New on the Web 28: July 2005
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.
From The Commonwealth Fund: "Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help," "A Shared Responsibility: U.S. Employers and the Provision of Health Insurance to Employees," "Variations in the Impact of Health Coverage Expansion Proposals across States"
From Georgetown University: "Medicaid's Coverage of Nursing Home Costs: Asset Shelter for the Wealthy or Essential Safety Net?"
From Health Affairs: "Insured but Not Protected: How Many Adults Are Underinsured?"
From Health Care Financing Review: "Estimating Medicare Advantage Lock-In Provision's Impact on Vulnerable Medicare Beneficiaries"
From the Kaiser Family Foundation: "Low-Income Assistance under the Medicare Drug Benefit," "Medicaid: An Overview of Spending on 'Mandatory' vs. 'Optional' Populations and Services," "Stress to the Safety Net: The Public Hospital Perspective," "Trends and Indicators in the Changing Health Care Marketplace," "Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences," "Low-Income Subsidies for the Medicare Prescription Drug Benefit: The Impact of the Asset Test"
National Association of Health Underwriters: Healthcare Coverage Options Database: Assistance for Obtaining Health Coverage
From the National Conference of State Legislatures: "2005 Prescription Drug State Legislation"
From The Commonwealth Fund
Young adults are one of the largest and fastest-growing segments of the U.S. population without health insurance. They often lose coverage under their parents' policies at age 19 or when they graduate from high school or college. The updated Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help suggests several policy changes that could extend coverage to uninsured young adults. (May 2005)
Between 2000 and 2003, the number of Americans without health insurance coverage grew by 5 million, with nearly the entire increase attributed to a decline in employer-sponsored coverage. A Shared Responsibility: U.S. Employers and the Provision of Health Insurance to Employees explores the characteristics of workers who do not receive coverage from their own firms; examines how health care costs are spread across workers, employers, and the government; and recommends policy options to expand and strengthen employer-sponsored coverage. (June 2005)
Most studies of health coverage expansion policies focus on their potential national impact. Variations in the Impact of Health Coverage Expansion Proposals across States finds that federal strategies have greatly varied effects on the different states. This report examines the variability among states with regard to economic characteristics, health care markets, and numbers of uninsured. (June 2005)
From Georgetown University
Some contend that Medicaid has stretched beyond its original purpose of providing a safety net for the poor and has evolved into an asset shelter for the rich. Medicaid’s Coverage of Nursing Home Costs: Asset Shelter for the Wealthy or Essential Safety Net? reviews the empirical evidence and finds that asset transfers are not significant contributors to Medicaid costs now, and implementing policies designed to further limit them is unlikely to significantly reduce Medicaid costs. (May 2005)
From Health Affairs
In addition to the 45 million uninsured adults in the United States, another 16 million adults were underinsured in 2003, meaning their insurance did not adequately protect them against catastrophic health care expenses. Insured but Not Protected: How Many Adults Are Underinsured? explains that underinsured adults are almost as likely as the uninsured to go without needed medical care and to incur medical debt. (Full article available with subscription.) (June 14, 2005)
From Health Care Financing Review
Beginning in January 2006, open enrollment period limitations (also known as enrollment lock-in provisions) will restrict the number of times (and the times of the year) that Medicare beneficiaries can change health plans. Estimating Medicare Advantage Lock-In Provisions Impact on Vulnerable Medicare Beneficiaries examines Medicare managed care enrollment and disenrollment of vulnerable beneficiaries from 1999 to 2001 to estimate the impact of these upcoming restrictions. (Spring 2005)
From the Kaiser Family Foundation
Beginning in 2006, 42 million elderly and disabled Medicare beneficiaries will have access to prescription drug coverage through Part D of the Medicare program, including an estimated 14.4 million who will be eligible for low-income subsidies. Low Income Assistance under the Medicare Drug Benefit provides an overview of the drug benefit and the low-income subsidies, including participation and eligibility. (June 2005)
With discussions on restructuring Medicaid occurring in state capitols and Washington, DC, two new reports provide the latest data on how much of Medicaid's spending is used to cover mandatory versus optional populations and services. The issue paper, Medicaid: An Overview of Spending on “Mandatory” vs. “Optional” Populations and Services,offers a brief summary of the data and a discussion of the practical implications of policy changes. The background report, “Medicaid Enrollment and Spending by ‘Mandatory’ and ‘Optional’ Eligibility and Benefit Categories,” offers a more detailed examination of the methodology and results. (June 2005)
Financing for the nation’s health care safety net is fragmented, and providers must knit together resources from many different funding sources to cover the costs of providing a broad range of services. Stresses to the Safety Net: The Public Hospital Perspective describes those sources of revenue, documenting that nearly 40 percent of all safety net revenues are from Medicaid. (June 2005)
Over the past few years, a number of states have implemented new or increased existing out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public coverage programs. Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences reviews the key findings from this activity, including the impact on enrollment in public coverage programs, on providers, and on access to care. (May 2005)
Trends and Indicators in the Changing Health Care Marketplace is an online chartbook that presents up-to-date information on key health care marketplace trends. The chartbook highlights national health expenditures, health care spending and costs, employee and retiree health coverage, HMO enrollment, hospital data, and public views on topics such as managed care, medical errors, and quality information. (May 2005)
In January 2006, Medicare will begin providing coverage for outpatient prescription drugs, and many low-income beneficiaries will have to meet both an income and asset test to receive assistance. Low-Income Subsidies for the Medicare Prescription Drug Benefit: The Impact of the Asset Test estimates that in 2006, 2.37 million low-income Medicare beneficiaries will not qualify for subsidized coverage because they will fail the asset test. The report also examines how the low-income asset test works and the characteristics of people likely to be excluded. (April 2005)
From the National Association of Health Underwriters
Healthcare Coverage Options Database: Assistance for Obtaining Health Coverage: This Web site provides information on health insurance options for low-income U.S. residents. The site includes comprehensive information on large-scale programs like Medicaid, the State Children's Health Insurance Program (SCHIP), and the federal Health Care Tax Credit Program, as well as hundreds of smaller state, federal, and private programs. (May 2005)
From the National Conference of State Legislatures
According to 2005 Prescription Drug State Legislation, in 2005, state legislatures have focused more than ever on prescription drug legislation. As of June, more than 600 separate bills and resolutions in all 50 states were proposed to address a wide array of policies affecting access, affordability, payment, and other regulation of prescription drugs. (July 2005)
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