Leading the Way? Maine’s Initial Experience in Expanding Coverage Through Dirigo Health Reforms

Source: Debra J. Lipson, James M. Verdier, and Lynn Quincy, Mathematica Policy Research, Inc., December 2007

In this evaluation of Maine’s health reform plan, researchers examine interim indicators of progress after two years of program implementation. Since enacting comprehensive health care reform in 2003, the effort has helped expand coverage for low- and moderate-income individuals. Yet by late 2006, the initiatives had enrolled less than 10 percent of previously uninsured residents.

Researchers identify both the successes and challenges of the program. They also consider how Maine’s experiences could serve as a lesson for other states which are exploring initiatives to expand access and provide affordable insurance.

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.

REAL ID Final Rule

Source: U.S. Department of Homeland Security

From press release:
The U.S. Department of Homeland Security (DHS) announced today a final rule establishing minimum security standards for state-issued drivers’ licenses and identification cards. The rule sets uniform standards that enhance the integrity and reliability of drivers’ licenses and identification cards, strengthen issuance capabilities, and increase security at drivers’ license and identification card production facilities. The final rule also dramatically reduces state implementation costs by roughly 73 percent.

Final Rule, Part 1 (PDF, 120 pages – 4.2 MB)
Final Rule, Part 2 (PDF, 164 pages – 5.6 MB)
Privacy Impact Assessment for REAL-ID (PDF; 277 KB)

If, When, How: A Primer on Fiscal Stimulus

Source: The Brookings Institution

Recent economic data provide the clearest signs that the problems in the housing and financial markets are affecting the economy as a whole. In December 2007 payroll employment growth fell nearly to zero and the unemployment rate rose 0.3 percentage points to 5.0 percent. The last time the unemployment rate climbed this much in one month was in the 2001 recession. Delinquency and foreclosure rates are rising and risk spreads in financial markets remain much wider than last summer. On the other hand, there are some reassuring indicators: net exports have been trending up, and consumer spending rose at a brisk pace in October and November. However, most forecasters are predicting a marked slowdown in economic growth for several quarters, and many put the odds of recession in the neighborhood of 50 percent.

Full Document (PDF; 913 KB)

ACLU Report: Government Must Abandon Misguided Approach to Pandemic Preparedness

Source: American Civil Liberties Union

As fears of a flu pandemic have grown, the Bush administration has pursued a misguided approach to pandemic preparation that relies on a law enforcement/national security approach, rather than a public health approach to the problem, and which exposes Americans to unnecessary risk. That is the finding of an expert report being released today by the American Civil Liberties Union at the National Press Club in Washington, DC.

“A law enforcement approach is just the wrong tool for the job when it comes to fighting disease,” said Barry Steinhardt, director of the ACLU’s Technology and Liberty Program. “History makes clear that a heavy-handed, coercive approach to pandemics that treats the sick as potential enemies is not only an unnecessary violation of civil liberties but is also ineffective from a public health standpoint and will leave more Americans stranded, sick and untreated.”

“When people are sick, they want help – help getting treated and help ensuring they don’t make others sick,” said Parmet. “History shows that treating sick people like potential enemies only spurs them to avoid the authorities and exacerbates the spread of disease.”

Full Report (PDF; 711 KB)

Sourcebook of Criminal Justice Statistics, 31st Edition

Source: Bureau of Justice Statistics

The Sourcebook of Criminal Justice Statistics brings together data from more than 100 sources about many aspects of criminal justice in the United States. These data are displayed in over 1,000 tables. The site is updated regularly as new statistics become available. The Sourcebook is supported by the U.S. Department of Justice, Bureau of Justice Statistics.

Data tables are organized into six topical sections. Access information of interest by browsing the content lists of these sections, the index, or by searching the website. You will be directed to individual tables displayed separately in Adobe® Acrobat and spreadsheet formats.

To be aware of newly added material see this page.

