With recent policy debates about the future of Medicaid, the Foundation’s Kaiser Commission on Medicaid and the Uninsured has created a resource page of recent publications that address key policy issues when examining Medicaid’s role for high cost populations and in long-term care. Of particular interest are a report profiling six Medicaid populations with serious health needs resulting in high costs for the program and a recent analysis showing more than half (52%) of Medicaid spending goes towards all the care (LTC and acute services) of beneficiaries who use long-term care services.

Profiles of Medicaid’s High Cost Populations

Medicaid’s Long-Term Care Beneficiaries: An Analysis of Spending Patterns

Medicaid 1915(c) Home and Community-Based Service Programs: Annual Data Update

Profiles of Nursing Home Residents on Medicaid

Beyond Cash and Counseling: The Second Generation of Individual Budget-Based Community Long-Term Care Programs for the Elderly

Medicaid Long-Term Services Reforms in the Deficit Reduction Act

Medicaid’s Role in Long-Term Care Fact Sheet

Long-Term Care: Understanding Medicaid’s Role for the Elderly and Disabled

Embargoed for release until:Friday, December 8, 2006

For further information contact:Craig Palosky, cpalosky@kff.org, (202) 347-5270Larry Levitt, llevitt@kff.org, (650) 854-9400

New Poll Finds Broad Support Among Democrats, Independents, and Republicans for Drug Price Negotiation, Reimportation, and Prioritizing Children for Coverage of the Uninsured…Views on Stem Cells More Mixed

Public Sees Health Care Prices as Unreasonable and Wants Governmentto Take Steps to Lower Them

Iraq By Far Remains the Public’s Top Priority for the New Congress and Presidential Campaign, With the Economy and Health Care Next But Well Behind

A new national survey finds widespread support across the political spectrum for a number of health initiatives likely to be taken up by the new Congress, as well as a widely-held view that government should do more to address the high cost of health care. At the same time, the war in Iraq continues to play a dominant role among the public’s priorities, with economic and health concerns following distantly.

The poll, conducted November 9-19 by the Kaiser Family Foundation and the Harvard School of Public Health, included a nationally representative sample of 1,867 adults. The survey looks at the public’s priorities and views on health issues as a new Democratic majority takes the leadership of Congress and as the 2008 presidential campaign begins to take shape. It focuses, in particular, on differences and similarities among Democrats, Republicans, and those who identify themselves as Independents or something else.

The Congressional Agenda and the Public’s Priorities

While there is debate in Washington about whether and how to do it, substantial majorities of Democrats (92%), Independents (85%), and Republicans (74%) support allowing the government to negotiate drug prices under Medicare (85% overall, including 65% strongly and 20% somewhat favoring it). There is also widespread support for permitting Americans to buy lower-priced prescription drugs from Canada (79%, including 55% strongly and 24% somewhat). Eight in 10 people believe drug price negotiation will make medications more affordable, while 31% believe it will result in less research and development by U.S. drug companies.

“Many of the health policy proposals currently on the congressional agenda are broadly popular with the public, from drug price negotiation to reimportation to children’s health insurance,” said Drew Altman, president and CEO of the Kaiser Family Foundation. “Health care is well positioned to emerge as a top national issue in 2008 and beyond, but only if the situation in Iraq stabilizes and presidential candidates spark a national discussion about health reform.”

More than half of Americans support broader federal funding for stem cell research, though with sharp partisan divisions: 67% of Democrats and 61% of Independents favor it, compared to 37% of Republicans. The public in general favors greater government support for medical research. When asked to pick a public health priority, 67% chose increased spending to develop treatment and cures for diseases such as cancer, heart disease, and diabetes, compared to 14% who pointed to prevention and treatment of HIV/AIDS and 13% who said better preparation for public health threats like avian flu.

Overall, Iraq by far tops the list of policy priorities for the public, with 46% naming it as one of the two issues they would most like the president and Congress to act on next year. Health care and the economy came next but followed far back at 15% each.

