The increased use of U.S. hospital emergency departments has received considerable attention from both the health care community and policymakers in recent years. This analysis from the Kaiser Family Foundation examines the demographic and health characteristics of people who frequently visit the emergency room to help understand why their utilization is so high.

Using data from the nationally representative Medical Expenditures Panel Survey, the analysis finds that high emergency department users (those who made four or more visits during a two-year period) are more likely to be in poor health and have higher anticipated needs for health care—specifically the elderly, the poor, and those living with chronic conditions. The findings also reveal that these individuals do not obtain care exclusively in the emergency room, but also use outpatient services at a greater rate than people who rarely visit emergency departments.

In terms of health insurance coverage, the analysis finds that the uninsured are not more likely to frequently visit emergency departments than those who are insured. High emergency department users are far more likely to have Medicare or Medicaid coverage, likely due to the poor health and age of these populations, whereas the majority of low users and non users are privately insured.

Issue Brief (.pdf)

This report examines the structure and impact of Medicaid’s role in long-term care. Based on a roundtable discussion of policy makers and experts and drawn from a body of health services research, the report highlights policy challenges facing the Medicaid program today and identifies issues in providing long-term care going forward. By gathering evidence to address key policy issues, such as integrating services, benefit design, quality monitoring and financing, the report can serve as a foundation for the current and ongoing policy debate regarding Medicaid’s future role as a provider of long-term care services and supports for low-income elderly and disabled Americans.

Report (.pdf)

Diabetes was the sixth leading cause of death in the US in 2004 and is among the top 10 most expensive medical conditions on the country. Although more than one in seven diabetics in America rely on the Medicaid program for their health coverage, little is known about who they are or what the program spends on their behalf. This brief provides a first look at what Medicaid spends on the nearly 2 million enrollees with diabetes. Included among the findings is that the six percent of enrollees with diabetes accounted for 16 percent of total Medicaid spending.

Issue Brief (.pdf)

Benefit Improvements for Low-Income Medicare Beneficiaries

The Kaiser Family Foundation has prepared a summary showing how the House-passed Children’s Health and Medicare Protection (CHAMP) Act legislation would change current law regarding assistance for low-income Medicare beneficiaries.

The summary describes proposed changes to current programs that provide assistance to low-income Medicare beneficiaries, including the Medicare Savings Program and the Medicare Part D Low-Income Subsidy (LIS) Program.

The summary reviews how the CHAMP Act would modify each of these programs in terms of eligibility requirements, verification of income and resources, re-enrollment procedures, coordination with other programs, application requirements, and estate recovery.

Summary (.pdf)

Women’s Health Policy: Are the Times Really A-Changing? – Editorial

This editorial describes the current state of key women’s health policy issues, including reproductive health, long-term care, and Medicaid, and assesses how policymakers might address these issues in the future. The piece was written by Kaiser Vice President and Director of Women’s Health Policy, Alina Salganicoff, and was published in the journal Women’s Health Issues.

Editorial (.pdf)

A new, detailed analysis of the latest US Census Bureau data on health insurance coverage looks behind the 2.2 million increase in the number of uninsured, examining changes by age and income. Reversing years of steady declines, the number of uninsured children has grown by one million over the last two years. And, as debate continues on reauthorization of SCHIP, the analysis shows that 48 percent of the increase in uninsured children from 2005 to 2006 was among families with incomes between 200% and 399% of the federal poverty level (roughly $40,000 to $80,000 for a family of four in 2006). Among kids, the share with employer-sponsored insurance declined by 1.2 percentage points, but there was no change in the share with Medicaid or SCHIP coverage to offset the employer decline since most children in this income group are not eligible for public coverage under current rules.

Issue Brief (.pdf)

UPDATED: An updated version of this analysis is now available online.

Recent policy debate has focused on the issue of rising health care costs and whether it might be possible to control costs by requiring consumers to pay a larger share of their health care costs out of pocket. While most of the policy discussion has focused on people of working age, rising health care costs and the burden of out-of-pocket spending also affects seniors, who generally have higher medical expenses and lower incomes than younger adults.

This analysis examines the relative burdens of out-of-pocket spending on seniors and younger adults. Using data from the Consumer Expenditures Survey from 1998 to 2003, it finds that seniors consistently spent a larger share of their income out of pocket on health care than younger people. Given the persistent differences between young and old, it suggests that even with Medicare’s prescription drug benefit, significantly narrowing the wide gap between seniors and younger adults in their out-of-pocket spending burdens is unlikely.

The paper presents analysis by Katherine A. Desmond, M.S., and Thomas Rice, Ph.D., of the University of California, Los Angeles; and Juliette Cubanski, Ph.D. and Patricia Neuman, Sc.D., of the Kaiser Family Foundation.

Issue Brief (.pdf)

This document contains the detailed toplines from the Kaiser Health Tracking Poll: Election 2008 – August 2007

 Toplines (.pdf)

This document presents key findings from the August 2007 Kaiser Health Tracking Poll: Election 2008, which tracks changes in the saliency of health as a political and policy priority, what the public’s priorities are for a health reform plan and whether any candidates are breaking through with the public with their health reform plans.

 Key Findings (.pdf)

This August 2007 tracking poll finds that health care remains the top domestic issue that the public wants presidential candidates to address in the campaign, trailing only Iraq on the public’s overall priority list.

Both Republicans and Independents rank health care second to Iraq, while Democrats for the first time rank the two issues as equally important for the candidates to discuss.

The poll also examines the public’s perceptions of the presidential candidates’ positions and commitment to health care as an issue. Consistent with the previous two tracking polls, nearly six in 10 people don’t know or can’t name a candidate who best represents their own views on health.

The Kaiser Health Tracking Poll: Election 2008 is part of a broader effort by the Kaiser Family Foundation to provide a central hub for resources and information about health policy issues in the 2008 election. The August poll was designed and analyzed by Foundation researchers and involved a nationally representative random sample of 1,500 adults, who were interviewed by telephone between August 2 and August 8. The margin of sampling error for the survey is plus or minus 3 percentage points; for results based on subgroups, the sampling error is higher.

Key Findings

Topline/Survey