The start of summer finds Americans remain divided on the health reform law, but favorable views of the new law increased seven percentage points over the past month to 48 percent, compared to 41 percent who have “generally unfavorable” views and 10 percent who have yet to make up their minds.

With four months remaining until the midterm congressional elections, an early look suggests that the contests could be impacted by a number of different issues, with the economy in the lead but health care also in the mix.

Roughly a third (35%) of registered voters say that a candidate who voted for the health reform law will be more likely to get their vote, a third (32%) say such a candidate would be less likely to get their vote, and a third (31%) say the candidate’s vote for the law would not matter either way. The results vary greatly by party identification.

Across political party lines, most Americans believe that the disagreements between candidates of both political parties on the merits of the health reform law stem more from efforts to gain political advantage (65%) than from genuine policy differences (29%).

Support for individual elements of the law reported in earlier tracking polls has not slipped; many remain very popular, including on a bipartisan basis. Those with support from strong, bipartisan majorities of Americans include the health insurance exchange (94% of Democrats (D) have a favorable view, 88% of independents (I), and 77% of Republicans (R)), tax credits to small business (89% D, 79% I, 79% R), assistance with the Medicare doughnut hole (96% D, 77% I, 71% R), high-risk pool for those with pre-existing conditions (85% D, 78% I, 67% R), and insurance subsidies for individuals (90% D, 73% I, 63% R). By far the least popular element asked about is the individual mandate, which is viewed favorably by about a third (34%) of Americans.

Findings (.pdf)

Chartpack (.pdf)

Toplines (.pdf)

While most people in the U.S. get health insurance through their employer, about 14 million people under age 65 have coverage through the non-group or individual market, which has faced scrutiny recently in news reports about some insurers’ steep rate increases and in the market reforms in the new health reform law that will take effect in 2014.

This survey provides insight into the current state of the non-group market and finds policyholders report that their insurers most recently requested premium increases averaging 20 percent. Most say they paid the increase, but some say they switched plans, either buying a less expensive policy from their current insurer or switching companies altogether.

The survey also provides national data on the average premiums and deductibles reported by people who buy their own coverage in the non-group market. It examines policyholders’ views and experiences with non-group coverage and a focused look at the issues facing policyholders with pre-existing conditions.

The survey involved a nationally representative random sample of 1,038 people ages 18-64 who purchase their own health coverage, conducted between March 19 and April 2, 2010.

News Release

Report (.pdf)

Toplines (.pdf)

This data spotlight examines at enrollment trends in Medicare Advantage plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and Private Fee-for-Service (PFFS) plans. These plans are paid by the government to provide Medicare-covered benefits to those who choose to enroll in them.

As of March 2010, a record 11.1 million people – nearly one in four of all Medicare beneficiaries – were enrolled in private Medicare Advantage plans, up from 10.5 million in March 2009. The gain in enrollment occurred even though the total number of Medicare Advantage plans declined between 2009 and 2010. Notably, while most Medicare beneficiaries have dozens of private Medicare Advantage plans available in their community, enrollment is highly concentrated among a small number of firms in nearly all states.

This spotlight is one in a series looking at the 2010 Medicare Advantage plan options and trends around the Medicare Advantage plan. These spotlights were prepared by a team of researchers at Mathematica Policy Research Inc. and the Kaiser Family Foundation.

Data Spotlight (.pdf)

The ability to maintain health insurance in the face of rising costs and an uncertain economy is a key concern for families and featured prominently in the health reform debate. While the percentage of the population without coverage at any one time changes by only a relatively small amount over a one- or two-year period, the percentage of people who start out with coverage and lose it for a meaningful amount of time during the same period can be much larger. Lapses in coverage affect millions of Americans and contribute to the worries that many have about their financial and health security.

This brief by Kaiser Family Foundation researchers presents information about changes in health insurance status for adults age 18 to 64 with coverage in January 2006 and shows their health insurance status through December 2007. It also presents the alternative, examining gains in coverage over the two-year period among those that began the period uninsured.

Issue Brief (.pdf)

Slides

This updated issue brief from the Kaiser Commission on Medicaid and the Uninsured examines key issues related to state financing and the expansion of the Medicaid program under the new health reform law.

