New on the Web 32: July 2006
From the Commonwealth Fund: "Cultural Competency: Understanding the Present and Setting Future Directions," "Health Insurance for All: What We Can Learn from Massachusetts," "Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help," "The U.S. Health Care Divide: Disparities in Primary Care Experiences by Income," "Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences and Remedies," "Automatically Enrolling Eligible Children and Families into Medicaid and SCHIP: Opportunities, Obstacles, and Options for Federal Policymakers"
From Health Affairs: "A First Look at the New Medicare Prescription Drug Plans"
From the Kaiser Family Foundation: "Premiums and Cost Sharing Features in Medicare’s New Prescription Drug Program, 2006," "Medicaid’s Role for Women," "Distribution of Out-of-Pocket Spending for Health Care Services," "Retired Steelworkers and Their Health Benefits: Results from a 2004 Survey," "The Stability of Medicaid Coverage for Low-Income Dually Eligible Medicare Beneficiaries," "What Have We Learned and Where Do We Go From Here? Three Years of the National Healthcare Disparities Report," "Medicare Health and Prescription Drug Plan Tracker"
From KaiserEDU.org: "Consumer-Directed Health Plans"
From Mathematica Policy Research, Inc: "Extending Medicaid to Workers with Disabilities: The Medicaid Buy-In Program"
From the National Academy of Social Insurance: "Improving the Medicare Savings Programs"
From the National Health Law Program: Resources on the impact of the Deficit Reduction Act (DRA), including "Role of State Law in Limiting Medicaid Changes," “The Deficit Reduction Act of 2005: Implications for Advocacy"
From the National Immigration Law Center: "Immigrants Are Not Affected by the New Medicaid Law"
From The Commonwealth Fund
Granting states the flexibility to automatically enroll people into Medicaid and SCHIP using information that state officials already have could significantly extend health insurance coverage to uninsured but eligible children and their families, according to Automatically Enrolling Eligible Children and Families into Medicaid and SCHIP: Opportunities, Obstacles, and Options for Federal Policymakers. Unfortunately, legal and technical barriers now prevent auto-enrollment in public health insurance programs. Federal policymakers need to provide states with additional flexibility in determining eligibility and new resources for investing in information technology. (June 2006)
Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences and Remedies reviews national and state studies and interviews Medicaid and SCHIP administrators, as well as providers and health plan representatives, in four states that have implemented policies to improve coverage. It finds that coverage instability can largely be averted by adopting key policies and procedures, such as limiting the frequency of required renewals; developing easy, seamless transitions between public programs; and setting affordable limits on premiums. (June 2006)
Cultural Competency: Understanding the Present and Setting Future Directions brings together researchers, providers, policymakers, and others to discuss research on and measurements of cultural competency in health care, as well as practices that may improve cultural competency. This e-forum features audio and slide presentations on topics that include the following: "Improving Quality and Achieving Equity: What Is the Role of Cultural Competence and Quality in Reducing Racial/Ethnic Disparities in Health Care?", "Cultural Competency and Quality of Care: Obtaining the Patient's Perspective," and "Taking Cultural Competency into Action." (May 2006)
Health Insurance for All: What We Can Learn from Massachusetts argues that Massachusetts’ new law offers lessons for every state. (May 2006)
Americans between the ages of 19 and 29 represent the largest and fastest-growing segment of the population without health coverage. Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help argues that there are several ways to extend coverage to young adults—and prevent others from losing it. These include extending eligibility for Medicaid and SCHIP beyond age 18; extending eligibility for dependents beyond age 18 or 19 regardless of student status; and ensuring that colleges and universities require full- and part-time students to have insurance. (May 2006)
Given the strong correlation worldwide between low income and poor health, it is especially critical for people with limited incomes to have ready access to medical care. The U.S. Health Care Divide: Disparities in Primary Care Experiences by Income reveals that in most other countries, low-income patients are better off in comparison to their richer counterparts in the U.S. (April 2006)
From Health Affairs
Beneficiaries who choose to remain in traditional fee-for-service Medicare are charged much higher monthly premiums for drug coverage, on average, than those enrolled in managed care plans, according to A First Look at the New Medicare Prescription Drug Plans. The article also reports that, while variations in cost-sharing and formularies provide beneficiaries with choices, they also make the system much more complex. (May 2006) SUBSCRIPTION REQUIRED
From the Kaiser Family Foundation
The Medicare Health and Prescription Drug Plan Tracker provides current and historical information about Medicare Advantage plans at the national, state, and county level. It includes such data as the numbers of eligible beneficiaries by county, breakdowns of Medicare managed care payment rates in different regions, as well as local data about the new Medicare stand-alone prescription drug plans (PDPs). (June 2006)
