Category Archives: Health Care

New Reports Show Aggressive Efforts by States To Expand Coverage, but Indicate Economy and New Rules May Compromise Progress

Source: Kaiser Family Foundation Commission on Medicaid and the Uninsured, January 28, 2008

From press release:
New reports released today by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) describe aggressive efforts by states in the past year and a half to expand coverage to low-income children and their families, but the actions may be curtailed as a deteriorating economic climate and new limits on federal assistance take effect.

A downturn in the economy, the federal failure to reauthorize the State Children’s Health Insurance Program (SCHIP) and new federal rules affecting Medicaid and SCHIP eligibility all suggest that the recent period of aggressive expansion of coverage by states may be over. This is the conclusion based on a series of new studies by the KCMU, including a 50-state survey of eligibility and enrollment rules in Medicaid and SCHIP for children and families, interviews with Medicaid directors in ten states representing all regions of the country, and recent studies of enrollment in Medicaid and SCHIP.

Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles
Current Issues in Medicaid: A Mid-FY2008 Update Based on a Discussion with Leading Medicaid Directors
SCHIP Enrollment in June 2007: An Update on Current Enrollment and SCHIP Policy Directions
Medicaid Enrollment in 50 States: December 2006 Update
State Children’s Health Insurance Program (SCHIP): Reauthorization History

Updated Fact Sheets on Women’s Health Insurance Coverage

Source: Kaiser Family Foundation

Health insurance is a key element in ensuring access to health care for women, as women with coverage are more likely to obtain preventive, primary, and specialty care services. However, many women face barriers to obtaining coverage because they have limited access to private insurance or do not qualify for public programs. Kaiser has released two updated fact sheets that provide the most current information and data on health insurance coverage for women ages 18-64. The fact sheet, “Women’s Health Insurance Coverage,” provides new statistics on health coverage and describes the major sources of health insurance for non-elderly adult women, including employer-sponsored coverage, Medicaid, individually purchased insurance, and Medicare. It also summarizes the major policy challenges facing women in obtaining health coverage, and provides data on the more than 17 million women who are uninsured.

The second fact sheet, “Health Insurance Coverage of Women by State,” provides state-by-state data on the uninsured rate, as well as rates of private insurance and Medicaid coverage.

CMS Reports U.S. Health Care Spending Growth Accelerated Only Slightly in 2006, but Still Faster Than Economic Growth and General Inflation

Source: Centers for Medicare & Medicaid Services (HHS)

Health care spending growth in the United States accelerated slightly in 2006, increasing 6.7 percent compared to 6.5 percent in 2005, which was the slowest rate of growth since 1999. Health care spending, however, continues to outpace overall economic growth and general inflation, which grew 6.1 percent and 3.2 percent, respectively, in 2006.

In 2006, health care spending reached a total of $2.1 trillion, or $7,026 per person, up from $6,649 per person in 2005, according to a report by the Centers for Medicare & Medicaid Services (CMS). The health spending share of the nation’s Gross Domestic Product (GDP) remained relatively stable in 2006 at 16.0 percent, up by only 0.1 percentage point from 2005.

Health care spending data

Financial Burden of Health Care, 2001-2004

Source: Health Affairs (Commonwealth Fund)

Rising health care costs, combined with slowed economic growth, have created greater financial burdens for U.S. families in recent years–and raised the likelihood that they will face problems paying bills, accumulate medical debt, and even forgo needed medical care. In a Commonwealth Fund-supported study examining families’ financial burdens and out-of-pocket spending between 2001 and 2004, researchers found that by 2004, more than 45 million Americans lived in families with high financial burdens–spending more than 10 percent of their after-tax income on health care. That represents an increase of nearly 6 million people over 2001.

Full Report

Insurers Maintain Record Profits in 2007 by Overpricing Policies and Underpaying Claims

Source: Consumer Federation of America

From press release:
State and national consumer organizations joined the Consumer Federation of America (CFA) today to release a new study concluding that the property/casualty insurance industry continued in 2007 to systematically overcharge consumers and reduce the value of home and automobile insurance policies, leading to profits, reserves, and surplus that are at or near record levels. The study estimates that insurer overcharges over the last four years amount to an average of $870 per household.

The report provides extensive data demonstrating that property/casualty insurance companies are paying out lower claims in relationship to the premiums they charge consumers than at any time in decades. The pure loss ratio, the actual amount of each premium dollar insurers pay back to policyholders in benefits, was only 54.6 cents in 2007. Over the past 20 years, the amount paid back as benefits has dramatically declined from over 70 cents per premium dollar, indicating a huge loss in the value of insurance to consumers.