When asked to pick their top health care priority, most people point either to expanding coverage for the uninsured (35%) or reducing health care costs (30%). Fewer (18%) choose improving the Medicare drug benefit. And, while policymakers struggle with the budget deficit, few people (6%) rank reducing spending on government health programs as their top priority. But partisan differences emerge on priorities, with Democrats placing a much higher priority on expanding coverage, Republicans emphasizing reducing costs, and Independents split.

The public is most likely to prioritize coverage for children over other groups of the uninsured if Congress judges that guaranteed health insurance for everyone is not affordable, an issue likely to arise with reauthorization of the State Children’s Health Insurance Program on the horizon.

Looking Ahead: The Broader Health Reform Debate and the Beginning of the Presidential Campaign

What the public would like to hear from presidential candidates largely mirrors the priorities for the new Congress, with the war in Iraq mostly pushing aside other issues at this point. Among health care issues, the public cites the twin issues of coverage and costs as top priorities, with similar partisan splits as for the congressional agenda. Medicare’s drug benefit remains of lesser concern.

Democrats, in particular, say they are looking for more far-reaching proposals from candidates – 73% say they would like to see a health proposal from a candidate that makes a major effort to provide near universal coverage even with a substantial increase in spending, compared to 18% who would prefer a more limited plan and 7% who prefer a plan that maintains the status quo. Far fewer, though still a majority (55%), of Independents would like to see a major plan proposed, along with 37% of Republicans.

“The public shows some appetite for the kind of broader health measures that have largely been absent from the agenda for many years, but that interest could wane in a full-fledged debate when critics mount opposition campaigns or if people come to believe that a plan would threaten their own medical arrangements,” said Mollyann Brodie, vice president and director of Public Opinion and Media Research for Kaiser.

The poll also finds a strong desire among the public for initiatives to address health care costs.

With previous polls showing health care affordability topping the list of personal worries for Americans, it is not surprising that substantial majorities see health care prices as unreasonable compared with other goods and services, including hospital charges (86%), brand name drugs (83%), health insurance premiums (70%), nursing home charges (63%), and physician fees (59%). But the public does discriminate – just 20% see the prices of generic drugs as unreasonably high.

Perhaps more unexpected is that almost two-thirds (64%) of the public believes government can do a lot to address the cost of health care, and people across the political spectrum believe government should try to address health care prices – 65% of Republicans, 74% of Independents, and 86% of Democrats, among the large majorities who say any health-related prices are unreasonable.

“These findings suggest that we are likely to see more public pressure on Congress to address the health care cost issue in the years ahead,” said Robert J. Blendon, professor of Health Policy and Political Analysis at the Harvard School of Public Health and the Kennedy School of Government.

When faced with a choice between the government trying to solve the health care cost problem by dealing directly with providers and insurers and limiting what they can charge versus giving consumers tax incentives to buy high-deductible coverage and encouraging them to shop for lower prices and better quality, most people (59%) choose direct government action over the more market-oriented solution (34%). That was true across the board for Democrats (66%), Independents (58%), and Republicans (52%).

The full survey results, including question wording, are available online here. A webcast of a briefing discussing the results and the health priorities for Congress and the Administration also will be available there later today.

Methodology

The Kaiser Family Foundation/Harvard School of Public Health Survey, The Public’s Health Care Agenda for the New Congress and Presidential Campaign, was designed and analyzed by researchers at the Kaiser Family Foundation and Harvard School of Public Health. The Kaiser/Harvard survey research team included Drew E. Altman, Ph.D., Mollyann Brodie, Ph.D., and Claudia Deane, M.A. from the Kaiser Family Foundation; and Professor Robert Blendon, Sc.D., and John Benson, M.A. of the Harvard School of Public Health.

Fieldwork was done by telephone November 9 to 19, 2006 among a nationally representative sample of 1,867 respondents ages 18 and over — including 1,363 respondents who reported voting in the midterm election — by ICR/International Communications Research. The survey included an oversample of respondents ages 65 and over; a total of 718 respondents in this age group were interviewed. Overall results have been weighted to reflect the actual demographic distribution of the nation.

The margin of sampling error for results based on the full sample is plus or minus 3 percentage points. For results based on smaller subsets of respondents, the margin of sampling error is somewhat higher. Note that sampling error is only one of many potential sources of error in this or any other public opinion poll.

