New on the Web 62 (November 2009)
From the Center for American Progress: “Insurers’ Black Box: Now-Secret Claims Denial Rates Could Tell Consumers a Lot about Their Insurance Company”
From the Children’s Partnership and the Kaiser Commission on Medicaid and the Uninsured: “Why Express Lane Eligibility Makes Sense for States and Low-Income Families”
From Health Affairs: “Uninsured Adults with Chronic Conditions or Disabilities: Gaps in Public Insurance Programs”
From the Kaiser Commission on Medicaid and the Uninsured: “Changes in Health Insurance Coverage, 2007-2008: Early Impact of the Recession,” “Medicaid Beneficiaries and Access to Care”
From the Kaiser Family Foundation: “Explaining Health Reform: What Is Comparative Effectiveness Research?”, “Medicare Advantage 2010 Data Spotlight: Plan Availability and Premiums,” “Medicare Part D Spotlight: Part D Plan Availability in 2010 and Key Changes Since 2006”
From the National Committee to Preserve Social Security and Medicare: “Price Negotiation for the Medicare Drug Program: It Is Time to Lower Costs for Seniors”
From the New England Journal of Medicine: “Physicians’ Views of the Massachusetts Health Care Reform Law—A Poll”
From the Robert Wood Johnson Foundation: “Achieving Universal Coverage through Comprehensive Health Reform: The Vermont Experience,” “Assuring Health Coverage for Rural People through Health Reform,” “Wisconsin’s BadgerCare Plus Coverage Expansion and Simplification: Early Data on Program Impact”
From the Center for American Progress
Insurers’ Black Box: Now-Secret Claims Denial Rates Could Tell Consumers a Lot about Their Insurance Company discusses the dramatic variation in denial rates among insurance companies in California—the only state that requires such data to be made public. The denial rates suggest insurers may be putting profits ahead of patients’ best interests. The brief argues that health reform proposals must require insurers to release their denial rates to help educate consumers. (October 2009)
From the Children’s Partnership and the Kaiser Commission on Medicaid and the Uninsured
Why Express Lane Eligibility Makes Sense for States and Low-Income Families explains how Express Lane Eligibility would help states streamline enrollment and renewal of children in Medicaid and CHIP by coordinating across programs. The brief highlights the potential benefits of an Express Lane Eligibility initiative, including increasing access to care for low-income children, making coverage more stable, and reducing administrative costs. (October 2009)
From Health Affairs
Uninsured Adults with Chronic Conditions or Disabilities: Gaps in Public Insurance Programs discusses why an increasingly large number of working-age adults with low incomes and chronic health conditions or disabilities lack insurance. The brief argues that narrow eligibility requirements for Medicaid often exclude this vulnerable group. Expanding these requirements to ensure greater access to coverage should be a priority in national health reform. (October 2009) Subscription Required
From the Kaiser Commission on Medicaid and the Uninsured
Changes in Health Insurance Coverage, 2007-2008: Early Impact of the Recession indicates that the sharp decrease in coverage over this time period (1.5 million newly uninsured adults) was largely due to declines in job-based insurance. Coverage through public programs has bridged some of this gap, but increases in coverage for children were substantially larger than for adults. (October 2009)
Medicaid Beneficiaries and Access to Care examines Medicaid’s role in providing access to health care for low-income children and adults. The brief explains that Medicaid has increased access to care, provides comprehensive and affordable coverage, and addresses the special needs of its target populations. It also notes that health reform provides a unique opportunity to expand and strengthen access through Medicaid. (October 2009)
From the Kaiser Family Foundation:
Explaining Health Reform: What Is Comparative Effectiveness Research? explains how such research could be used to reduce unnecessary treatments and lower costs. The brief discusses the kinds of treatments that could be compared, how the results will be used, and whether the research will actually save money. (October 2009)
Medicare Advantage 2010 Data Spotlight: Plan Availability and Premiums discusses information recently released by the Centers for Medicare and Medicaid Services (CMS) about Medicare Advantage Plans that will be available in 2010. The brief looks at plan options, availability, and premiums, and it highlights important changes between 2009 and 2010. (November 2009)
Medicare Part D Spotlight: Part D Plan Availability in 2010 and Key Changes Since 2006 uses information released by the Centers for Medicare and Medicaid Services (CMS) about Medicare Part D prescription drug plans that will be available in 2010. The brief provides an overview of the different options available in 2010 and highlights key changes from previous years. (November 2009)
From the National Committee to Preserve Social Security and Medicare:
Price Negotiation for the Medicare Drug Program: It Is Time to Lower Costs for Seniors explores the restriction that prohibits Medicare from negotiating for lower drug prices for beneficiaries. Without such a restriction, Part D, like other public programs such as Medicaid and the Department of Veterans Affairs (VA), could save billions of dollars and finally close the “doughnut hole.” (October 2009)
From the New England Journal of Medicine
Physicians’ Views of the Massachusetts Health Care Reform Law—A Poll shows that 70 percent of physicians in Massachusetts support the state’s health reform law. The support of doctors provides critical insight into how well the law is actually functioning and how it has affected access to high-quality health care. (October 2009)
From the Robert Wood Johnson Foundation
Achieving Universal Coverage through Comprehensive Health Reform: The Vermont Experience looks at three key dimensions of Vermont’s 2006 universal health care legislation: health coverage and affordability, access to health services, and sustainability. Early indications are that the reforms have been successful. Vermont continues to strengthen its system by improving health care quality and containing costs. (October 2009)
Assuring Health Coverage for Rural People through Health Reform compares health insurance trends of rural and urban residents. Rural workers tend to have less job-based coverage and pay more than urban workers for similar plans. Several provisions in the current health reform proposals, such as providing subsidies to purchase insurance and expanding Medicaid, would significantly benefit rural consumers. (October 2009)
Wisconsin’s BadgerCare Plus Coverage Expansion and Simplification: Early Data on Program Impact presents preliminary findings from an evaluation of BadgerCare Plus since its creation in February 2008. The program combines CHIP, Medicaid, and Healthy Start program dollars to create one larger, more streamlined program with expanded eligibility guidelines. Initial data look promising, and as the program develops, it will become clearer whether this type of reform is effective. (October 2009)
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