copenlu/druid huggingface dataset:
Claim: “For African American families in particular, the homeownership rate remains relatively unchanged since 1968, the year the Fair Housing Act was signed into law.” (Tim Scott, 2023-04-11)
Evidence (2018-09-01): Unfortunately, as shown in table 3, not all of the benefits associated with improved education have readily translated to other economic advancement. Black median income is still only about 60 percent of whites’, and the black unemployment rate continues to remain twice that of whites. The homeownership rate for blacks is basically unchanged, and the relative median value of their home has changed only marginally. [...] As shown in table 4, some form of action was taken on many of the report’s recommendations, much of it within the first five years of publication—a position also shared by the commission’s executive director David Ginsburg (1988). Some action was on a very significant scale; the 1968 Housing Act, for instance, created new housing programs and national assisted-housing goals and was called by Senate House Banking Committee Chairman John Sparkman as "the most comprehensive housing and urban development bill . . . ever presented to the Senate."19 Funding for Model Cities and Urban Renewal doubled in a very short time. The Equal Employment Opportunity Commission was substantially strengthened. The House passed a bill in 1970 that would have revolutionized welfare. The Comprehensive Employment and Training Act consolidated ten employment and training programs into one. Funding for education doubled in many areas.
Claim: “For African American families in particular, the homeownership rate remains relatively unchanged since 1968, the year the Fair Housing Act was signed into law.” (Tim Scott, 2023-04-11)
Evidence (2019-05-29): Most American families accrue wealth from owning homes that appreciate more rapidly than overall inflation, generating equity. The African American home ownership rate of 41 percent was unchanged from 1968 to 2015, while the white rate grew from 66 percent to 71 percent. Yet the wealth difference is not solely attributable to the difference in homeownership rates. Rather, it is also that whites typically own homes in white segregated neighborhoods where values appreciate more rapidly than in the segregated neighborhoods where African Americans typically own homes.43 [...] This is not to say that nothing has changed since the report’s release in 1968. Our examination of just two areas highlighted in the Kerner Report—policing and housing—reveals the nuances of how our governments and institutions dealt with questions of race, then and now. In the area of policing and criminal justice, we found that in some cases, the situation has actually become worse. Incarceration rates are drastically higher today, proportionally and in real numbers, for African Americans than they were in the 1960s. In many cases, police still operate using the "broken windows" philosophy, which leads to more frequent and aggressive policing in mostly Black, high-poverty urban areas. Despite research showing that foot patrols help build police-community relations, motorized patrols are overused.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2021-03-21): Born asserts cost shouldn’t be factored in to whether Medicaid or private insurance offers better coverage. But the cost of premiums, deductibles and copays are a fundamental part of everyone’s health insurance decisions. And studies show cost is one of the biggest reasons many low-income people don’t get needed care. Born’s claim also ignores the tens of thousands of uninsured who would be able to get largely free coverage through an expanded Medicaid. And experts say access to health care providers is generally similar between Medicaid and private-sector plans, though some specialists are more difficult to find under Medicaid.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2021-03-21): No, private insurance doesn’t provide 'better coverage' than Medicaid [...] But the other portion of his claim is more unique. Does private insurance really provide "better coverage" to the individual than Medicaid? [...] Born said in an interview that "private insurance gives … better coverage" than people would get under a Medicaid expansion.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2023-02-17): At the ten year mark since the passage of the Affordable Care Act (ACA), a substantial body of research has investigated effects of the Medicaid expansion on coverage; access to care and related measures (including utilization, quality of care and health outcomes, provider capacity, and affordability and financial security); and various economic measures. This issue brief summarizes findings from 404 studies (including 80 newly included since the last update of this analysis) of the impact of state Medicaid expansions under the ACA published beginning in January 2014 (when the coverage provisions of the ACA went into effect) and updates earlier versions of this brief with studies through January 2020.1 [...] Coverage: Studies show that Medicaid expansion states experienced significant coverage gains and reductions in uninsured rates among the low-income population broadly and within specific vulnerable populations. States that implemented the expansion with a waiver have seen coverage gains, but some waiver provisions appear to compromise coverage. Access to care and related measures: Most research demonstrates that Medicaid expansion has improved access to care, utilization of services, the affordability of care, and financial security among the low-income population. Studies show improved self-reported health following expansion and an association between expansion and certain positive health outcomes. A small subset of study findings showed no effects of expansion on certain specific measures within these access-related categories. Findings on expansion’s effect on provider capacity are mixed, with studies showing increases, decreases, or no effects on measures like appointment availability or wait times.