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  • Snapshots: Insurance Premium Cost-Sharing and Coverage Take-up

    Issue Brief

    One of the many reasons an individual may be uninsured is that she or he decides an employer’s offer of health insurance is too expensive. Several studies have noted the likelihood that a worker will decline an employer’s offer of health insurance increases with the amount he or she is required to contribute. Alternatively, employees may obtain coverage through a spouse, opt for publicly provided coverage if eligible, or decide to do without coverage entirely.…

  • Aging Out of Early and Periodic Screening, Diagnostic and Treatment (EPSDT): Issues for Young Adults with Disabilities

    Issue Brief

    Early and Periodic Screening, Diagnostic and Treatment (EPSDT) coverage offered through the Medicaid program has played an important and unique role for low-income children with disabilities, and maintaining this support is a key concern. This issue brief discusses the challenges and implications for young people with disabilities when they become adults and lose their EPSDT benefits and how recent changes to the Deficit Reduction Act give states an opportunity to increase the availability of services…

  • A Decade of SCHIP: Experience and Issues for Reauthorization

    Issue Brief

    A Decade of SCHIP: Experience and Issues for Reauthorization As the SCHIP program is due for reauthorization in 2007, this brief explores some lessons learned and highlights key policy issues for the upcoming debate. Issue Brief (.pdf)

  • Medicaid 1915(c) Home and Community-Based Service Programs: Annual Data Update

    Issue Brief

    Developing home and community-based service (HCBS) alternatives to institutional care has been a priority for many state Medicaid programs over the last two decades and the focus of Medicaid policy debates recently. While the majority of Medicaid long-term care dollars go toward institutional care, the national percentage of Medicaid spending on HCBS has more than doubled from 1992 to 2003. This report presents a summary of the main trends to emerge from the data for…

  • Profiles of Medicaid’s High Cost Populations

    Issue Brief

    This paper examines the role that Medicaid plays in addressing six populations (preterm birth babies, foster care children, individuals with spinal cord and traumatic brain injuries, individuals with mental illness, individuals with intellectual and developmental disabilities, and people with Alzheimer's disease) with serious health needs resulting in high costs. For each population profiled, the report describes the condition and the need for services and supports, as well as the role of Medicaid in meeting those…

  • Snapshots: Illustrating the Potential Impacts of Adverse Selection on Health Insurance Costs in Consumer Choice Models

    Issue Brief

    A current strategy for addressing the cost of health insurance involves consumer-directed health plans (CDHPs). These plans generally are less expensive than more traditional health plan designs, but it is not clear whether the lower costs derive entirely from the new benefit structure or whether some of the savings result because these new arrangements attract a disproportionate share of enrollees in good health who have relatively low health spending. Public discussions of enrollment bias tend…

  • Why Did the Number of Uninsured Continue to Increase in 2005?

    Issue Brief

    This paper examines health coverage trends in 2005 and places them in the context of trends occurring since 2000. The paper concludes that despite the improving economy, the percentage of the population with employer-sponsored insurance continued to decline while the number of the uninsured continued to increase. Issue Brief (.pdf)

  • Changes in Employees’ Health Insurance Coverage, 2001-2005

    Issue Brief

    This paper examines the underlying reasons behind the decline in employer coverage among employees from 2001 to 2005. The paper finds that almost half of the decline in employer-sponsored coverage was due to a loss of employer sponsorship. Another quarter of the decline was due to lost eligibility for benefits or losing access as a dependent of another employee. The remaining quarter of the decline was due to employees not participating in the offer of…

  • Health Savings Accounts and High Deductible Health Plans: Are They An Option for Low-Income Families?

    Issue Brief

    Health Savings Accounts (HSAs) are a type of medical savings account that allow consumers to save for medical expenses on a tax-fee basis. They are linked with high deductible health plans (HDHPs), and together these insurance and savings options represent a new approach to health care, commonly referred to as consumer-directed care. This brief, based on analyses of available data and research, finds that most low-income families would not benefit from HSA-HDHPs due to an…