Issue Brief (.pdf)

Washington, D.C. — The Henry J. Kaiser Family Foundation has selected 12 individuals as the 2010 Barbara Jordan Health Policy Scholars.  The Scholars have an opportunity to learn first-hand about health policy and the policymaking process during a nine-week position as staff to a congressional office.

The Foundation established the Barbara Jordan Scholars Program in memory of former U.S. Congresswoman Barbara Jordan — the first African American woman elected to Congress from Texas and a deeply respected member of the Foundation’s board of trustees.

“This year’s group of bright young Scholars will have a unique opportunity to delve into health policy during the early implementation of comprehensive national health reform,” Foundation President and CEO Drew Altman said. “The experience and insights that they gain will help prepare these students to be future leaders in our country, which is a fitting legacy for Barbara Jordan.”

The program is designed to introduce recent college graduates with an interest in issues affecting racial and ethnic minority and underserved communities to the federal legislative process and current issues in health policy.  In addition to working on Capitol Hill, Scholars participate in seminars and site visits organized by the Foundation to broaden their knowledge of health policy issues.  Under the guidance of the Foundation’s staff, the Scholars also complete an in-depth analysis of a health policy issue and produce a policy memo.

This year’s Scholars were chosen from more than 250 applicants.  Cara James, Ph.D., is the director of the Barbara Jordan Scholars Program at the Foundation.  The program operates in partnership with Howard University.

More information about the Barbara Jordan Health Policy Scholars Program is available online.

The 12 Barbara Jordan Health Policy Scholars for 2010 are:

Randall BaldassarreHometown: San Mateo, CASchool: Rice UniversityMajor: Hispanic Studies and Biochemistry & Cell BiologyPlacement: House Energy and Commerce (Minority Staff)

Ashley CastilloHometown: Mesa, AZSchool: Arizona State UniversityMajor: MicrobiologyPlacement: Rep. John Lewis (D-GA)

Trenell DarbyHometown: Kenosha,WISchool: University of Wisconsin-MadisonMajor: NursingPlacement: Sen. Tom Harkin (D-IA)

Alexandra FergusonHometown: Seattle, WASchool: Brown UniversityMajor: Political SciencePlacement: Senate Committee on Health, Education, Labor and Pensions (Majority Staff)

Yvette GonzalezHometown: Salt Lake City, UTSchool: University of UtahMajor: Social Justice Education & Community Based ResearchPlacement: Rep. Charles Rangel (D-NY)

Mariah JonesHometown: Broken Arrow, OKSchool: Howard UniversityMajor: BiologyPlacement: Rep. Donna Christian-Christensen (D-VI)

Elizabeth LamosteHometown: Troy, MISchool: Columbia UniversityMajor: Sociology and Political SciencePlacement: Sen. Olympia Snowe (R-ME)

Victoria MaciasHometown: Santa Fe, NMSchool: Colorado State UniversityMajor: Natural Sciences and SpanishPlacement: Sen. Thomas Udall (D-NM)

Elieth MartinezHometown: Los Angeles, CASchool: University of California San DiegoMajor: Human BiologyPlacement: Rep. Lucille Roybal-Allard (D-CA)

Ryan O’QuinnHometown: Miami, FLSchool: University of PittsburghMajor: Neuroscience and EconomicsPlacement: Rep. Sheila Jackson Lee (D-TX)

Nitrecus SimmonsHometown: Atlanta, GASchool: Bennett College for WomenMajor: BiologyPlacement: Rep. Jesse Jackson, Jr. (D-IL)

Rebecca SnidermanHometown: Barrington, RISchool: Brandeis UniversityMajor: Sociology and PhilosophyPlacement: Rep. Eleanor Holmes Norton (D-DC)

The Kaiser Family Foundation is a non-profit private operating foundation, based in Menlo Park, California, dedicated to producing and communicating the best possible information, research and analysis on health issues.

Analysis Projects Steep Decreases in Uninsured, With Federal Government Covering Vast Majority of CostsWASHINGTON — The expansion of Medicaid under the new health reform law will significantly increase the number of people covered by the program and markedly reduce the uninsured in states across the country, with the federal government picking up the overwhelming majority of the cost, according to a state-by-state analysis released today by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU).