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2024-09-03): - How to Choose the Best Health Care Coverage for You - Frequently Asked Questions (FAQs) [...] If you live in one of the 12 states that chose not to expand Medicaid, coverage for nonelderly adults is limited to people who have a child, pregnant women or people who have a disability. "If you’re an adult with no children, you don’t have a disability and you’re not pregnant, you’re not eligible no matter how low your income is," says Garfield. [...] How to Choose the Best Health Care Coverage for You
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2023-03-03): Medicaid Expansion also gives the adopting states an enhanced federal matching assistance percentage (FMAP) for the populations served by the expansion. States with Medicaid Expansion receive 90% FMAP while those without Medicaid Expansion receive nothing. [...] This provides a pathway to coverage for millions of low-income adults in America. [...] Medicaid Expansion is a provision of the ACA designed to increase coverage for non-disabled adults under 65 who have low incomes. Currently, this program is only available in about 40 American states.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2016-10-01): Meanwhile, half a dozen states have received federal approval to expand under the ACA using alternative program features, including the private option.46 There is keen interest in assuring that federal flexibility does not jeopardize care for newly insured populations. We found few significant differences between Arkansas’s private option and Kentucky’s Medicaid expansion. Other than the type of coverage obtained (primarily private insurance in Arkansas and Medicaid in Kentucky), the only significant difference was higher glucose monitoring rates among patients with diabetes in Kentucky compared with those in Arkansas. All other outcomes related to utilization, quality of care, and self-reported health were similar for Kentucky and Arkansas. Of particular relevance to clinicians, we found no significant differences in access to primary and specialty care between private insurance and Medicaid expansions. Overall, more than 85% of low-income adults in both expansion states reported no difficulties obtaining physician appointments in 2015. Whether other state expansion models using different features than Arkansas’s program would produce similar results is unclear and worthy of future study. Subgroup analyses suggested that racial/ethnic minorities may be differentially affected by alternative expansion approaches. For nonwhites, the private option decreased reliance on the ED and improved self-reported health, but increased out-of-pocket spending compared with Medicaid. The latter finding likely relates to Arkansas’s decision to impose more cost-sharing for higher-income private option beneficiaries than most states require in traditional Medicaid.47 Overall, the 2 alternate expansions were associated with very similar changes for most outcomes. [...] RJ. Low-income residents in three states view Medicaid as equal to or better than private coverage, support expansion.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2024-06-14): [9] Matthew Buettgens and Urmi Ramchandani, "2.3 Million People Would Gain Health Coverage in 2024 if 10 States Were to Expand Medicaid Eligibility," Urban Institute, October 23, 2023, https://www.urban.org/research/publication/23-million-people-would-gain-health-coverage-2024-if-10-states-were-expand. [...] [20] Sherry Glied and Mark Weiss, "Impact of the Medicaid Coverage Gap: Comparing States That Have and Have Not Expanded Eligibility," Commonwealth Fund, September 11, 2023, https://www.commonwealthfund.org/publications/issue-briefs/2023/sep/impact-medicaid-coverage-gap-comparing-states-have-and-have-not [21] Benjamin B. Albright et al., "Impact of Medicaid expansion on women with gynecologic cancer: a difference-in-difference analysis," American Journal of Obstetrics and Gynecology, August 7, 2020, https://www.ajog.org/article/S0002-9378(20)30835-8/fulltext. [...] [61]Lisa Dubay and Genevieve Kenney, "Expanding Public Health Insurance to Parents: Effects on Children’s Coverage under Medicaid," Health Services Research, October 7, 2003, https://onlinelibrary.wiley.com/doi/abs/10.1111/1475-6773.00177.