adults, and many more. While some plans already covered these services, millions of Americans were previously in health plans that did not. Using information from the Kaiser Family Foundation's Employer Health Benefits Survey and the most recent data from the Census Bureau, we estimate that approximately 71 million Americans are now receiving expanded coverage of one or more preventive services due to the Affordable Care Act
 
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Alternative Names
Benjamin Sommers American physician and health economist

Benjamin Sommers econoom

Languages
English (37)