The Maturing of America — Getting Communities on Track for an Aging Population

Source: National Association of Area Agencies on Aging, in partnership with the International City/County Management Association, National Association of Counties, National League of Cities and Partners for Livable Communities (via Smart Growth Resource Library)

The vast majority of older Americans want to age in their homes and communities for as long as possible. However, the aging of the population will pose new challenges for the delivery of local services such as health care, recreation, housing, transportation, public safety, employment and education. While these services assist a broad segment of the population, they also have a major impact on the quality of life of older Americans. The aging of America will also present opportunities as the nation’s communities realize the largest population of educated and skilled older adults in its history. To help cities and counties better meet the needs of their aging population, and to harness the experience and talent of their older citizens, five national organizations joined forces to identify ways to prepare for the aging of this population. Known as The Maturing of America — Getting Communities on Track for an Aging Population, the project is being led by the National Association of Area Agencies on Aging, in partnership with the International City/County Management Association, National Association of Counties, National League of Cities and Partners for Livable Communities. The initiative is funded by a grant from MetLife Foundation. In the project’s first phase, Maturing of America partners surveyed 10,000 local governments to:
• determine their “aging readiness” to provide programs, policies and services that address the needs of older adults and their caregivers;
• to ensure that their communities are “livable” for persons of all ages; and
• to harness the talent, wisdom and experience of older adults to contribute to the community at large.

The survey found that only 46 percent of American communities have begun to address the needs of the rapidly increasing aging population. The survey results show that although many communities have some programs to address the needs of older adults, few have undertaken a comprehensive assessment to make their communities “elder friendly” or livable communities for all ages.

Survey findings indicate that local governments generally offer basic health and nutrition programs, but as yet do not have the policies, programs or services in place to promote the quality of life and the ability of older adults to live independently and contribute to their communities for as long as possible. These services might include job retraining, flextime and other job accommodations; home chore services, home modification and senior-friendly housing options, tax relief, roadway redesign or public transportation assistance as well as volunteer opportunities targeted to older adults.

The needs of older adults are often interrelated. For example, providing housing will not be sufficient if residents lack transportation to get to basic services such as medical offices, the pharmacy or grocery store. These interdependent needs of older adults may require a completely new comprehensive, holistic approach to service delivery organization and management. American’s communities need to take a fresh look at their existing policies, programs and services to see if they address the needs of an aging population. Those communities who have already begun to test their “aging readiness” are now reaching out to their older citizens to engage them in discussions about what changes to local government services may be needed to enhance their quality of life and ensure that they can grow old successfully in the community.

Full Report (PDF; 2.8 MB)

Effect of State Food Stamp and TANF Policies on Food Stamp Program Participation

Source: USDA Economic Research Service

The effectiveness of the Food Stamp Program (FSP) depends on the extent to which it reaches those who are entitled to benefits. In the mid- to late 1990s, participation fell sharply. In recent years, it rebounded somewhat, reaching 65.1 percent in 2005. Changes in participation patterns can be attributed partly to economic fluctuations, but they were also shaped by the rapidly changing State policy environment. This study combines data from the Survey of Income and Program Participation, 1996-2003, with data on State-level food stamp, welfare, minimum wage, and Earned Income Tax Credit policy to investigate the effects of policy on food stamp participation. The findings show strong evidence that some FSP policy reforms made after 1999 (such as more lenient vehicle-exemption policies, longer recertification periods, and expanded categorical eligibility) increased food stamp participation. The use of biometric technology, such as fingerprinting, however, lowered participation. The study shows less consistent evidence that more lenient immigrant eligibility rules, simplified reporting, Electronic Benefit Transfers, or outreach spending raised food stamp participation.

Disclaimer: This study was conducted by The Urban Institute under research agreement number 43-3AEM-3-80085 with the Economic Research Service. The views expressed are those of the authors and not necessarily those of ERS or USDA.

Full Report (PDF; 387 KB)

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