This brief explains the proposed federal rule that requires private health plans to provide a short, easy-to-read uniform summary of benefits and coverage to all health insurance applicants and enrollees. The rule, which implements a provision in the Affordable Care Act (ACA), is intended to make it simpler for consumers to compare health plans before they enroll and understand their coverage once they are enrolled. Currently, consumers in employer-sponsored plans receive summaries of their benefits, but in many cases they’re written in complex, technical language and can be 100 pages long.

The brief details what must be included in the summary of benefits and coverage and how the information must be presented to consumers. The brief also discusses the potential costs to insurers and third-party administrators for implementing the regulation and the benefits to consumers of having more understandable, standardized information about their health coverage.

Issue Brief (.pdf)

This data note examines public opinion among Washington, D.C.’s black residents about HIV/AIDS through a new analysis of the findings of the May 2011 Washington Post/Kaiser Family Foundation 2011 Survey of District of Columbia Residents. The District of Columbia has one of the highest AIDS rates in the nation, and black residents have been especially hard hit by the epidemic, accounting for about three-quarters of people living with HIV/AIDS in the city. Yet experiences and attitudes about HIV/AIDS can differ greatly across various groups of black residents, and this analysis – a joint project of the Disparities Policy Project and Public Opinion and Survey Research teams – examines that variation, taking into account the way views and concerns differ by age, education and geography.

Data Note (.pdf)

State revenues have been rebounding after experiencing a severe decline caused by the Great Recession that ran from December 2007 through June 2009. Nevertheless, tax collections remain below their 2008 peak level and state and local governments continue to shed jobs. As states prepare their fiscal year 2013 budgets, some are projecting a fifth consecutive year of gaps between expected revenues and spending.

This policy brief analyzes recent developments in state government finances and prospects for the future. After an overview of state revenue sources and spending priorities, it discusses what happened in the Great Recession and how states and the federal government responded. The brief then considers challenges to states’ long term fiscal sustainability.

Issue Brief (.pdf)

This issue brief provides an overview of California’s “Bridge to Reform” Medicaid Demonstration Waiver, which was approved in 2010 and will make up to roughly $8 billion in federal Medicaid matching funds available to California over a five-year period to expand coverage to low-income uninsured adults and preserve and improve the county-based safety-net. The waiver also allows the state to enroll Medicaid-eligible seniors and persons with disabilities into managed care plans that meet specified readiness and network adequacy requirements. Enrollment in the coverage expansion is targeted to begin on a county-by-county basis on July 1, 2011 and the transition of seniors and people with disabilities into managed care plans was scheduled to start on June 1, 2011.

The California waiver may serve as a model for other states to use Section 1115 Medicaid demonstration waivers to facilitate the transition to health reform in 2014. Operational experience from the waiver could help to inform implementation of the ACA by other states, safety net providers, and the federal government. A related fact sheet on the California waiver is also available.

Fact Sheet (.pdf)

Issue Brief (.pdf)

There is increased interest among states in operating Medicaid managed long-term services and support (MLTSS) programs rather than paying for long-term services and supports (LTSS) on a fee-for-service basis, as has been the general practice. This issue brief examines key issues for states to consider if they are contemplating a shift to covering new populations and LTSS benefits through capitated payments to traditional risk-based managed care organizations (MCOs). It draws on current literature as well as discussions conducted during the spring and summer of 2011 with a variety of respondents – federal and state officials, researchers, representatives from managed care organizations, service providers, and consumer advocates.

Issue Brief (.pdf)

The nation’s primary payer for long-term services and supports, Medicaid finances 43 percent of all spending on long-term care services and covers a range of services and supports, including those needed by people to live independently in the community, as well as services provided in institutions.

This report provides an overview of long-term care users and their acute and long-term care service spending. The report finds that although the individuals who rely on long-term care are diverse and comprised only six percent of the Medicaid population in 2007, they accounted for nearly half of total Medicaid spending that year.

Issue Brief (.pdf)

This analysis uses the Center for Studying Health System Change’s (HSC) 2010 Health Tracking Household Survey, the 2007 HSC Health Tracking Household Survey and the 2003 HSC Community Tracking Household Survey to describe the uninsured population and how it has changed over the past decade, especially between 2007 and 2010 when the recession caused many with previously stable coverage to become uninsured. It finds that although the uninsured population remains disproportionately made up of younger people, the poor and racial/ethnic minorities, uninsurance rose the fastest among the near-elderly, whites and those with higher incomes. Many of these demographic shifts may be attributed to the recent recession, which triggered a rise in unemployment and the loss of job-based health insurance for many laid off workers, while other trends in the characteristics of the uninsured have been longstanding and show little change.

Issue Brief (.pdf)

This issue brief provides a broad-based grounding in adolescent health and related policy by examining access to health services for adolescents, their insurance coverage, and the role of state and federal policies in shaping access to care. While generally enjoying good health, teenagers face a range of physiological and developmental changes, including puberty, burgeoning independence, experimentation and risky behaviors, which shape their health decisions and needs. There are multiple initiatives underway to improve future health outcomes for teens, such as development of teen-friendly health settings and initiatives to increase the supply of providers trained to address the sensitive health issues that arise in teenage patients. The brief also discusses how implementation of the the health reform law may affect health coverage, access, and incentives to use preventive care for adolescents.

Issue Brief (.pdf)

When leaders from the world’s 20 major economies gather for the upcoming G-20 Summit in France, one of their priorities will be finding new ways to maintain and expand the impact of global development programs in the wake of an international financial crisis and mounting efforts to control public spending and debt. The previous decade saw significant increases in support for global health, but there is growing pressure on traditional funding channels. As a result, greater attention is now being paid to what are called “innovative financing mechanisms” – a broad category of proposed approaches to supplement traditional funding for global health.

This report examines some of the most prominent new financing mechanisms for global health across a range of categories, with particular attention to the current level of U.S. government involvement. While these financing mechanisms are not meant to be a substitute for traditional sources of health assistance, they do have the potential to generate additional revenues or extend the impact of existing resources. The report explores the status of U.S. government participation in these financing mechanisms and identifies the potential opportunities and challenges for further engagement by the U.S. as part of its global health effort.

Report (.pdf)

This data spotlight examines the stand-alone Part D drug plan options available to Medicare beneficiaries in 2012. Medicare beneficiaries will, on average, be able to choose from 31 stand-alone Medicare Part D prescription drug plans to choose from, a new Kaiser analysis finds. Average premiums would increase by 4 percent from 2011 to 2012 if beneficiaries remain with their current plans during the open enrollment period, which begins October 15 and December 31. That represents the lowest projected increase since the program began in 2006.

The analysis is the first in a series of planned reports examining the private plan choices available to Medicare beneficiaries. The analysis was conducted jointly by Jack Hoadley and Laura Summer of Georgetown University, Juliette Cubanski and Jennifer Huang of the Kaiser Family Foundation, and Elizabeth Hargrave of NORC at the University of Chicago.

A related fact sheet summarizes the plan options available by state.

Data Spotlight (.pdf)