KFF designs, conducts and analyzes original public opinion and survey research on Americans’ attitudes, knowledge, and experiences with the health care system to help amplify the public’s voice in major national debates.
Although regional variations in health spending have been studied for decades, there is renewed focus on this issue because of the role of health care costs in health care reform and the potential source of funds if addressing cost variations can yield savings.
This explainer examines what is known about regional variations in health care costs and their relationship to quality of care, and addresses key questions about their role in health reform.
While Medicaid and the Children’s Health Insurance Program (CHIP) have become increasingly important sources of health coverage for low-income children in all racial and ethnic groups, the program plays an especially large role for children of color, who are more likely than white children to be low-income. In 2007, Medicaid and CHIP covered nearly one in five white children, but roughly two in five African American and Hispanic children.
As policymakers engaged in health reform consider the merits of public and private approaches to expanding coverage, this report provides an assessment of Medicaid’s relative impact on racial and ethnic disparities in access. The analysis compared health care access for white, African American and Hispanic children who were privately insured, uninsured, or enrolled in Medicaid or CHIP.
Key findings include:
Racial and ethnic disparities in access to care were no more likely among children enrolled in Medicaid than among privately insured children.
Insurance coverage – both private and Medicaid – often improved access for children in each racial and ethnic group, but generally did not significantly narrow racial and ethnic disparities in their access to health care.
This report analyzes data for more than 15,000 children from the 2003 and 2004 Medical Expenditure Panel Survey, a nationally representative household survey conducted by the Agency for Healthcare Research and Quality.
This document contains the chartpack from the December Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted December 7 through December 13, 2009, among a nationally representative random sample of 1,204 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (403, including 111 who had no landline telephone) were carried out in English and Spanish. The margin of sampling error for the total sample is plus or minus 3 percentage points. For results based on subgroups, the margin of sampling error is higher.
This Part D Data Spotlight examines key differences between basic and enhanced Medicare stand-alone prescription drug plans (PDPs), including monthly premiums, cost sharing, and gap coverage. It also examines plan names to assess whether they convey meaningful differences between basic and enhanced PDPs.
Companies that sponsor Medicare Part D prescription drug plans are required to offer a basic benefit, either the standard Part D benefit defined by law or an actuarially equivalent benefit design. Plan sponsors can also offer plans with enhanced drug benefits. Enhanced plans are required to have a greater actuarial value than basic plans, but plans vary in the ways in which they improve coverage.
The spotlight is one in a series analyzing key aspects of the Medicare Part D drug plans that will be available to beneficiaries in 2010. The analysis was conducted jointed by Jack Hoadley and Laura Summer of Georgetown University, Elizabeth Hargrave of NORC at the University of Chicago, and Juliette Cubanski and Tricia Neuman of the Kaiser Family Foundation.
The December Kaiser Health Tracking Poll finds a dip on several measures of public opinion on health care reform. The number of Americans who say they personally will be better off if reform passes fell to 35 percent in December, down from 42 percent last month. Meanwhile, 27 percent say they will be worse off, and 32 percent said they don’t expect to see much of a difference. Similarly, 45 percent say the country would be better off if health care reform passes down from 54 percent in November. This compares to 31 percent who say the country will be worse off and 17 percent who see no impact. Public opinion in December looks more like it did in August, the last time this debate became so contentious.
Despite the dip on these measures, 54 percent of the public says that it is more important than ever to pursue health reform now, while 41 percent say the country cannot afford it. Those proportions have remained fairly steady throughout the fall, though the gap between the majority who want reform now and those who don’t tightened this month.
The December poll, the ninth in a series designed and analyzed by the Foundation’s public opinion survey research team, examines voters’ specific health care issue interests and experiences and perceptions about health care reform.
Medicare Part D helps cover the cost of outpatient prescription drugs for 27 million beneficiaries enrolled in private stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug (MA-PD) plans. The majority of Part D enrollees pay a monthly premium for Medicare drug coverage. This data spotlight examines premiums for enrolling in Medicare’s PDPs in 2010 and trends since 2006.