The Kaiser Family Foundation is a non-profit, private operating foundation dedicated to providing information and analysis on health care issues to policymakers, the media, the health care community, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.

Harvard School of Public Health is dedicated to advancing the public’s health through learning, discovery, and communication. More than 300 faculty members are engaged in teaching and training the 900-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: www.hsph.harvard.edu.

This report finds that monthly SCHIP enrollment reached a record high of more than 4 million in June 2005, reversing the decline seen in the previous 12 month period. SCHIP enrollment rose in all but nine states, including large increase in California, Georgia, and Illinois.

Report (.pdf)

The Ryan White CARE Act: A Side-by-Side Comparison of Prior Law to the Newly ReauthorizedCARE Act

This side-by-side provides a comparison of prior law to the newly reauthorized Ryan White HIV/AIDS Treatment Modernization Act of 2006.

December 2006 Report (.pdf)

Previous Versions:

November 2006 (.pdf)

June 2006 (.pdf)

This report explores how pervasive media multitasking is among young people, potential cognitive and social development implications, and which teens are most likely to multitask.

The report was released at a forum held on Tuesday, December 12, in Washington, D.C. A webcast of the forum is available.

Report (.pdf)

The key findings explore how pervasive media multitasking is among young people, potential cognitive and social development implications, and which teens are most likely to multitask.

It was released at a forum held on Tuesday, December 12, in Washington, D.C. A webcast of the forum, The Teen Media Juggling Act: the Implications of Media Multitasking Among American Youth is available.

Key Findings (.pdf)

These charts highlight data from a poll on Seniors and the Medicare Prescription Drug Benefit, conducted jointly by the Kaiser Family Foundation and the Harvard School of Public Health between November 9 and 19, 2006. It included a nationally representative sample of 718 seniors, including 275 who reported being enrolled in a Medicare drug plan.

The questions about experiences under the Medicare drug benefit were part of a larger survey of 1,867 adults on the public’s health agenda for Congress and the presidential campaign. The survey’s margin of sampling error is plus or minus 4 percentage points for all seniors, and plus or minus 7 percentage points for seniors enrolled in the Medicare drug benefit.

Chartpack (.pdf)

This includes the full report on the 2006 Kaiser/Hewitt survey of large businesses that provide retiree health benefits to their workers. The Kaiser/Hewitt study, the fifth joint survey since 2002, analyzes responses from a non-probability sample of 302 businesses with 1,000 or more employees that offer retiree health benefits. These large firms collectively provide health benefits for 5.2 million retirees and dependents, including 3.4 million Medicare-eligible retirees. Together they account for more than one quarter of the 12 million Medicare beneficiaries with retiree health benefits nationally and nearly half of the 7.2 million beneficiaries with private-sector retiree health coverage. The survey was conducted online between June and October 2006.

Report (.pdf)

Health Benefits

This document presents key data from the 2006 Kaiser/Hewitt Survey on Retiree Health Benefits.

Chartpack (.pdf)

This report describes the views and experiences of 35 Medicare beneficiaries under the new drug benefit in advance of the 2007 open enrollment period. The report finds that drug plan enrollees generally say that they are satisfied with their drug coverage and have not encountered major difficulties using their plan. At the same time, many of them don’t fully understand how their plan works even after almost a year of experience with this new benefit.

The report is the third from a year-long series of one-on-one structured interviews with a diverse group of Medicare beneficiaries in four cities: Baltimore, Miami, Sacramento, and Lincoln, Nebraska. The Kaiser Family Foundation commissioned Lake Research Partners and American Viewpoint to conduct these interviews.

The first report, “Profiles of Medicare Beneficiaries With Medicaid Drug Coverage Prior to the Medicare Drug Benefit,” profiled four people who are dually eligible for Medicare and Medicaid to provide greater insights into their circumstances as the new Medicare drug benefit went into effect. The second report, “Voices of Beneficiaries: Early Experiences with the Medicare Drug Benefit,” addressed the first months of Part D coverage in 2006.

Report (.pdf)