New on the Web 17: January 2003
We've collected information on several new reports and other resources available on the Web that we hope you'll find interesting and useful. Descriptions and links appear below.
Center on Budget and Policy Priorities: "Proposed State Medicaid Cuts Would Jeopardize Health Insurance Coverage for One Million People," "Why Are States' Medicaid Expenditures Rising?"
Center for Studying Health System Change: "Mounting Pressures: Physicians Serving Medicaid Patients and the Uninsured, 1997-2001"
Commonwealth Fund: "Health Insurance Purchasing Cooperatives", "Staying Covered: The Importance of Retaining Health Insurance for Low-Income Families," "Health Insurance Tax Credits: Will They Work for Women?"
Kaiser Commission on Medicaid and the Uninsured: "Medicaid Spending Growth: A 50-State Update for Fiscal Year 2003"
Kaiser Family Foundation: "The Current State of Retiree Health Benefits: Findings from the Kaiser/Hewitt 2002 Retiree Health Survey"
Mathematica Policy Research: "Trends in Medicare+Choice Benefits and Premiums, 1999-2002"
Center on Budget and Policy Priorities:
Why Are States' Medicaid Expenditures Rising? cites two reasons for continued increases in Medicaid costs: 1) increases in health care costs for the current caseload; and 2) increases in the costs of caring for beneficiaries who are seniors or who have disabilities. The authors argue that Medicaid costs increases are not a sign that Medicaid spending is out of control but rather are symptomatic of demographic changes and spiraling health costs that are affecting both the private and the public sector. (January 2003)
Proposed State Medicaid Cuts Would Jeopardize Health Insurance Coverage for One Million People reports that the state budget deficits projected for fiscal year 2004 represent the largest state deficits in half a century and are at least twice as large as the deficits states faced in the recession of the early 1990s. Because of these budget shortfalls, several states have made major reductions in their Medicaid programs or are considering budget proposals that include deep Medicaid cuts. This report provides brief summaries of actions taken recently or proposals being discussed in 11 states that would lead to the elimination of health coverage for about 1 million low-income people. (December 2002)
Center for Studying Health System Change:
Mounting Pressures: Physicians Serving Medicaid Patients and the Uninsured, 1997-2001 reports that the percentage of doctors providing any kind of charity care decreased from 76.3 percent in 1997 to 71.5 percent in 2001. The proportion of physicians serving Medicaid patients decreased by a lesser amount during that time frame, from 87.1 percent to 85.4 percent. The authors note that while these decreases do not appear to have had any negative consequences for Medicaid beneficiaries, they are consistent with other evidence showing decreased access to physicians by the uninsured. (December 2002)
Commonwealth Fund:
Staying Covered: The Importance of Retaining Health Insurance for Low-Income Families argues that improving insurance retention is both a cost-effective and under-appreciated way to increase the number of people with health coverage. For example, the number of uninsured, low-income children would decline by almost 40 percent, and the number of uninsured adults would decline by more than one-quarter, if every person with public or private coverage at the beginning of a given year retained it for the next 12 months. The authors recommend strategies that federal and state governments and employers can use to improve retention. (December 2002)
Health Insurance Tax Credits: Will They Work for Women?, which examines premium and benefit quotes for health insurance plans in 25 cities, finds that tax credit proposals within the range of those proposed by the Administration would not be large enough to make health coverage affordable to women with low incomes. According to the study, tax credits of $1,000 or $1,500 would leave even healthy young women with a choice of plans with deductibles that were high relative to their incomes, if such plans were available at all. For older women, no plans with premiums in this range were available in most cities. (December 2002)
Health Insurance Purchasing Cooperatives reports that cooperative purchasing arrangements in general have not been able to control enough market share to bargain effectively for premium reductions. They have also not been able to yield significant savings by centralizing administration. However, co-ops have succeeded in one important respect: they have enabled small employers to offer their employees a choice among different health plans. (November 2002)
Kaiser Commission on Medicaid and the Uninsured:
Medicaid Spending Growth: A 50-State Update for Fiscal Year 2003 updates a survey of state officials conducted in June 2002 and aims to reflect the most current information on state Medicaid spending and cost control strategies. The survey was undertaken because it became clear in the fall of 2002 that states' fiscal situations had deteriorated further and states reported that their budget gaps were widening even more. It shows that 49 states have planned or implemented Medicaid cuts in fiscal year 2003, and 32 of them have taken such action twice. (January 2003)
Kaiser Family Foundation:
The Current State of Retiree Health Benefits: Findings from the Kaiser/Hewitt 2002 Retiree Health Survey presents findings from a study of large private-sector employers conducted between July and September of 2002. Information was collected on a variety of topics, including costs, premiums, retiree contributions, benefit design, prescription drug benefits, recent changes, changes expected within the next three years, and the implications of a Medicare drug benefit for employers. (December 2002)
Mathematica Policy Research:
Trends in Medicare+Choice Benefits and Premiums, 1999-2002 examines broad trends in benefits and premiums and analyzes 2002 benefit packages, focusing on changes that are likely to affect chronically ill beneficiaries who require more services. The report also analyzes patterns in plan benefit and premium changes since 1999 and speculates about what these patterns might reveal about health plan strategies. Among the key findings is that M+C plans continued to increase premiums and cost-sharing while scaling back benefits. (November 2002)
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