Andrew Hyman, Robert Wood Johnson Foundation

TITLE: Senior Program Officer

FUNDING AREAS: Health care access

CONTACT: ahyman@rwjf.org, 877-843-7953

IP TAKE: Hyman has a track record of navigating bureaucratic systems and legislative complexities to fight for uninsured Americans. 

PROFILE: The Robert Wood Johnson Foundation (RWJF) has been deeply immersed in the push to expand health coverage and make the Affordable Care Act (as well as a variety of other state and local programs) work. It has a "Coverage" team that spearheads its work in this area, and Andrew Hyman is its Senior Program Officer. RWJF makes more than 60 grants each year to advance its coverage work.

Hyman is a lawyer by training who knows his way around the Byzantine U.S. healthcare system. He spent years at the Department of Health and Human Services in the 1990s, and then worked on state mental health issues. This background is especially handy right now, with the fight to expand coverage touching every corner of the healthcare system, from federal programs downward. And RWJF is involved in seemingly everything, with grants targeting innumerable obstacles, challenges, and kinks in America's emerging new healthcare systme. 

But Hyman is no mere technocrat. He's passionate about this stuff, saying that "The promise of equal opportunity in this country is empty while we permit millions to be uninsured." Indeed, Hyman and RWJF truly believe that the disparities in health coverage among different socioeconomic groups serve to further impoverish the poor and cocoon the relatively wealthy.

Hyman routinely talks at conferences and in the media about healthcare coverage and what RWJF is doing to expand that coverage. Recent publicized work focuses on Medicaid expansion programs under the Affordable Care Act (ACA). According to the RWJF, the Medicaid expansion program accounts for about 50% of health-coverage gains made possible by the ACA—a percentage sure to change over time depending on what states do. 

To help states figure how (and whether) to implement their Medicaid expansion programs, the RWJF sponsors an analytical tool called the State Health Reform Assistance Network. With this tool, state policymakers can assess how various scenarios related to the ACA (expanding Medicaid, accepting federal funds, etc.) influence a state's long-term fiscal health. In defending the State Health Reform Assistance Network program to the Health Affairs Blog, Hyman and his colleague Heather Howard wrote:

While this tool allows states to gauge the financial impact of expanding their program, states' paramount consideration must be the positive impact of covering the uninsured, something that does not necessarily show up on a state's balance sheet. A study of uninsured low-income adults in Oregon demonstrated how enrolling in Medicaid increased health care utilization, lowered out-of-pocket health care expenditures and medical debt, and resulted in better physical and mental health.

In short, Hyman and the RWJF have analyzed the fiscal effects of Medicaid expansion on states and determined there are monetary benefits to keeping people healthy. This finding is not in itself shocking (intuitively, it makes sense that preventive care will lower costs incurred from emergency ER visits, for example), but in the age of austerity, being able to explain—with numbers—how expanding a government program can actually save money is valuable for anyone trying to get a policy adopted.

When and if more states come around to accepting Medicaid expansion, we'll be able to partly credit the work of RWJF.