New on the Web 60 (September 2009)
From the Commonwealth Fund: “Out of Options: Why So Many Workers in Small Businesses Lack Affordable Health Insurance, and How Health Care Reform Can Help,” “Paying Medicare Advantage Plans by Competitive Bidding: How Much Competition Is There?,” “Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2009 Update”
From the Department of the Treasury: “The Risk of Losing Health Insurance over a Decade: New Findings from Longitudinal Data”
From Health Affairs: “Containing Costs and Improving Care for Children in Medicaid and CHIP,” “Medicare Governance and Provider Payment Policy,” “How Medicare Could Get Better Prices on Prescription Drugs”
From the Journal of Women, Politics and Policy: “Health Coverage and Expenses: Impact on Older Women’s Economic Well-Being”
From the Kaiser Family Foundation: “In Pursuit of Affordable Health Care: On the Ground Lessons from Families in Massachusetts,” “Individuals with Special Needs and Health Reform: Adequacy of Health Insurance Coverage,” “Explaining Health Care Reform: What Are Health Insurance Subsidies?”
From the Robert Wood Johnson Foundation: “Health Reform in Massachusetts: An Update on Insurance Coverage and Support for Reform as of Fall 2008”
From the Urban Institute: “Current Health Reform Proposals: No Government Takeover of American Health Care”
From the Commonwealth Fund
Out of Options: Why So Many Workers in Small Businesses Lack Affordable Health Insurance, and How Health Care Reform Can Help examines why small businesses often have more difficulty offering their employees health insurance, as well as how the economic downturn has intensified the problem. The brief also outlines how measures in the health reform proposals, such as the creation of an exchange and tax credits for small businesses, could help small businesses and their employees gain access to affordable, comprehensive coverage. (September 2009)
Paying Medicare Advantage Plans by Competitive Bidding: How Much Competition Is There? details how private insurance companies that sell Medicare Advantage (MA) plans receive 13 percent more than traditional Medicare and examines reform proposals that recommend replacing overpayments with a system of competitive bidding. Often, a small number of insurance companies dominate the MA market, meaning that a system of competitive bidding could still be highly influenced by the bids of a few companies, limiting true competition. (August 2009)
Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2009 Update explains why young people ages 19-29 continue to be one of the largest and fastest-growing groups without health insurance and the possible repercussions of this trend. The brief also suggests policy reforms that could help young adults stay insured as they become more independent. (August 2009)
From the Department of the Treasury
The Risk of Losing Health Insurance over a Decade: New Findings from Longitudinal Data reveals that nearly half of all Americans under the age of 65 go without health insurance in a 10-year period. In fact, 36 percent will go without coverage for at least one full year during that period. Given the frequency of gaps in coverage among Americans under 65, the study concludes that, without health reform that expands coverage, these trends are likely to worsen in the years to come. (September 2009)
From Health Affairs
Containing Costs and Improving Care for Children in Medicaid and CHIP explains that spending in both programs is highly concentrated, particularly among children with chronic health problems. The report suggests that strategies to contain costs by reducing avoidable hospitalizations among children with chronic problems and policies that increase preventive care would help both CHIP and Medicaid better serve their enrollees. (September 2009) Subscription Required
Medicare Governance and Provider Payment Policy examines the decision-making processes governing Medicare and how they tend to become overly politicized by both Congress and the White House. The report makes several recommendations for protecting Medicare payment decisions from political interference, including establishing a new, independent Medicare policy board. (September 2009)
How Medicare Could Get Better Prices on Prescription Drugs examines federal spending for Medicare Part D plans under the current “noninterference” provision that prevents the government from negotiating prescription drug prices on behalf of enrollees. The report compares and assesses several options for reforming this system, including adopting a system of rebates similar to those used by state Medicaid programs, expanding the use of generic drugs, and other options that may reduce federal spending without requiring price negotiations. (July 2009) Subscription Required
From the Journal of Women, Politics and Policy
Health Coverage and Expenses: Impact on Older Women’s Economic Well-Being explores gender-based differences in health and long-term care use, spending patterns, and the financial burden of out-of-pocket expenses among Medicare beneficiaries. The study reveals that women’s health care expenses were higher than men’s, and older women had an even greater overall financial burden with less income at their disposal. It concludes that controlling health spending and developing options to help finance long-term care for Medicare enrollees are key to improving the economic security of older women. (August 2009)
From the Kaiser Family Foundation:
In Pursuit of Affordable Health Care: On the Ground Lessons from Families in Massachusetts details how the state’s health reform legislation has achieved near-universal coverage (94.7 percent) by combining a foundation of public coverage with greater access to private insurance through employers. While some budgetary challenges remain, the program has been largely successful, including a marked increase in job-based coverage. (September 2009)
Individuals with Special Needs and Health Reform: Adequacy of Health Insurance Coverage examines the health care needs and medical expenses of three individuals who require extensive acute and long-term care to discover how reform proposals can best serve those with special health needs. It concludes that a comprehensive benefits package, limits on out-of-pocket expenses, subsidies, and strong Medicaid programs are essential to ensuring that people with special needs are fully supported under health reform. (September 2009)
Explaining Health Reform: What Are Health Insurance Subsidies? explains what insurance subsidies are and how they can help lower-income families and individuals afford health coverage. The brief also examines different ways of structuring subsidies and describes how each would affect the reform proposals that are currently under discussion in Congress. (August 2009)
From the Robert Wood Johnson Foundation:
Health Reform in Massachusetts: An Update on Insurance Coverage and Support for Reform as of Fall 2008 provides an update of the impact on working-age adults, the primary target of reform policies, as well as an update on public support for health reform. The state has achieved its goal of near universal health coverage, and residents continue to show strong support for health reform, despite the rising costs of the program. (September 2009)
From the Urban Institute
Current Health Reform Proposals: No Government Takeover of American Health Care found that health reform proposals would create consumer protections to improve the quality of coverage, use subsidies to help make insurance more affordable, and build on existing public programs so that they are better able to serve those who qualify. Health reform would retain a strong private sector, increase consumer choices, and help the uninsured purchase insurance. (September 2009)
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