Michigan's approach to Medicaid expansion and reform.

  title={Michigan's approach to Medicaid expansion and reform.},
  author={John Z. Ayanian},
  journal={The New England journal of medicine},
  volume={369 19},
  • J. Ayanian
  • Published 6 November 2013
  • Medicine
  • The New England journal of medicine
Michigan's approach to expanding and reforming Medicaid may be a model for other Republican-dominated states that might choose to expand coverage for low-income adults, introduce market-oriented reforms, and limit the impact on their budget. 
Launching the Healthy Michigan Plan--the first 100 days.
The early experience with Medicaid expansion in Michigan, a Republican-controlled state that received a federal waiver to implement modifications, may provide useful insights as this new coverage
The ACA Medicaid Expansion in Michigan and Financial Health
It is found that enrollment in the Healthy Michigan Program is associated with large improvements in several measures of financial health, including reductions in unpaid bills, medical bills, over limit credit card spending, delinquencies, and public records.
Examination of Changes in Health Status Among Michigan Medicaid Expansion Enrollees From 2016 to 2017
This survey study examines the self-reported health of enrollees in Michigan’s Medicaid expansion, the Healthy Michigan Plan, among respondents to surveys in 2016 and 2017.
Adverse Selection in Medicaid
A discontinuous premium increase at the federal poverty level in Michigan’s Medicaid expansion program is exploited to test low-income individuals’ sensitivity to premiums using linked enrollment and claims data and suggests that healthier low- income individuals may be sensitive to even modest health insurance premiums.
Medicaid expansion: the dynamic health care policy landscape.
The evidence to date suggests Medicaid expansion would have several benefits to states including improved population health from expanded coverage, improved financial positions of hospitals and other providers, and economic benefits such as increased employment and tax revenues.
Macroeconomic Feedback Effects of Medicaid Expansion: Evidence from Michigan.
Michigan's Medicaid expansion yields clear fiscal benefits for the state, in the form of savings on other non-Medicaid health programs and increases in revenue from provider taxes and broad-based sales and income taxes through at least 2021.
The changing landscape of Medicaid: practical and political considerations for expansion.
It has long been anticipated that 2014 would be the year in which most major elements of the Patient Protection and Affordable Care Act of 2010 (ACA) would be implemented.1 Yet even after surviving
Changes in Insurance Coverage Among Hospitalized Nonelderly Adults After Medicaid Expansion in Michigan.
This study uses Michigan Inpatient Database data to describe proportions of insured and uninsured, nonelderly patients hospitalized in Michigan before and after Medicaid expansion in 2014.
Adverse Selection in Medicaid: Evidence from Discontinuous Program Rules
A discontinuous premium increase at the federal poverty level in Michigan’s Medicaid expansion program is exploited to test low-income individuals’ sensitivity to premiums using linked enrollment and claims data, and it is suggested that premiums may induce adverse selection in Medicaid plans.
Counterproductive Consequences of a Conservative Ideology: Medicaid Expansion and Personal Responsibility Requirements.
It is argued that these reforms prioritize ideology over sound public health knowledge, deflecting attention away from the social, economic, and structural factors that influence the health of the poor, and may ultimately contribute to counterproductive public health and fiscal outcomes.


Mortality and access to care among adults after state Medicaid expansions.
State Medicaid expansions to cover low-income adults were significantly associated with reduced mortality as well as improved coverage, access to care, and self-reported health.
The Oregon experiment--effects of Medicaid on clinical outcomes.
This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.
The ACA’s Medicaid expansion: Michigan impact
  • Ann Arbor, MI: Center for Healthcare Research & Transformation,
  • 2012