SUMMARIES OF
KAISER REPORTS
Apr 2004- Nov 2003
PUBLICS ATTITUDE TOWARD PRIORITIES IN HEALTH INSURANCE
Data from the 2003 Kaiser Health Insurance survey is used to examine the public's expectations and priorities for health insurance and their attitudes towards employer-sponsored coverage. It also explores people's opinions about several alternative health insurance plans that are currently under consideration. 1) A large majority of non-elderly adults says that the most important reason to have insurance is to protect against high medical bills (71%), rather than to pay for everyday health care expenses (25%). 2) Nearly six in ten (57%) insured adults under age 65 say they feel well protected by their insurance plan while nearly four in ten (38%) say they worry that they may have health care needs that will not be covered. 3) When given the choice, 55% of adults with employer-sponsored insurance would prefer to continue to have their employer pay for their coverage, rather than receive cash to buy insurance on their own (7%); 37% say it wouldn't make much difference either way.
CLICK HERE for the original Kaiser document .
STATE PRESSURED BY SCHIP AND MEDICAID
Medicaid and the State Children's Health Insurance Program (SCHIP) have helped to offset growth in the uninsured population by providing access to health care amid weak economic conditions. But states continue to face budget pressures that could limit public coverage. 1) Medicaid grew at an average rate of 9.5 percent in fiscal year (FY) 2004, basically unchanged from FY2003; 2) The major factors contributing to cost growth were increases in enrollment as a result of the economic downturn, rising prescription drug costs, and increasing overall health care costs; 3) Over the last four years 38 states took actions to cut eligibility and 34 states acted to limit benefits; and 4) Thirty-nine Medicaid directors expect pressure on their programs to grow in FY2005 while the remaining 12 expect the pressure to remain constant at current levels.
CLICK HERE for the reports and related materials
EMPLOYERS ARE COVERING LESS HEALTH INSURANCE COSTS
Employer-sponsored health insurance premiums increased an average of 11.2% in 2004 -- less than last year's 13.9% increase, but still the fourth consecutive year of double-digit growth. Premiums for employer-sponsored health insurance rose at about five times the rate of both inflation (2.3%) and workers' earnings (2.2%). This year, premiums reached an average of $9,950 annually for family coverage ($829 per month) and $3,695 ($308 per month) for single coverage, according to the new survey. In 2004, family premiums for PPOs, which cover most workers, rose to $10,217 annually ($851 per month), up significantly from $9,317 annually ($776 per month) in 2003. Since 2001, premiums for family coverage have risen 59%. There are at least 5 million fewer jobs providing health insurance in 2004 than 2001. The decline in the percentage of small employers (three to 199 workers) offering health insurance over this period is a likely contributing factor.
CLICK HERE for the reports and related materials
DATA ON PRESCRIPTION DRUG USE AND SPENDING BY STATE
Data on prescription drug use and spending for all 50 states and the U.S. includes the number of retail prescriptions filled, retail prescriptions filled per capita, the average price of prescriptions, and total spending on retail prescriptions for each state. The percent change from 2002 to 2003 for these indicators is also included. The 2003 data are available by age group and gender. The data show that retail prescription sales totaled $163 billion across the US in 2003, with about 3.1 billion retail prescriptions filled. Average price per retail prescription varied across states - from a low of $45 in New Mexico and Arkansas to $67 in Alaska and in the District of Columbia. The nation averaged about 11 prescriptions per capita in 2003, with women filling an average of 13 prescriptions in 2003 and men filling an average of 8 prescriptions. Seniors (age 65 and older) filled an average of 26 retail prescriptions in 2003, ranging from a high of 37 in Tennessee to a low of 16 prescriptions in Alaska.
CLICK HERE for the original Kaiser documents
CENSUS DATA ON THE UNINSURED - SUMMARIES
The US Census Bureau released annual update on health insurance coverage and the number of uninsured Americans. Several Kaiser resources provide background: 1) A fact sheet describing the characteristics of the uninsured population, the difference health insurance makes, and why there is a large uninsured population.
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2) For a fact sheet and report detailing job-based coverage patterns and profiling uninsured workers
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3) For a fact sheet summarizing whether being uninsured is a short- or long-term condition for most individuals
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4) For "The Cost of Care for the Uninsured: What Do We Spend, Who Pays, and What Would Full Coverage Add to Medical Spending?" which finds that uninsured Americans could incur nearly $41 billion in uncompensated health care treatment in 2004, with federal, state and local governments paying as much as 85% of the care. It also finds that if the country provided coverage to all the uninsured, the cost of additional medical care provided to the newly insured would be $48 billion.