Full Report (PDF; 316 KB)

State Children’s Health Insurance Program: Program Structure, Enrollment and Expenditure Experiences, and Outreach Approaches for States That Cover Adults

Source: U.S. Governmental Accounting Office

In 2006 about 4.5 million individuals were enrolled in the State Children’s Health Insurance Program (SCHIP). Congress created SCHIP with the goal of significantly reducing the number of low-income uninsured children. Under certain circumstances, states may also cover adults, and in June 2006 about 349,000 adults were enrolled. Each state receives an annual allotment of federal funds, available as a federal match based on the state’s expenditures. Generally, states have 3 years to use each fiscal year’s allotment, after which unspent federal funds may be redistributed. Congress initially authorized SCHIP for 10 years, from 1998 through 2007, and provided approximately $40 billion for that period.

GAO examined (1) how 10 states that cover adults–parents, childless adults, or both–in SCHIP structured their programs; (2) these states’ enrollment and expenditure experiences for adults, which GAO considered in the context of those for all other SCHIP populations (children and pregnant women); and (3) the approaches these states adopted to attract all eligible individuals. To accomplish this, GAO reviewed 10 states that covered adults in SCHIP as of 2007. GAO interviewed officials in the 10 states; reviewed states’ 2006 annual reports and information available on states’ Web sites; and analyzed enrollment and expenditure data obtained primarily from the 10 states, as well as from the Centers for Medicare & Medicaid Services (CMS) and published sources.

Full-text

New Medicaid Rules Would Limit Care for Children in Foster Care and People With Disabilities in Ways Congress Did Not Intend

Source: Center on Budget and Policy Priorities

On December 4, the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services published interim final rules governing case management services provided by state Medicaid programs. CMS claims the new rules are necessary to implement changes Congress made in the Deficit Reduction Act of 2005 (DRA). In fact, the rules go well beyond what Congress intended in the DRA and would have a detrimental impact on beneficiaries, particularly poor children in foster care and poor individuals with physical or mental disabilities or other chronic health conditions.

Report

State Tobacco Settlement Report

Source: Campaign for Tobacco-Free Kids, American Heart Association, American Lung Association and American Cancer Society Cancer Action Network

Since the November 1998 multi-state tobacco settlement, we have issued regular reports assessing whether the states are keeping their promise to use a significant portion of their settlement funds – expected to total $246 billion over the first 25 years–to attack the enormous public health problem posed by tobacco use in the United States.

This year, we find that the states have made important progress by increasing funding for tobacco prevention and cessation programs by 20 percent to a total of $717.2 million in fiscal year 2008, which is the highest level in six years. However, most states still fail to fund tobacco prevention programs at minimum levels recommended by the U.S. Centers for Disease Control and Prevention (CDC), and altogether, the states are providing less than half what the CDC has recommended.

Complete Report (PDF; 5.7MB)
Individual state reports and supporting materials also available.

Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries

Source: Annals of Internal Medicine

From press release (American College of Physicians):
In a new evidence-based paper, the American College of Physicians (ACP) analyzes health care in the United States and 12 other industrialized countries and identifies lessons that could be applied to the particular political and social culture of the United States to achieve a high performing health care system, including achieving universal health insurance coverage for all Americans.

In the paper, “Achieving a High Performance Health Care System with Universal Access: What the USA Can Learn from Other Countries,” published on the Web site of ACP’s flagship journal, Annals of Internal Medicine, ACP notes that spending on health care in the United States is the highest in the world and has been rising at a faster pace than spending in the rest of the economy. Yet an estimated 47 million Americans – nearly 16 percent of the population – lack health insurance protection. Even among those with health insurance coverage, wide variations exist in terms of cost, utilization, quality, and access to health care services.

Statistics: Nearly One in Five Americans Say They Can’t Afford Needed Health Care

Source: Health, United States, 2007 Edition

From the summary/news release:
Nearly one in five U.S. adults – more than 40 million people – report they do not have adequate access to the health care they need, according to the annual report on the nation’s health released today by the Centers for Disease Control and Prevention (CDC).

The report, “Health, United States, 2007,” is a compilation of more than 150 health tables prepared by CDC’s National Center for Health Statistics. The report also contains a special section focusing on access to care, which shows that nearly 20 percent of adults reported that they needed and did not receive one or more of these services in the past year – medical care, prescription medicines, mental health care, dental care, or eyeglasses – because they could not afford them.