The analysis, performed by John Holahan and Irene Headen of the Urban Institute for the Foundation, is among the first to show for all 50 states and the District of Columbia the distribution of new Medicaid enrollees and costs, as well as the impact on the uninsured.  Health reform will offer Medicaid coverage to millions of low-income adults for the first time and help establish a national floor for Medicaid eligibility that contrasts sharply with the wide variation in eligibility across state Medicaid programs today.

States with large uninsured populations today are expected to see the biggest increases in the numbers of people who obtain health coverage through Medicaid.  California and Texas, for example, two states with considerable numbers of uninsured residents, are each projected to see 1.4 million fewer uninsured adults in 2019 due to the Medicaid expansion, with the federal government covering 95 percent of the cost in Texas and 94 percent in California.

“For a relatively small investment of state dollars, states could see huge returns in terms of additional coverage for their lowest income residents — with federal dollars covering the bulk of the bill,” said Diane Rowland, executive vice president of the Foundation and executive director of the KCMU.

Nationally, the analysis projects that Medicaid enrollment will climb by 15.9 million more people by 2019 than it otherwise would have, and the number of uninsured will fall by more than 11 million.  The cost of the Medicaid expansion between 2014 and 2019 would be jointly financed with the federal government paying $443.5 billion (or 95.4 % of the total cost) and the states contributing $21.2 billion.MethodsIt is difficult to predict the impact of the new Medicaid outreach and enrollment efforts under health reform, as well has how states will respond.  So the analysis contemplates two scenarios and applies a uniform rate of enrollment (participation rate) among those eligible for Medicaid.

The “Standard Scenario” approximates participation rates used by the Congressional Budget Office to achieve the 16 million-person increase in Medicaid enrollment by 2019.  The “Enhanced Scenario” examines the potential impact of more aggressive outreach efforts by federal and state governments, community based organizations and providers combined with the influence of the new individual mandate that everyone obtain health coverage.  It demonstrates the higher level of enrollment (and costs) that might be achieved if newly eligible people were to enroll at much higher rates than are seen among already eligible populations today. Of course, due to fiscal, political and administrative pressures, it is possible that some states may not achieve the expected enrollment gains contemplated under either scenario, leading to smaller increases in coverage and costs.

Both scenarios examine the coverage and cost impact of the Medicaid expansion for adults with annual incomes at or below 133% of the federal poverty level, which is $14,404 for an individual under current poverty guidelines.  The scenarios do not account for the impact of reform for children or state savings related to reductions in uncompensated care costs or reductions in Medicaid coverage for adults currently covered above 133% FPL.  Nor do they factor in other changes in Medicaid in health reform related to provider payment rates, changes to the drug rebates or new options related to payment reform.

For more data on how individual states are expected to be affected, see Table 1 in the executive summary of the report.The Kaiser Family Foundation is a non-profit private operating foundation, based in Menlo Park, California, dedicated to producing and communicating the best possible information and analysis on health issues.

The Kaiser Commission on Medicaid and the Uninsured provides information and analysis on health care coverage and access for the low-income population, with a special focus on Medicaid’s role and coverage of the uninsured. Begun in 1991 and based in the Kaiser Family Foundation’s Washington, D.C. office, the Commission is the largest operating program of the Foundation. The Commission’s work is conducted by Foundation staff under the guidance of a bipartisan group of national leaders and experts in health care and public policy.

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In today’s column I investigate a somewhat lighter topic than my last column on micro-simulation modeling: What was the impact of shows like Jon Stewart’s The Daily Show and Stephen Colbert’s The Colbert Report on the health reform debate?  Who among us has not wondered about the answer to this question?  Please don’t answer that.

I should start by acknowledging that I am a frequent but not religious viewer of these shows, and believe that whatever else they do they perform a deeper public service by helping us take a semi-comical/semi-serious look at the less functional aspects of our democracy.  That made health reform—especially the political and legislative process—a prime topic for both shows over the last year.

In our May tracking poll, 12% of the American people said they got information on health reform from shows like The Daily Show and The Colbert Report (or their websites).  The numbers were higher for college graduates (16%); higher still for 18-29 year olds (19%); and self-reported liberals (20% vs. 9% for conservatives).

