New on the Web 19: May 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: "Did States Spend Their Way into the Current Fiscal Crisis?," "Changing the Poor More for Health Care: Cost-Sharing in Medicaid"
Commonwealth Fund: "On the Edge: Low-Wage Workers and Their Health Insurance Coverage"
Health Affairs: "Improving the Quality of Medicaid Personal Assistance through Consumer Direction"
Health Assistance Partnership: "Health Insurance Portability and Accountability Act (HIPAA) Privacy Regulations: Questions and Answers for Consumer Health Assistance Programs"
Kaiser Commission on Medicaid and the Uninsured: "Health Insurance Premiums and Cost-Sharing: The Impact on Low-Income Populations," "The New Middle Class Americans--Is It Real?"
Kaiser Family Foundation: "Private Long-Term Care Insurance: Who Should Buy It and What Should They Buy?," "Talking with Your Parents about Medicare and Health Coverage"
The Packard Foundation's Journal, The Future of Children: "Health Insurance for Children," "Presumptive Eligibility"
Urban Institute: "How Are States Responding to Fiscal Stress"
From the Center on Budget and Policy Priorities:
Some have argued that the federal government shouldn't provide fiscal relief to the states on the theory that their crises are the result of massive spending increases by states during the 1990s. Did States Spend Their Way into the Current Fiscal Crisis? examines the basis of the claim that helping the states would be equivalent to rewarding irresponsible behavior and encouraging continued overspending. This report finds that states actually spent less per resident between 1989 and 1999 than they did during the 1980s overall. (May 2003)
Charging the Poor More for Health Care: Cost-Sharing in Medicaid makes the point that, while cost-sharing is commonplace for middle-class people with private insurance, its consequences are more serious for low-income beneficiaries served by Medicaid. This report examines the effects of cost-sharing on health care utilization and status, examines how much beneficiaries pay now, looks at who the most vulnerable beneficiaries are, and shows that increased cost-sharing can jeopardize health for low-income beneficiaries. (May 2003)
From The Commonwealth Fund:
Low-wage workers are at a serious disadvantage when it comes to health insurance coverage and access to care, even when they work for large businesses. On the Edge: Low-Wage Workers and Their Health Insurance Coverage assesses the relative health insurance experiences of workers across the country by the wages they earn and the size of the companies in which they work. The study reveals that, although employees of small companies are particularly unlikely to have coverage through their jobs, low-wage workers in firms of all sizes have less access than their higher-earning counterparts. (April 2003)
From Consumers Union and the Kaiser Family Foundation
A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan, 2003 Update was created to help consumers who are seeking ways to resolve disputes with their health plans or better understand their coverage. The guide will help consumers navigate their plan's internal claims review process, as well as their state's external review process. It also provides consumers with state-specific guidelines and other practical information. (January 2003)
From Health Affairs:
Improving the Quality of Medicaid Personal Assistance through Consumer Direction reports on the initial findings from an ongoing evaluation of the Cash and Counseling demonstration project. In the project, participating Medicaid beneficiaries with disabilities are given an allowance and a high degree of flexibility and freedom to choose personal care assistants. The study found that participants in Arkansas who directed their own supportive services were significantly more satisfied and appeared to get better care than those receiving services through home care agencies. (March 2003)
From the Health Assistance Partnership:
Health privacy regulations that dictate when a person has a right to obtain his or her medical records and other health information and when health plans and other health care entities can share protected information went into effect on April 14, 2003. Health Insurance Portability and Accountability Act (HIPAA) Privacy Regulations: Questions and Answers for Consumer Health Assistance Programs guides consumer health assistance (ombudsman) programs through their rights and responsibilities under these HIPAA privacy regulations. (May 2003)
From The Kaiser Family Foundation:
Private Long-Term Care Insurance: Who Should Buy It and What Should They Buy? explores the feasibility of long-term care insurance (LTCI) for working families and older adults. It looks at how many working-age families can afford LTCI and whether it is a sensible investment for people who are decades away from requiring long-term care. It also examines the affordability of LTCI for older people, what kind of policies make sense for seniors, and whether there are less costly products that might reach more buyers and still provide some meaningful protection. (March 2003)
Talking with Your Parents about Medicare and Health Coverage, a consumer guide updated for 2003, helps seniors and their adult children sort through the basic facts about Medicare and the choices seniors make related to health coverage and paying for care. This guide answers questions on a range of issues, including Medicare coverage, supplemental insurance, Medicare managed care, and ways of paying for prescription drugs. It also includes state-by-state resources that can be used to obtain more specific help with questions. (March 2003)
From The Kaiser Commission on Medicaid and the Uninsured:
Health Insurance Premiums and Cost-Sharing: The Impact on Low-Income Populations summarizes the issues surrounding premiums and cost-sharing in public coverage programs. The fact sheet also discusses the impact of these mechanisms on participation and health outcomes: It asserts that research shows that even low premiums can decrease participation in public health programs, and cost-sharing can negatively affect health care utilization and health outcomes. (March 2003)
Statistics from the most recent Census report on the number of uninsured have been interpreted by some as evidence that lack of health coverage is now becoming a problem of middle-income families. The New Middle Class of Uninsured Americans-Is It Real? examines the difference between Kaiser's findings and the Census Bureau's data in an effort to clarify how much the uninsured problem is shifting to higher-income Americans. The authors conclude that the Census data have been misinterpreted and that the middle- to upper-classes did not account for most of the recent growth in the number of uninsured. (March 2003)
From The Packard Foundation's Journal, The Future of Children:
The spring issue of The Future of Children, called Health Insurance for Children, contains numerous articles on many aspects of providing health coverage for children. Topics covered include a historical overview of children's health coverage, why some children are still uninsured, access to health care for special populations of children (including children with special health care needs), reducing health disparities among children, and express lane eligibility. (Spring 2003)
Presumptive Eligibility, from Health Insurance for Children, provides an overview of the use of presumptive eligibility to increase participation in Medicaid and SCHIP. The article discusses the process of determining presumptive eligibility, describes the benefits of the process for children, and examines some concerns that have slowed wider adoption of presumptive eligibility. It also discusses possible solutions that will enable presumptive eligibility to meet its potential to cover eligible children and increase the continuity of their care. (Spring 2003)
From the Urban Institute:
How Are States Responding to Fiscal Stress? examines the methods seven states used to balance their budgets during a time of economic difficulty. These states have done little to increase revenue, relying instead on reducing spending by implementing across-the-board cuts or delaying planned program expansions. The report maintains that high matching rates in Medicaid and SCHIP (the State Children's Health Insurance Program) protected these programs to some extent. (March 2003)
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