This report examines Medicaid spending growth nationally during the last decade, with a focus on growth during the recession of 2007 to 2009.

The recession-driven enrollment growth in recent years drove program spending to increase faster than national health spending overall, but on a per enrollee basis the growth in Medicaid spending has remained lower than the rise in private insurance premiums and overall national health expenditures. The recession-driven increase in Medicaid enrollment has been the primary cause of the increase in overall Medicaid spending.

Report (.pdf)

This analysis examines the potential costs and savings that the health reform law may generate for state budgets, a topic of great interest at a time when states continue to struggle with tight budgets in the wake of the recession. The analysis seeks to explain why recent state estimates of the likely impact of health reform on their budgets vary widely, and discusses the major expected sources of costs and savings as the new law is implemented.

It finds that there are many opportunities and new options to offset the state costs related to the expansion of Medicaid, such as reducing payments for uncompensated care costs as the number of uninsured declines. The actual impact on states will vary based on current state coverage and according to how each state implements the law. The review of state analyses found most state estimates reflected potential cost increases but did not account for the full range of potential savings.

Executive Summary (.pdf)

Issue Brief (.pdf)

The Washington Post/Kaiser Family Foundation/Harvard University partnership conducted a survey to examine how the recession has reshaped the lives of Americans and takes a closer look at experiences by race and ethnicity. This survey is the 21st in a series of surveys dating back to 1995 that have been conducted as part of The Washington Post/Kaiser Family Foundation Survey Project.

Toplines (.pdf)

Read The Washington Post articles on the survey:Economy poll: African Americans, Hispanics were hit hardest but are most optimisticIn rough economic times, black Americans hold on to their optimismPoll: Whites without college degrees especially pessimistic about economyBlacks, Hispanics hold few investments, poll showsHispanics trail other groups in Web usage, confidence

Data Note: The Digital Divide and Access to Health Information Online

As both federal and state governments gear up to implement the Patient Protection and Affordable Care Act (ACA), concerns about the supply and distribution of physicians, particularly primary care physicians, are being raised. In many areas of the country, there is a shortage of primary care physicians, and some worry about whether the current workforce can meet the growing demand for services that will likely accompany coverage expansions.

To inform provider workforce issues related to health reform, this brief examines insurance coverage and access to care among the population residing in Primary Care Health Professional Shortage Areas (HPSAs), which are areas with documented shortages of physicians and other health providers.

Brief (.pdf)

Three papers from the Foundation’s Commission on Medicaid and the Uninsured examine Medicaid enrollment and spending during the recent recession. The analyses show Medicaid enrollment rose above 50 million people nationally for the first time in 2010, reflecting the program’s counter-cyclical role of helping people who become uninsured when the economy falters, with many turning to Medicaid after losing jobs and employer-based health insurance. Without access to Medicaid coverage, millions more people who suffered economic hardship likely would have joined the ranks of America’s now 50 million uninsured.

The recession-driven enrollment growth in recent years drove program spending to increase faster than national health spending overall, but on a per enrollee basis the growth in Medicaid spending has remained lower than the rise in private insurance premiums and overall national health expenditures. The recession-driven increase in Medicaid enrollment has been the primary cause of the increase in overall Medicaid spending.

The papers include:

Medicaid Spending Growth Over The Last Decade and the Great Recession, 2000 to 2009

Medicaid Spending Growth and the Great Recession, 2007-2009 (A Fact Sheet)

Medicaid Enrollment June 2011 Data Snapshot

This fact sheet examines how the recent recession drove up Medicaid enrollment as millions of Americans lost jobs and income, and how that increase in enrollment has been the primary cause of the increase in overall Medicaid spending.

Fact Sheet (.pdf)

With the passage of health reform, the Money Follows the Person (MFP) demonstration grant program was extended five years through 2016 giving states further options to transition Medicaid beneficiaries living in institutions back to the community.

Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the MFP demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. Twenty-nine states and DC are currently participating in this demonstration program and more states plan to apply for MFP grants in the coming year.

In July 2010, the Kaiser Commission on Medicaid and the Uninsured (KCMU) surveyed states about the current status of their MFP program including trends in enrollment, services and per capita spending. The 2010 survey is a follow-up to the 2008 KCMU MFP survey and highlights findings based on responses from twenty-six states.

Aiming to take a snapshot of the state of global health journalism, a report produced for the Kaiser Family Foundation found that shrinking newsroom budgets and the closing of many foreign bureaus are curtailing global health coverage within traditional news media outlets. Advocacy and nongovernmental organizations are increasingly bypassing news outlets and producing their own content, leading to questions about how global health news will evolve. In addition, with outside sources now funding some global health journalism coverage, the long-term sustainability of such funding is brought into question.

Commissioned by the Foundation, journalists Nellie Bristol and John Donnelly interviewed 51 stakeholders in global health journalism, including reporters, editors and producers from mainstream publications and news outlets, and policy, trade and medical journals; writers from advocacy outlets; and staff at journalism fellowship organizations.

Those interviewed suggested that disaster-related health crises and infectious disease outbreaks were the main focus of global health reporting. In many cases, journalists said that they were having a difficult time finding compelling angles for long-time global health stories such as HIV/AIDS or policy stories emerging from Washington, D.C.

Brief (.pdf)

On February 9, 2011, the Foundation convened a forum examining the state of global health journalism drawing on the findings of this report. A summary of that discussion is available online.

As Congress and the Administration increasingly focus on the nation’s budget deficit, many policy experts and several bipartisan deficit reduction panels have proposed significant changes to Medicare to reduce federal spending and address rising health care costs.

This primer provides an overview of Medicare spending trends, how the program is financed, and factors contributing to the growth in Medicare spending. Medicare now covers 47 million seniors and younger people with disabilities, with total expenditures of $524 billion in fiscal year 2010, representing 15 percent of federal outlays.

It also describes the expected effects of provisions in the 2010 health reform law on future Medicare spending. The primer reviews the financial obligations and out-of-pocket spending for people covered by Medicare, outlines several ways to assess Medicare’s long-term fiscal outlook, and discusses future financing challenges facing the program.

Primer (.pdf)

Previous versions:

Primer – July 2009 (.pdf)

Issue Brief – January 2008 (.pdf)

New: Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

In 2012, Medicare Advantage plans will be awarded additional payments based on their quality ratings as a result of the 2010 health reform law. The Centers for Medicare and Medicaid Services has proposed a demonstration that would modify the quality-based payments for plans, providing additional payments for 2012 to 2014.

This policy brief by the Kaiser Family Foundation examines the quality ratings of private Medicare Advantage plans by plan characteristics, and beneficiaries’ access to highly rated plans in 2011. The brief shows the potential for Medicare Advantage plans to receive quality-based bonuses under both the 2010 health reform law and the proposed demonstration.

Issue Brief (.pdf)