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2021-01-05): As of summer 2018, 17 states have chosen not to expand Medicaid. However, some are considering placing a portion of or all newly eligible individuals into private insurance. Even some expansion states are considering similar changes, arguing that private plans may produce better quality at a lower cost to the state. Yet, numerous studies comparing the effects of Medicaid versus private coverage have been confounded by selection bias: people who are able to access private insurance differ from those who qualify for Medicaid in observable and unobservable ways. So there remains little evidence on how public and private coverage compare in their effects on low-income adults. [...] It is plausible that private insurance–with broader provider networks, higher reimbursement, and market-based competition–may produce better outcomes than Medicaid. Alternatively, Medicaid may be uniquely designed to provide appropriate health care to low-income adults, who differ in significant ways from the customers typically served by commercial plans. This analysis seeks to shed light on the value of Medicaid versus other coverage types, with important implications for state expansion approaches, as well as the debate over whether to include a public option in the ACA Marketplaces. In an article recently published in JAMA Network Open, Heidi Allen, Sarah H. Gordon, Dennis Lee, Aditi Bhanja and Benjamin D. Sommers use data from Colorado to compare individuals with similar incomes across coverage types, highlighting the key differences between Medicaid and Marketplace insurance.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2018-09-27): Better coverage means better health [...] Medicaid expansion is linked to increased insurance coverage across ethnic, racial, age and income groups. Researchers found coverage gains for "specific vulnerable populations," including young adults, patients who take prescription drugs, people with HIV, newly diagnosed cancer patients and early retirees. Access. Medicaid expansion was linked with a higher proportion of low- and moderate-income adults having a usual source of care.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2023-02-17): Some studies exploring the effects of Medicaid expansion on private insurance coverage found no evidence of Medicaid expansion coverage substituting for private coverage including employer-sponsored insurance, while other studies showed declines in private coverage associated with expansion overall or among certain specific population groups. These declines in private coverage may occur if individuals previously covered through employer-sponsored or self-pay insurance opt in to Medicaid given Medicaid’s typically lower out-of-pocket costs and more comprehensive benefit packages, or if employers alter their offering of coverage in response to the expansion of Medicaid. Private coverage changes in studies that include states that expanded later than January 2014 may also reflect people above 100% FPL transitioning from subsidized Marketplace coverage to Medicaid after their state adopts the expansion.248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2020-07-01): Expanding Medicaid helps low-income families’ health and financial well-being, especially those in which someone has lost a job. In states that expanded Medicaid under the Patient Protection and Affordable Care Act (ACA), unemployed workers experienced large gains in coverage.1 These gains improved access to medical care, reducing forgone care.2 Better access translates into better health and lower mortality.3 Moreover, there are spillover benefits for economic well-being: lower debt and better credit scores.4 Physical health and financial health are inextricably linked. Expanding Medicaid improves both for low-income families. [...] "We don’t want to add more people to a broken system." Opponents of expanding coverage often deride Medicaid as a low-quality program. Yet a majority of people in the US—Democrats, Republicans, and independents alike—believe that the program is working well. Most Medicaid enrollees are quite happy with their coverage, reporting higher rates of satisfaction than people with private insurance. Furthermore, in states that have not expanded Medicaid, a clear majority favor doing so. And, as noted, there is clear evidence that Medicaid coverage leads to substantial improvements in health and financial well-being. The Urban Institute has estimated that if all states adopted Medicaid expansion, 4.1 million individuals would gain coverage.10 The evidence is clear that this expansion would save lives and mitigate the tremendous ongoing economic damage resulting from the COVID-19 pandemic.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2021-01-04): In terms of clinical quality, we found no difference for the primary outcome of ambulatory care–sensitive hospitalizations. Among secondary outcomes, 5 measures favored Marketplace coverage (though 1 was of minimal clinical relevance, a 1 percentage-point difference in flu vaccination), 1 measure favored Medicaid, and the rest (6 of 12) showed no significant differences. Lower rates of mammography and chlamydia testing in Medicaid are consistent with a previous analysis, though that study lacked individual-level measures of socioeconomic status.36 Results for chronic disease measures varied, with higher rates of hemoglobin A1c and urine microalbumin testing among diabetic patients in Marketplace coverage but higher rates of β-blocker prescription for coronary artery disease in Medicaid. Our finding of similar rates of low-value care in both insurance types was consistent with a prior study.26 Overall, our results suggest a mixed picture on quality, with a plurality of secondary outcomes favoring private coverage, but with more than half of the primary and secondary measures showing no significant differences, similar to a prior quasi-experimental study comparing Kentucky’s Medicaid expansion to Arkansas’ private insurance expansion for low-income adults.34
