Population Health Blog

Population Health Blog

Why It Matters

Research confirms that expanding Medicaid is good for the economic of low income people

By Dennis Archambault

The proponents of Healthy Michigan have not had much share of voice in the debate over work rules for the expanded Medicaid program. However, a recent University of Michigan Ross School of Business study has confirmed the economic benefit of the health insurance benefit for low income individuals and suggests that the proposed work rules would put thousands of unemployed enrollees at risk.

It’s interesting to read, in specific detail, what proponents of expanded Medicaid have felt for some time. On one hand, the target population is struggling and in debt. They also are likely to have a chronic disease, which requires regular medical care, if not urgent episodes of hospitalization. On the other hand, however, having their health insurance covered reduces the economic burden and makes it more likely that their health will be better managed.

Note some of the findings:

  • Reduced the amount of medical bills in collections that the average enrollee had by 57 percent, or about $515.
  • Reduced the amount of debt past due but not yet sent to a collection agency by 28 percent, or about $233.
  • Led to a 16 percent drop in public records for financial events such as evictions, bankruptcies and wage garnishments; bankruptcies alone fell by 10 percent.
  • Resulted in enrollees’ being 16 percent less likely to overdraw their credit cards.
  • Led to improvement in individual credit scores, including the number with a “deep subprime” rating falling by 18 percent and the number listed as “subprime” falling by 3 percent.
  • Allowed enrollees to engage in more borrowing to buy cars or other goods and services, which is consistent with better credit scores. Enrollees experienced a 21 percent increase in automotive loans. Other studies have found that Medicaid expansion reduced use of payday loans and reduced interest rates for low-income people.
  • Helped people with chronic illnesses and those who had a hospitalization or emergency department visit during the study period with bigger reductions in their bills sent to collection and bigger increases in their credit scores.

Miller and colleagues published an academic report on the research in the Journal of Public Economics. Check that out for more details: https://www.sciencedirect.com/science/article/abs/pii/S0047272718300707.

Dennis Archambault is vice president, Public Affairs, at Authority Health.


What does urban agriculture have to do with the Farm Bill?

By Kathy Beard

MOTION Coalition in Support for 2018 Revision of Agricultural Act of 2014

The growing movement towards urban farming has a champion in Senator Stabenow, but her efforts may be jeopardized soon. In 2016 she introduced the Urban Agriculture Act of 2016[1]. The act provides assistance to urban farmers with the goal of providing fresh, healthy options to the underserved. This Act became part of the revisions by the Senate to the Agricultural Act of 2014, frequently referred to as the Farm Bill. Section 7212 of the revised Senate Farm Bill amends the 1990 version to include grants for research, education and training to enhance urban and indoor agricultural production and for evaluation of these methods. It provides $4 million dollars per year (2019-2023) and an additional $10 million each year to carry out the process. It also authorizes $14 million for a two-year census data-gathering project to collect information on urban agricultural production including community gardens and farms, rooftop farms, greenhouses and vertical farming[2]. The House Bill does not address urban agriculture[3].Excluding urban farmingputs the Senate’s bi-partisan proposal addressing this issue at risk for a number of reasons.

As in the general legislature, the conference committee is dominated by Republicans (34/22), putting any chance of a democratic initiative in jeopardy of being cut from the final proposal. Second, the influence on the type of agriculture is heavily biased toward commodity cash crops, corn, wheat and soy. Texas, for example, which has the largest representation on the committee, produces primarily cattle and cotton[4]. California, with four representatives is the largest vegetable and fruit producer[5]. Commodity cash crops, dairy and farm animals are the primary sources of income for the remaining States represented on the committee. In most urban areas, it is still against the law to raise farm animals. The focus then, of the committee will not be on urban agriculture but on those cash producing items that bring money to the State.

Further, House Republican Chairman, Mike Conaway is a strong proponent of a improving the rural, not urban, environments and was the driving force behind the recent  HOUSE review of SNAP benefits which ultimately led to the proposal to restrict SNAP benefits by “offering SNAP beneficiaries a springboard out of poverty to a good paying job, and opportunity for a better way of life for themselves and their families”[6] – code for tightening the work restrictions for ABAWD (Able Bodied Adults Without Dependents)[7]. It is this portion of the bill that will be the most heavily debated.

There is a sense of urgency to speed the process of completing a bill by September 30 when the 2014 version is set to expire. In cases like this, what many would consider a small matter may be sacrificed for expediency. Proponents of urban agriculture should be vigilant during this time and prepare to react to any threats to this portion of the bill. Click here to learn more about the committee hearings.

Recommended sites:

House Committee on Urban Agriculture

USDA Data on Cash Crops by State








Kathy Beard is program manager, MOTION Coalition, an initiative of Authority Health