We also asked people what their “most important” source of information was on health reform.  Cable TV news and their related websites topped the list, picked by 30%, followed by newspapers and their websites and friends and family at 12% and 11% respectively.  (Note: some respected bloggers questioned whether this could be so given TV ratings data showing far fewer people tuned in to cable than, say, network news, but how frequently people view a news show and what they cite as their “most important” source of information on an issue can be very different things.)  In any event, shows like The Daily Show and The Colbert Report were picked by a tiny 1% as people’s “most important” source of information.  If that sounds very low, by comparison “your doctor or another health care professional” was picked by 3% (19% said they got some information on health reform from their doctor or a health professional).

We also know from an earlier Time magazine poll conducted in October of 2008 that 11% of likely voters cited Stewart/Colbert as a ”major source” of news about politics and current events, 25% as a “minor source”, and 63% as “not a source”.

So what do numbers like these mean?   I suspect the 12% who cite Stewart and Colbert as a “source of information about health reform” is a real undercount; respondents may not think of these shows as providing “information” even if they get them to “think” about a subject like health reform or about government or politics.  These shows are primarily viewed by people as entertainment.  Also, the data should be viewed in the context of the changing information consumption habits of many Americans, especially younger people.  They are fast becoming one-person-news-aggregators, pulling together what they see and learn from multiple websites and shows to form their own overall picture of issues and events (even if they seldom pick up a newspaper or watch broadcast news).  For viewers what they see or learn on The Daily Show is a piece of a “daily” puzzle they assemble themselves. An unknown and I suspect very small percentage of people get their only exposure to information about current events from shows like The Colbert Report, or The Daily Show, or Real Time with Bill Maher, or the other late night shows. The shows engage this group in public affairs when they otherwise might not be engaged but may also fuel skepticism about government and our ability to solve problems as a country which polling suggests seems to be growing.

Another way these shows have impact is that people often forward show segments to their friends, especially young people.  For example, I am forwarding this Jon Stewart interview about “death panels” to you now, one of his interviews that was flipped widely around the internet during the health reform debate.  Lastly, episodes of these shows often create buzz that influences mainstream media, makes news itself, and becomes part of the ever intensifying news cycle.  The impact of a “hot” segment or interview on a show like The Daily Show or The Colbert Report is not told simply through the number of viewers alone or the number of respondents who tell us they got information on an issue from the show in a poll.

One question is how much these shows will continue to pay attention to health reform as we move from a hot political debate to behind-the-scenes implementation issues that are not often grist for riveting television.  It is hard to imagine a Samantha Bee report on medical loss ratio regulations (although not impossible). It would be a good thing for Stewart and Colbert to continue following health reform because it would help keep the public engaged, especially younger people who watch these shows. But it also might be a sign that implementation is not going well if it becomes the focus of shows that capitalize on absurdities and gaffes. That’s the Repor(t).

Confusion over the new health reform law declined but remains widespread, with 44 percent of the public saying they were confused in May, compared to 55 percent in April. Moreover, more than a third of Americans (35%) say they do not understand what the impact of the law will be on themselves and their families, while 61 percent report feeling they do understand what that impact will be. Americans continue to report getting information about health reform from a wide variety of sources, including the news media, friends and medical professionals. More than half report having gotten information from friends and family (68%), or from cable (63%) or broadcast news programs (55%). Further breaking down those getting health reform information from cable news, 25 percent of Americans indicated their main cable source on this topic was FOX News, 22 percent named CNN and 6 percent MSNBC.”

Americans continue to report getting information about health reform from a wide variety of sources, including the news media, friends and medical professionals. More than half report having gotten information from friends and family (68%), or from cable (63%) or broadcast news programs (55%). Further breaking down those getting health reform information from cable news, 25 percent of Americans indicated their main cable source on this topic was FOX News, 22 percent named CNN and 6 percent MSNBC.

Adults ages 19 to 29 have the highest uninsured rate of any age group in the United States. The 13.7 million uninsured people in this age group comprise nearly a third of the overall uninsured population.  Most provisions in health reform do not specifically target young adults, but because of their high uninsured rate they will be one of the groups that is most affected by the new law. This paper explains the key ways in which the new law will impact young adults, and provides a brief overview of current health coverage for this population.

Issue Brief