U.S. State Health Policy, Public Opinion & Research

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Statehealthfacts.org
This redesigned and updated website provides the latest state-level data on demographics, health, and health policy, including health coverage, access, financing, and state legislation and budgets.

State Variation and Health Reform: A Chartbook
This chartbook and related interactive tables and maps present a variety of state-level economic and health care data that help illustrate the disparate impacts of potential health reform on the 50 states and the District of Columbia.

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Medicaid and Managed Care: Key Data, Trends, and Issues -- February 2010

This policy brief provides an overview of the Medicaid program’s increasing reliance on managed care to deliver services. The goal of this approach is to improve access to care and coordination of care by assuring that enrollees have a "medical home" with a primary care provider, and to rely more heavily on preventive and primary care.

State High-Risk Pools: An Overview -- January 2010

This issue brief provides an overview of the primary components of state high-risk pools, discusses their benefits and challenges, and concludes with a discussion of high-risk pools in national health reform.

Building an Express Lane Eligibility Initiative: A Roadmap of Key Decisions for States -- January 2010
The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) includes new Express Lane Eligibility provisions that provide states new options to reach and enroll eligible but uninsured low-income children into Medicaid and CHIP by relying on eligibility findings from other need-based programs, such as Head Start or the National School Lunch Program. This brief, the third in a series called Putting Children on the Express Lane to Health Insurance, brief provides an overview of key decisions a state will need to address in designing an ELE initiative.

Medicaid and Children’s Health Insurance Program Provisions in Health Reform Bills: Affordable Health Care for America Act & The Patient Protection and Affordable Care Act – January 2010 -- January 2010
This brief compares the Medicaid and Children's Health Insurance Program provisions in the House health reform legislation, the Affordable Health Care for America Act, as passed by the full House on Nov. 7, 2009, with the Senate’s reform legislation, the Patient Protection and Affordable Care Act, as passed on Dec. 24, 2009.

Access to Abortion Coverage and Health Reform -- January 2010
This issue brief discusses the treatment of coverage for abortion services under the major health reform bills and explores the possible impact of the leading House and Senate passed legislation on coverage for abortion services.

Alternatives for Financing Medicaid Expansions in Health Reform -- December 2009

This report examines alternative ways of financing Medicaid expansions than those included in leading health reform legislation in the House and Senate. The analysis shows that it is possible to distribute increased federal payments in multiple alternative ways that could be less complicated and would avoid the inequities associated with providing higher matching rates just for new eligible Medicaid enrollees.

Coverage of Low-Income Children: Key Issues to Consider in Health Reform -- December 2009
This issue brief examines several key issues to consider about low-income children's coverage under health reform. It will be important to consider how to build upon Medicaid and CHIP, develop effective relationships and transitions between public and private coverage, and assure that low-income children receive coverage that meets the full range of their health needs. Adequately planning and funding for the transition to reform will be key to preventing any disruptions in children's coverage or care.

Protecting Children During the Recession: Spotlight on State Health Coverage Efforts -- December 2009

This issue brief highlights the experience of seven states (Alabama, Maryland, New Jersey, New York, Oklahoma, Texas and Vermont) in protecting children's health coverage during the beginning of the recession. In these seven states alone, 500,000 children gained coverage in 2008, representing nearly two-thirds of the national decline in uninsured children.

A Foundation for Health Reform: Findings of An Annual 50-State Survey of Eligibility Rules, Enrollment and Renewal Procedures and Cost-Sharing Practices in Medicaid and CHIP for Children and Parents During 2009 -- December 2009

Findings of an annual 50-state survey of Medicaid and CHIP eligibility and enrollment policies, as well as other papers on states' efforts to cover children and low-income adults.

Medicaid Home and Community-Based Service Programs - Data Update -- November 2009

This report presents a summary of the main trends to emerge from the latest (2006) expenditures and participant data for the three main Medicaid Home and Community-Based Service programs: optional 1915 (the letter "c") HCBS waivers; the mandatory home health benefit; and the optional state plan personal care services benefit.

The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) includes new Express Lane Eligibility provisions that provide states new options to reach and enroll eligible but uninsured low-income children into Medicaid and CHIP by relying on eligibility findings from other need-based programs, such as Head Start or the National School Lunch Program. This brief, the third in a series called Putting Children on the Express Lane to Health Insurance, brief provides an overview of key decisions a state will need to address in designing an ELE initiative.

This brief compares the Medicaid and Children's Health Insurance Program provisions in the House health reform legislation, the Affordable Health Care for America Act, as passed by the full House on Nov. 7, 2009, with the Senate’s reform legislation, the Patient Protection and Affordable Care Act, as passed on Dec. 24, 2009.

This issue brief discusses the treatment of coverage for abortion services under the major health reform bills and explores the possible impact of the leading House and Senate passed legislation on coverage for abortion services.

This issue brief examines several key issues to consider about low-income children's coverage under health reform. It will be important to consider how to build upon Medicaid and CHIP, develop effective relationships and transitions between public and private coverage, and assure that low-income children receive coverage that meets the full range of their health needs. Adequately planning and funding for the transition to reform will be key to preventing any disruptions in children's coverage or care.

Findings of an annual 50-state survey of Medicaid and CHIP eligibility and enrollment policies, as well as other papers on states' efforts to cover children and low-income adults.

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State Health Policy

States play a major role in the delivery and financing of health care and public health in the United States. Insurance regulation, Medicaid policy and financing of public health services, and many reproductive health policies are under state jurisdiction. States operate their own Medicaid programs within broad federal guidelines, the State Children’s Health Insurance Program (SCHIP) for low-income children, and in some cases also offer additional health care programs such as discount drug programs for seniors.

In recent years, states have been facing major budget shortfalls. These fiscal constraints have broad implications for many aspects of the health care financing and delivery system. Recent reductions to Medicaid coverage and benefit packages have been a reversal from the programs expansions of the late 1990s when states experienced unprecedented budget surpluses. State legislatures are also playing an increasingly important role in health policy, enacting legislation on issues that have been controversial and slow-moving at the national level, such as patients’ rights and reproductive health.

The Foundation’s work in state health policy cuts across nearly all of the Foundation’s policy priority areas. The Kaiser Commission on Medicaid and the Uninsured analyzes state Medicaid and SCHIP programs, and tracks changes states are making to their Medicaid programs as a result of their deteriorating fiscal conditions. The California Health Policy Program provides information and analysis about health policy issues and key trends in the nation's largest and most diverse state. Nearly all of the Foundation’s priority areas collect and conduct analyses on state-based policies. Much of this information is presented in State Health Facts Online, a web-based interactive database, including demographic information, health insurance coverage rates, Medicaid and Medicare enrollment, spending and policies, private insurance mandates, health care financing and delivery information, as well as disease and mortality statistics.