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5) For "At The Edge: Near Elderly Americans Talk About Health Insurance" which profiles six uninsured individuals as they struggle to maintain their lives during the years preceding Medicare eligibility.
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6) and for "Challenges and Tradeoffs in Low-Income Family Budgets: Implications for Health Coverage" which explores the experiences of families trying to make ends meet on limited budgets by discussing these families' work, spending patterns, financial challenges, priorities and tradeoffs and health care and coverage.
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MAJORITY OF AFRICAN AMERICANS SAY US LOSING GROUND ON HIV/AIDS
African Americans name HIV/AIDS the most urgent health problem, while Latinos place it the second most urgent behind cancer. 56% of African Americans (and 67% of young African-Americans, age 18-29) say the U.S. is losing ground on HIV/AIDS - an 18 percentage point increase since October 2003. Overall, the public ranks HIV/AIDS second, behind cancer, as the most urgent health problem facing the nation. In addition to being the most concerned about HIV/AIDS for the nation, African Americans are also most likely to say they personally know someone who currently has or has died from HIV/AIDS (64%), compared with about four in ten whites (42%) and Latinos (41%).
CLICK HERE for the original Kaiser document
RACIAL DISPARITIES IN CARDIAC CARE
"Disparities in Cardiac Care: Rising to the Challenge of Healthy People 2010," examines the evidence on racial/ethnic disparities in medical care, with a specific focus on cardiac care. The report was one part of a national initiative to raise physician awareness about racial and ethnic disparities in medical care. While the evidence is compelling, a nationally representative survey of physicians reveals that the majority of physicians still do not believe that a patient's racial/ethnic background is a factor in obtaining health care. Increasing physicians' awareness of the evidence on racial/ethnic disparities in care is important because most doctors are in a good position to directly and indirectly affect changes in clinical practice and patient behavior.
CLICK HERE for the original Kaiser document
POLL ABOUT CARING FOR THE DISABLED
June 22, 2004 marks the fifth anniversary of the US Supreme Court decision in the case of Olmstead v. L.C., which found that the unjustified institutional isolation of people with disabilities is a violation of the Americans with Disabilities Act of 1990 (ADA). A large majority of the public (82%) believes that life has gotten better for people with disabilities in the last fifty years. However, six in ten adults say that people with disabilities have too little influence in our society today, compared with about a third (34%) who say these people have the right amount of influence, and 3% who say they have too much influence. In addition, about two-thirds (65%) say there is a lot or some discrimination against people with disabilities in this country today, and four in ten say that our health care system very or somewhat often treats people unfairly based on physical disability.
The public is generally supportive of policy measures to help people with disabilities, but these reforms are not usually at the top of the list of competing health priorities. More than nine in ten say they would strongly or somewhat support various health reforms related to funding for people with disabilities, including government funding for long-term care insurance and volunteer organizations that help those who need ongoing care, and tax breaks for people who provide unpaid care to disabled family members. Three-quarters say that helping families with the cost of long-term care for elderly or disabled family members is a very important issue for the President and Congress to deal with.
CLICK HERE for the original Kaiser document .
ADA AND STATUS OF DISABLED WITH REGARD TO MEDICAID AND OTHER PROGRAMS
Five years after the Supreme Court's landmark Olmstead decision applying the Americans with Disabilities Act to the right of individuals with disabilities to receive health care in a community-based setting, two new reports and a video examining what progress has been made and the impact on the Medicaid program.
CLICK HERE1) "Interaction of the Americans with Disabilities Act and Medicaid" describes the relationship of the Americans with Disabilities Act and Medicaid services and the impact of the U.S. Supreme Court's Olmstead v. L.C. decision. You may view the reports and related materials at
CLICK HERE
2) "Assessing the Impact" brings together new research with a synthesis of research undertaken over the past five years, to help policymakers and program administrators understand the meaning of the Americans with Disabilities Act for health programs in Olmstead's aftermath. You may view the reports and related materials at
CLICK HERE
OREGON EXAMPLE IN MEDICAID RESTRUCTURING FOR DISABLED COSTS
Over the past three years, the fall off in state revenues, combined with rising health care costs, has prompted every state to make changes in its Medicaid program. Oregon recently restructured its Medicaid program through a Section 1115 waiver and other program changes, largely in response to particularly difficult state budget problems. "The Impact of Recent Changes in Health Care Coverage for Low-Income People: A First Look at the Research Following Changes in Oregon's Medicaid Program" summarizes key findings on the impact of Oregon's changes.