The spotlight is one in a series analyzing key aspects of the Medicare Part D drug plans that will be available to beneficiaries in 2010. The analysis was conducted jointed by Jack Hoadley and Laura Summer of Georgetown University, Elizabeth Hargrave of NORC at the University of Chicago, and Juliette Cubanski and Tricia Neuman of the Kaiser Family Foundation.
A key element of health reform will be meeting the needs of low-income children. Overall, a major goal of proposals is to expand coverage by building on Medicaid, providing subsidies to low- and moderate-income individuals to buy coverage through new health insurance exchanges, and requiring individuals to obtain coverage. Current proposals also could significantly change coverage for some children already eligible for Medicaid and CHIP.
This issue brief examines several key issues to consider about low-income children’s coverage under health reform. Medicaid and CHIP are proven programs that have successfully covered millions of low-income children with diverse health needs. As reform efforts continue, it will be important to consider how to build upon the accomplishments of 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 and offers meaningful financial protections for their families. Further, adequately planning and funding for the transition to reform will be key to preventing any disruptions in children’s coverage or care as reform is implemented.
This issue brief was released as part of a package of related materials in conjunction with a media briefing on the findings of an annual 50-state survey of Medicaid and CHIP eligibility and enrollment policies.
Although Medicare is not the main focus of current health reform legislation, the bill recently passed by the House—H.R. 3962, America’s Affordable Health Choices Act of 2009—and the bill before the Senate—H.R. 3590, Patient Protection and Affordable Care Act—include a number of provisions that would affect Medicare program expenditures.
This policy brief considers the proposed 10-year Medicare savings and increased spending in the two proposals in the context of other laws enacted during the last 15 years that have resulted in significant changes to the Medicare program. The analysis calculates net changes in 10-year projected Medicare expenditures estimated at the time each law was enacted as a share of the contemporaneous projected Medicare baseline spending. The results help to illustrate the relative magnitude of each law’s effect on Medicare expenditures as projected at the time of enactment.
In April 2010, the Foundation issued a policy brief examining key issues affecting the U.S. Global Health Initiative (GHI). This policy brief and chartpack provide a detailed breakdown of the U.S. budget for the global health programs in President Obama’s GHI, announced in May 2009. In addition, the regularly updated Budget Tracker provides the current status of key global health accounts throughout the budget and appropriations process.
The GHI, proposed as a six-year effort, would for the first time develop a comprehensive, U.S. government-wide strategy for global health focused on the health challenges and needs of those in low- and middle-income countries. The initiative builds on the Bush Administration’s efforts to address HIV, TB, and malaria through the President’s Emergency Plan for AIDS Relief (PEPFAR) and President’s Malaria Initiative (PMI) but also broadens and augments the focus on other global health challenges, particularly maternal and child health, family planning and reproductive health, and neglected tropical diseases. The effort currently encompasses most, but not all, of the federal government’s investment in global health.
The brief provides an overview of the projected budget for the GHI, including the $8.6 billion proposed by the Administration in its pending fiscal year 2010 request and the $8.4 billion approved in fiscal year 2009. It examines the different U.S. programs that would fall under the GHI over time, tracking data back to fiscal year 2001. The supplemental chartpack includes additional breakouts and budget trends over time.
Briefing – 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
In 2009, despite the bleakest economic picture in years, states managed to safeguard and in some cases expand health coverage for children and parents in their Medicaid and Children’s Health Insurance Programs, according to the Kaiser Family Foundation’s annual 50-state survey of Medicaid and CHIP eligibility rules, enrollment and renewal procedures and cost-sharing Practices. That was in large part due to the substantial help that states received through the congressional reauthorization of CHIP and the enactment of the American Recovery and Reinvestment Act (ARRA).
However, those gains, which could serve as a base for covering millions more people under health reform, are threatened by the impending end of key federal assistance for Medicaid programs at the end of 2010, the survey found. That in turn raises the prospect that new fiscal shortfalls could cause states to consider significant cuts to Medicaid and CHIP even before health reform coverage would begin.
The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured released its annual 50-state survey and a package of related reports that examine trends and key issues in the coverage of low-income children and adults during a media briefing at the Foundation’s Washington, D.C., office.
