This document contains the toplines from the September Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted September 11 through September 18, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 147 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.

Toplines (.pdf)

A Profile of American Indians and Alaska Natives and Their Health Coverage

This brief examines the health coverage, access to care and health status of American Indians and Alaska Natives across the country. Although the U.S. government has an established responsibility through tribal agreements to provide health care services to members of federally recognized Indian tribes, many American Indians and Alaska Natives lack access to health care.

The brief gives an overview of the some of the demographic factors that influence the health and insurance coverage of American Indians and Alaska Natives. It examines the relatively high rates of chronic conditions experienced by American Indians and Alaska Natives compared to other racial and ethnic groups.

The brief also provides information about the Indian Health Service and health coverage and access to care for this population.

Issue Brief (.pdf)

This document contains the chartpack from the September Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted August 4 through August 11, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 123 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.

Chartpack (.pdf)

This data note explores who is more or less likely to say that they are satisfied with their health insurance plan, examines how people’s opinions of their plan vary with health status and what people’s health care experiences and concerns can tell us about their health coverage.

Overall, the Foundation’s August 2009 tracking poll found that most Americans with insurance give their plan a favorable rating, and most are satisfied with various aspects of their coverage and care. However, on closer examination, the data finds that younger Americans, those with lower incomes and those who report being in poor personal health are significantly less likely to say they are satisfied with their insurance than their counterparts. And though most Americans say their insurance is “excellent” or “good,” these positive ratings do not necessarily paint a complete picture, as significant portions of those who rate their insurance positively still say they face problems paying their medical bills or are dissatisfied with certain aspects of their coverage. Additionally, recent Foundation polls indicate that substantial portions of insured people are concerned about the cost of their health care and insurance, the adequacy of their insurance to meet potential health care needs, and the stability of their insurance coverage.

Data Note (.pdf)

This brief highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates believe must be overcome to expand access to home and community-based services (HCBS).

Among the key ideas drawn from a working group discussion at the Foundation are the benefits of:

• providing additional federal financing to states to provide Medicaid HCBS and to administer these benefits;

• simplifying the process for states to provide HCBS;

• increasing Medicaid income-eligibility and resource limits for HCBS and expediting program eligibility determinations; and

• devoting greater attention to increasing capacity in the community and long-term care workforce development, including wages, training and benefits.

Brief (.pdf)

These briefs examine current issues in providing more people who need long-term care services and supports access to these Medicaid services in home and community-based settings rather than in institutional ones.

The first brief, Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts , highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates believe must be overcome to expand access to home and community-based services (HCBS).

A companion brief, Efforts in States to Promote Medicaid Community-Based Services and Supports, summarizes lessons in offering more home and community-based services from states at the forefront of the effort. The brief describes current options for state Medicaid programs and draws on interviews with state officials to provide details about specific policies and procedures in states.

This brief summarizes lessons in offering more home and community-based services from states at the forefront of the effort. It describes current options for state Medicaid programs and draws on interviews with state officials to provide details about specific policies and procedures in states.

Brief (.pdf)

This brief presents analysis of the latest available Medicaid spending and enrollment data to examine recent trends in program enrollment, total spending, spending by service, and spending per enrollee. The focus is on spending changes between 2006 and 2007, with historical context also provided.

After Medicaid spending declined in 2006 for the first time in the program’s history, spending climbed by 5.3 percent in 2007. In raw dollars, spending increased to $330.8 billion in 2007, up from $314.2 billion the year before. Main contributors to this growth included increases in spending on hospital inpatient care, Medicaid managed care and hospital outpatient care, with particularly large increases in a small number of states driving the overall trend.

Medicaid spending grew between 2006 and 2007 despite enrollment declines of 0.6 percent, defying historical patterns in which growth in Medicaid spending had been driven primarily by enrollment growth. In 2007, spending growth was related not to enrollment growth but rather to increases in the growth rate of spending per enrollee, particularly for acute care services. The current economic recession, however, suggests that Medicaid spending is likely to revert to historical patterns and grow along with enrollment increases.

Over the entire 2000 to 2007 period, annual growth in Medicaid spending per enrollee was considerably slower (4.8%) than growth in per capita national health expenditures (6.5%).

Issue Brief (.pdf)

This report, based on focus groups with adults in a variety of circumstances, highlights the experiences of Massachusetts residents in obtaining health coverage, accessing health care services and managing out-of-pocket costs in the wake of the state’s 2006 health reform law.

Report (.pdf)

This issue brief examines the health care needs and health costs of individuals with special health challenges, focusing on those with low-to-moderate incomes. It finds that even under a benefit package more generous than most offered in the private insurance market, individuals and families can face significant gaps in coverage and large out-of-pocket costs, especially if they have serious health conditions.

The findings have implications for the health reform debate as policymakers consider minimum standards for coverage, required cost sharing amounts and limits on covered benefits in health plans.

Issue Brief (.pdf)