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The experience in Oregon may be instructive, as other states have implemented or are considering implementing similar changes and include: 1) Premiums led to significant Medicaid coverage losses and most of those who lost Medicaid became uninsured, 2) Losses in coverage dwarfed coverage gains because only some parts of the waiver were implemented, 3) Cost sharing and limited benefits made it more difficult for people enrolled in the program to obtain needed care, 4) Medicaid reductions appeared to increase pressures on other of the health care system, and 5) Coverage reductions created short-term savings, but they resulted predominately from reduced coverage and care.
You may view the reports and related materials at
CLICK HERE
ELECTION YEAR UPDATE
Covering America's uninsured population remains a major health policy concern and the latest data indicates that the population saw its largest increase in over a decade. Some political leaders in Washington, DC have discussed putting forward new proposals to cover the uninsured population and Presidential candidates have offered their visions of how to expand coverage. With the upcoming election year likely to increase discussion of this policy issue, the Kaiser Commission on Medicaid and the Uninsured is releasing its latest analysis of federal government data and a side-by-side summary of the Presidential candidates' proposals to expand health coverage.
CLICK HERE for these documents. are available at and
** The Number of Nonelderly Uninsured Increased by 2.4 Million in 2002, to a Total of 43.3 Million.
In 2002, the effect of the economic downturn persisted and, for the second straight year, the primary reason more Americans lost insurance was due to decreased employer-sponsored coverage. Public coverage through Medicaid and SCHIP increased both years, leading to the proportion and number of uninsured children remaining steady in the face of a significant drop in their private coverage. As a result, adults accounted for nearly all of the growth in the number of uninsured in 2002.
** Nearly Two-Thirds of the Uninsured Have Low Family Incomes.
Over one-third of the poor and over one-quarter of the near-poor have no health insurance.
** Twenty-Six Million Workers are Uninsured; Over 80 Percent of the Uninsured Come from Working Families.
Over half of uninsured workers were fully employed for the entire year; blue-collar workers comprise 81 percent of uninsured workers.
These documents include:
>> "Health Insurance Coverage in America: 2002 Data Update" - provides 2002 data on health insurance coverage, with special attention to the uninsured and includes trends and major shifts in coverage and a profile of the uninsured population.
>> "The Uninsured and Their Access to Health Care" - a basic summary of the uninsured problem.
>> "The Uninsured: A Primer, Key Facts About Americans Without Health Insurance" - an in-depth discussion of the basic profile of the uninsured population, how they receive care, and what options for coverage are being discussed.
>> "Side-by-Side Summary of Presidential Candidates' Proposals for Expanding Health Insurance Coverage"
MOST SENIORS UNAWARE OF MEDICARE LAW'S PROVISIONS
The latest Kaiser Family Foundation Health Poll Report underscores the need to educate seniors about the new Medicare prescription drug program - both the transitional discount card program that will be go into effect on June 1st of this year, and the full Medicare benefit that begins in January of 2006. When asked if the new Medicare law includes a prescription drug discount card, about six in 10 seniors "didn't know enough to say" (54%) or said it wasn?t included (7%). About four in 10 (38%) knew a Medicare prescription drug discount card will be available this year.
Awareness of the subsidy for low-income seniors is even lower, with only 18% of seniors and 14% of the general public aware of a new $600 subsidy to help low-income seniors with their drug costs. Asked about the subsidy, 76% of seniors "didn't know enough to say" if it was included and 5% said it was not included.
CLICK HERE for the full results.
TAX CREDITS AND TAX DEDUCTIONS
The use of tax credits and tax deductions for people purchasing non-group health insurance are being discussed as possible options to help some of the more than 43 million uninsured people in America. A new report looks at the coverage and cost impacts of the Administration's tax credit and tax deduction proposals in the 2005 federal budget.
CLICK HERE for the detailed findings .
LARGE FIRMS INCREASE RETIREE CONTRIBUTIONS TO PREMIUMS
Of the largest U.S. employers 10% say they eliminated subsidized health benefits for future retirees in the past year, while 20% say they are likely to terminate retiree health coverage for future retirees in the next three years. These changes primarily affect new hires, rather than current retirees. The survey of large, private-sector employers was conducted and analyzed by the Kaiser Family Foundation and Hewitt Associates. Other findings include:
* The total cost for employers of providing retiree health benefits to pre-65 and age 65+ retirees and their dependents increased by an estimated 13.7% from $18.1 billion in 2002 to an estimated $20.6 billion in 2003.
* 46% of surveyed firms have placed "caps" (pre-determined limits) on their future financial retiree health obligations while one-third of all surveyed firms offering health benefits to pre-65 retirees and age 65+ retirees have either hit their cap or expect to hit their cap on retiree health obligations within the next one to three years.
