Participant: PROMISE AGEP Research Symposium
Cheryl A. Camillo
Department: Public Policy
Institution: University of Maryland, Baltimore County (UMBC)
The Comparative Effectiveness of Optional Medicaid Eligibility Policies: Post-ACA Implications for States
Despite implementation of the Medicaid eligibility provisions of the Affordable Care Act (ACA), including an optional expansion to adults without dependent children, recent surveys show that millions of eligible adults and children are not enrolled in the program. To assist states in identifying strategies to improve take-up, this study examines the effects of increasing income eligibility standards and adopting eligibility simplification policies on participation during the decade leading up to the ACA.
Controlling for variation in economic and demographic characteristics across states and within states across years, I use regression analysis to estimate the impacts of raising standards and implementing simplification policies on enrollment by non-disabled children and adults as reported by 50 states and the District of Columbia to the Centers for Medicare & Medicaid Services. I obtain estimates using both pooled ordinary least squares and fixed effects models.
Preliminary findings show that increasing the income standard had a statistically significant positive effect on the enrollment of children and adults. Eligibility simplification strategies had differential effects on enrollment–not all strategies were statistically significant and the magnitude of statistically significant strategies varied by eligibility category (i.e., children or adults).
These findings suggest that to improve take-up states that have not implemented the Medicaid expansion should consider raising their income standards to enroll more eligible adults. All states should consider adopting optional simplification strategies to improve coverage of children and adults.
Next steps for this study include analyzing the effects on age sub-groups and pregnant women.
Cheryl A. Camillo is a quantitative and qualitative researcher with over 17 years’ experience working on federal, state, and local health insurance and social assistance programs. She is a nationally recognized expert in eligibility and enrollment policies and procedures, state operations, and administrative data and systems. Her current work focuses on national and sub-national health system reforms.
Camillo conducted research for NORC at the University of Chicago and Mathematica Policy Research between 2009-2015. Before transitioning to research, she served at multiple levels of government. She was a deputy Medicaid director for the State of Maryland where she developed and implemented a Medicaid expansion to low-income adults that became a model for national health care reform (the Affordable Care Act). Prior to that, she was Technical Director for Medicaid eligibility, benefits, and payment at the Centers for Medicare & Medicaid Services. From 1998-2000, she was Special Assistant to the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services.
Camillo received a Master of Public Administration degree from the Maxwell School of Citizenship and Public Affairs at Syracuse University where she focused on social welfare policy. She received her bachelor’s degree in political science, with a concentration in comparative ideologies and political systems, from Yale University.
Camillo is a member of Academy Health, the Association for Public Policy Analysis & Management, the American Society for Public Administration, and the Canadian Association of Health Services and Policy Research and is a frequent reviewer of manuscripts and abstracts.
GENERAL SUMMARY OF GRADUATE RESEARCH
At the University of Maryland, Baltimore County, Cheryl Camillo is continuing her research on Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment dynamics and program implementation. Using insights obtained as a senior federal policymaker and state program executive, she employs qualitative and quantitative methods to investigate factors contributing to participation in public health insurance programs and leading to effective implementation of new programs, policies, and procedures. While recognized as an administrative data expert, she regularly uses survey data in her work. Camillo is also drawing on her political science training to examine health system reforms at the national and sub-national levels within federalist systems of government.
SELECTED LIST OF PRESENTATIONS AND PUBLICATIONS
- Association for Public Policy Analysis and Management Fall Research Conference, November 2014, Albuquerque, NM
- AcademyHealth Annual Research Meeting (poster), June 2014, San Diego, CA
- American Society for Public Administration 2014 Annual Conference, March 2014, Washington, D.C.
- “Implementing Eligibility Changes Under the Affordable Care Act: Issues Facing State Medicaid and CHIP Programs.” The Robert Wood Johnson Foundation State Health Access Reform Evaluation. Minneapolis, MN: July 2012
- Association for Public Policy Analysis and Management Fall Research Conference, November 2011, Washington, DC
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