Distribution of Out-of-Pocket Spending for Health Care Services takes a detailed look at out-of-pocket spending for health care, and, in particular, how out-of-pocket costs vary among different groups for different services. Comparisons focus on, for example, what types of drugs and treatments are most often handled out-of-pocket and what share of total health spending occurs out-of-pocket by income bracket. (May 2006)
Approximately 70 percent of Medicaid’s adult beneficiaries are low-income women. Medicaid’s Role for Women presents the latest data on women enrolled in Medicaid and discusses the program’s role in women’s health across several life stages. It also summarizes some of the latest policy developments in Medicaid and their consequences for low-income women. (May 2006)
Premiums and Cost Sharing Features in Medicare’s New Prescription Drug Program, 2006 examines the premiums, deductibles, and selected cost-sharing features of Medicare Advantage prescription drug plans. It finds that Medicare Advantage plans, on average, charge less for drug coverage ($18 per month) than stand-alone drug plans ($37 per month). This is due in part to the fact that the government pays these plans more to participate in the program. (May 2006)
Retired Steelworkers and Their Health Benefits: Results from a 2004 Survey looks at how the bankruptcies of two steel companies, the LTV Corporation and Bethlehem Steel, affected health coverage for the companies' retirees and dependents. The survey found that although nearly three-quarters of the retirees who responded had obtained replacement coverage or a supplement to their Medicare coverage, many reported that they were less satisfied with their new coverage than they had been with the benefits they lost. Many also had to delay retirement in order to secure replacement coverage. The survey also studied the effects of the Health Coverage Tax Credit (HCTC) enacted in 2002, finding that it played a major role in helping some steel workers renew coverage. (May 2006)
The Stability of Medicaid Coverage for Low-Income Dually Eligible Medicare Beneficiaries examines the health coverage of the 7 million Americans who rely on Medicaid to fill the gaps in their Medicare coverage. The analysis focuses on the rates of gain and loss of Medicaid coverage, among other topics. (May 2006)
The first National Health Care Disparities Report was issued by the Agency for Health Care Research and Quality in 2003. What Have We Learned and Where Do We Go From Here? Three Years of the National Healthcare Disparities Report is the title of a forum where panelists and audience members discussed how the report can inform policy, research, and efforts to improve quality and reduce disparities. (April 2006)
From KaiserEDU.org
Consumer-Directed Health Plans is a tutorial that explains the principles and different models of so-called consumer-directed health plans, including Health Savings Accounts (HSAs). The tutorial also discusses how such health plans are financed, as well as the impact they are likely to have on health care spending. (June 2006)
From Mathematica Policy Research, Inc.
Working-age adults with disabilities need adequate health insurance in order to enter or remain in the work force, but their options for coverage are limited. The Medicaid Buy-In program allows adults with disabilities to earn more than the allowable amount and still have Medicaid coverage. In return, participants “buy into” the Medicaid program, typically by paying premiums based on income. Extending Medicaid to Workers with Disabilities: The Medicaid Buy-In Program examines the participation and success of this program in a series of issue briefs. (June 2006)
From the National Academy of Social Insurance
Improving the Medicare Savings Programs details the findings of an independent panel tasked with developing strategies for enrolling more low-income seniors and people with disabilities in the Medicare Savings Programs (MSPs). It finds that the problem could largely be ameliorated by providing additional federal funding. That funding can then be used to increase participation through options such as using the information gathered by Social Security to facilitate enrollment in MSPs, or simplifying and liberalizing the eligibility rules to provide greater uniformity between the MSPs and the low-income Part D subsidy. (June 2006)
From the National Health Law Program
The Deficit Reduction Act of 2005 (DRA) will have a major impact on how Medicaid beneficiaries renew their coverage, as well as on how new applicants obtain coverage. This Web page provides descriptions of the act, its possible implications, discussions of its legality, and other resources, including reports titled “Role of State Law in Limiting Medicaid Changes” and “The Deficit Reduction Act of 2005: Implications for Advocacy.” (July 2006)
From the National Immigration Law Center
Many worry that the new Medicaid citizenship documentation requirements will affect immigrants’ access to care. Immigrants Are Not Affected by the New Medicaid Law explains that the procedures immigrants must follow for obtaining Medicaid coverage have not been changed. The report is also a useful resource for advocates working with immigrants. (June 2006)
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