* 71% of large-private sector firms surveyed increased retiree contributions to premiums in 2003. Retiree contributions and premiums increased by 20% for pre-65 retirees and by 18% for age 65+ retirees between 2003 and 2003.
* 86% of surveyed firms say they are likely to increase retiree contributions to premiums and 70% expect to increase contributions for dependent coverage, within the next three years.
CLICK HERE for the complete survey findings
HEALTH INSURANCE -CRITICAL ISSUE FOR WOMEN
Health insurance remains a critical issue for women - nationally 16 million women lack coverage. To provide up-to-date statistics on women's coverage at the state level. Nationally, 17.7% of women ages 18 to 64 are uninsured. Among the states, the uninsured rate varies considerably. Among low-income women with incomes below 200% of poverty, more than one-third are uninsured. Minnesota has the lowest percentage of uninsured women (7.9%), while Texas has the highest (28.3%). Rates of uninsured low-income women in the states range from a low of 18.9% in Massachusetts to a high of 50% in Texas.
Medicaid provides coverage for more than one in five low-income women nationally.
> Medicaid's role for women varies significantly among states. In Massachusetts, Vermont, Tennessee, Rhode Island, and the District of Columbia, more than one-third of low-income women have Medicaid, compared to Nevada, Colorado, New Hampshire, Wyoming, and Texas where fewer than 15% of low-income women are covered.
> Private coverage is less common among low-income women. 42.6% of low-income women in the U.S. have private health insurance, with a low of 35% in Alaska, New Mexico, and the District of Columbia.
CLICK HERE for the fact sheet .
DOCUMENTS DISCUSSING MEDICARE DRUG BENEFIT, STATES
"Coordinating Medicaid and Medicare Prescription Drug Coverage" reports on a discussion with state Medicaid officials on the implications of a Medicare drug benefit for states and dual eligibles. The discussion group was concerned that the proposals did not account for the states' current budget situations and their capacity to take on significant new responsibilities under a new initiative, particularly new administrative and coordination duties regarding low-income subsidies and dual eligible coverage. The group also was concerned that some provisions under discussion may inadvertently reduce coverage from current levels for Medicaid beneficiaries.
A key issue is whether to include those dually eligible for Medicare and Medicaid in the proposed Medicare drug benefit. Currently, states pay for the prescription drugs for dual eligibles. "Shifting the Cost of Dual Eligibles: Implications for States and the Federal Government" details that all care for this population accounts for over 42 % of Medicaid spending on services. With the dual eligible population growing, how to handle the increasing cost of caring for this population is a central issue for both Medicare and Medicaid policy. This publication provides state-level estimates on spending on dual eligibles and illustrates the fiscal effects of scenarios where the federal government assumes the cost of prescription drugs, Medicare premiums, acute care, and long-term care for this population.
CLICK HERE for the original Kaiser documents
RACIAL AND ETHNIC DISPARITIES IN WOMEN'S HEALTH COVERAGE
Access to care for low-income women and racial and ethnic disparities in women's health coverage are important public policy challenges. To document the health access challenges that low-income women and women of color face two issue briefs were prepared from the 2001 Kaiser Women's Health Survey. The reports include these two documents:
"Racial and Ethnic Disparities in Women's Health Coverage and Access to Care" - This brief finds that there are significant differences between women of color and white women that cut across insurance coverage, communication with health care providers, use and site of care, and perceived quality of care.
"Health Coverage and Access Challenges for Low-Income Women" - This analysis examines the experiences of low-income women in gaining access to health care. For example, compared to their higher income counterparts, low-income women are more than three times as likely to be uninsured, twice as likely to lack a usual source of care, and nearly three times as likely to delay or forgo care due to costs.
CLICK HERE for these issue briefs
UNINSURED AMERICANS COULD INCUR NEARLY $41 BILLION IN UNCOMPENSATED HEALTH CARE
Uninsured Americans could incur nearly $41 billion in uncompensated health care treatment in 2004, with federal, state and local governments paying as much as 85 percent of the care. Even with uncompensated care, the study shows that people uninsured for the entire year can expect to receive about half as much care as people fully insured.
Another major finding of the study, authored by Urban Institute researchers Jack Hadley and John Holahan, is that if the country provided coverage to all the uninsured, the cost of additional medical care provided to the newly insured would be $48 billion-an increase of 0.4 percent in health spending's share of the gross domestic product.
"Leaving 44 million Americans uninsured exacts a substantial price on society as well as individuals, while covering the uninsured would improve their health care without generating large increases in overall health spending," said Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured.
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