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2024-06-14): [5] Rachel Garfield, Kendal Orgera, and Anthony Damico, "The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid," Kaiser Family Foundation, January 21, 2021, https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/. [...] [9] Madeline Guth, Rachel Garfield, and Robin Rudowitz, "The Effects of Medicaid Expansion under the ACA: Studies from January 2014 to January 2020," Kaiser Family Foundation, March 17, 2020, https://www.kff.org/medicaid/report/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review/. [...] [32] Lisa Dubay and Genevieve Kenney, "Expanding Public Health Insurance to Parents: Effects on Children’s Coverage under Medicaid," Health Services Research, October 7, 2003, https://onlinelibrary.wiley.com/doi/abs/10.1111/1475-6773.00177.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2024-02-26): States that have not implemented the expansion have uninsured rates that are nearly double the rate of expansion states (14.1% compared to 7.5%). People without insurance coverage have worse access to care than people who are insured. One in five uninsured adults in 2022 went without needed medical care due to cost and uninsured people are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases. [...] If all states adopted the Medicaid expansion, approximately 2.9 million uninsured adults would become newly eligible for Medicaid. This number includes the 1.5 million adults in the coverage gap and an additional 1.4 million uninsured adults with incomes between 100% and 138% FPL, most of whom are currently eligible for Marketplace coverage but not enrolled (Figure 7 and Table 1). Most of the adults who are currently eligible for coverage in the Marketplace qualify for plans with zero premiums; however, even with no premiums, Medicaid could provide more comprehensive benefits and lower cost-sharing compared to Marketplace coverage. The potential number of people who could be reached by Medicaid expansion varies by state.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2024-01-01): If your income is low and your state hasn’t expanded Medicaid If your state hasn’t expanded Medicaid, your income is below the federal poverty level, and you don't qualify for Medicaid under your state's current rules, you won’t qualify for either health insurance savings program: Medicaid coverage or savings on a private health plan bought through the Marketplace. [...] Even if your state hasn't expanded Medicaid and it looks like your income is below the level to qualify for financial help with a Marketplace plan, you should fill out a Marketplace application.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2023-11-01): North Carolina Expands Medicaid North Carolina has expanded health care coverage to more people. [...] If someone is pregnant, they may be eligible for other Medicaid programs to get full health benefits.
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2019-02-07): 11. Matthew Buettgens, The Implications of Medicaid Expansion in the Remaining States: 2018 Update (Urban Institute, May 2018); and Rachel Garfield, Anthony Damico, and Kendal Orgera, The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid (Henry J. Kaiser Family Foundation, June 2018). [...] 13. Sara R. Collins, "Consumers Shopping for Health Plans Are Left in the Dark by Trump Administration," To the Point (blog), Commonwealth Fund, July 19, 2018. [...] 23. Munira Z. Gunja, Sara R. Collins, and Sophie Beutel, How Deductible Exclusions in Marketplace Plans Improve Access to Many Health Care Services (Commonwealth Fund, Mar. 2016).
Claim: “Private insurance gives … better coverage” than people would get under a Medicaid expansion. (Mark Born, 2021-03-21)
Evidence (2023-10-26): The Commonwealth Fund Health Care Affordability Survey, fielded for the first time in 2023, asked U.S. adults with health insurance, and those without, about their ability to afford their health care — whether costs prevented them from getting care, whether provider bills left them with medical debt, and how these problems affected their lives. As the responses show, many Americans, regardless of where their insurance comes from, have inadequate coverage that’s led to delayed or forgone care, significant medical debt, and worsening health problems. While having health insurance is always better than not having it, the survey findings challenge the implicit assumption that health insurance in the United States buys affordable access to care. Difficulties affording care are experienced by people in employer, marketplace, and individual-market plans as well as people enrolled in Medicaid and Medicare. In this brief, we present findings for survey respondents who were insured for the full year and those who spent all or part of the year uninsured. People who were insured all year are grouped by the coverage source they reported at the time of the survey, though it should be noted that some may have switched insurance during the year.