The independent source for health policy research, polling, and news.
Who are the Uninsured? A Consistent Profile Across National Surveys
This issue brief examines the differences in the estimates of the uninsured population from three major surveys and finds that the estimates are actually more consistent than what is often perceived. In addition, the analysis shows that who the uninsured are does not vary much across national surveys.
This report offers insights into Medicare beneficiaries’ experiences with the new drug benefit, based on observations of State Health Insurance Assistance Plan (SHIP) directors convened for a moderated focus group discussion. Because SHIP directors work closely with the Centers for Medicare and Medicaid Services and are on the front lines providing one-on-one counseling for beneficiaries who have questions or problems related to the new drug benefit, they are a key resource for understanding issues that have emerged during the first six months of the new Medicare benefit. At the same time, because SHIPs are a resource for people who need help and seek assistance, the issues identified in this report should not be construed to apply generally to the Medicare population.
SHIP directors who participated in the focus group reported significant casework related to data system errors resulting in beneficiaries being enrolled in a plan other than the one they had selected, being enrolled into multiple plans, or inadvertently disenrolled from a plan. Another major source of casework involved Part D premium payments, particularly for those who elected to have premiums deducted from their Social Security checks. Other issues include concerns about marketing practices by some Part D plans, prior authorization requirements, beneficiaries’ limited knowledge of Medicare Advantage products, emerging concerns related to the “doughnut hole,” and problems with the automatic enrollment of the dual eligible population.
On the first anniversary of Hurricane Katrina’s landfall, a paper authored by Foundation staff, released as a web exclusive by the journal Health Affairs, examines the impact of the storm on New Orleans, the current state of health care in the city, and lessons learned about the city’s health care delivery system.
Health Affairs article:
The Deficit Reduction Act of 2005 (DRA), signed into law on February 8, 2006, contains a large number of changes in Medicaid policy that are expected to affect almost all elements of the Medicaid program—eligibility, benefits and cost-sharing, provider payments and program integrity. In most instances the policy changes are optional for state Medicaid programs, but in some the changes are mandatory. At the federal level, the interpretation and implementation of these legislative policy changes is primarily the responsibility of the Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS). State Medicaid agencies and state legislatures look to CMS for guidance as to what policy changes they must make and what policy changes they are allowed to make.
This policy brief outlines the roles of Congress, CMS and the states in implementing Medicaid policy changes and highlights some of the changes included in the DRA. The brief also examines how the forms and timing of guidance can affect the transparency of the public policy process as well as lead time for state implementation of new policies.
Issue Brief (.pdf)
The Kaiser Family Foundation released a new report on the implications of the new Medicare Part D prescription drug benefit for people living with HIV/AIDS. The report looks at the coverage and cost of antiretroviral drugs under the new private, stand-alone Medicare drug plans.
Report (.pdf)
WEBCASTING
In collaboration with the International AIDS Society, the Toronto Local Host and co-organizers of the conference, Kaiser provides free, online access to the archived conference proceedings to NGOs, news organizations, policymakers, researchers and others on kaisernetwork.org. The daily coverage included:
Access complete conference coverage at http://www.kaisernetwork.org/aids2006.
SPECIAL SESSIONMedia and AIDS: Spreading Information Faster than the DiseaseMonday, August 14, 2006 at 18:00 -20:00 – Metro Toronto Convention Center – Session Room 5 / Level 800Richard Gere, actor and founder of Healing the Divide, opened a session on the critical role of media in raising awareness, changing attitudes, and fighting stigma. Moderated by Bill Roedy of MTV Networks International, this panel of broadcast executives and a leading AIDS advocate discussed the mobilization of the media industry following the 2004 launch of the Global Media AIDS Initiative by UN Secretary-General Kofi Annan at a special meeting organized by the Kaiser Family Foundation and UNAIDS.
Major new media coalitions and public awareness campaigns have emerged in Africa, the Caribbean, India and Russia. Media executives from these regions and countries discussed and shared key challenges and achievements in their expanded response to HIV/AIDS. Panelists also discussed models of partnership between local organizations, government institutions, and media companies that have led to well-coordinated and highly-leveraged campaigns.
NEWS CONFERENCEMonday, August 14, 2006, at 17:00 – 17:45 – Media Center, Metro Toronto Convention CenterThe Heroes Project and Star TV made an important announcement regarding their stigma reduction and HIV prevention campaign in India. Launched in 2004, the Heroes Project is the largest nongovernmental public service campaign in India, which is responsible for mainstreaming HIV/AIDS messaging throughout the country. Participants included: Richard Gere, Co-Chair, Heroes Project; Peter Mukerjea, CEO, STAR India; Askok Alexander, Director, Avahan, India AIDS Initiative of the Bill & Melinda Gates Foundation; Matt James, Senior Vice President, The Henry J. Kaiser Family Foundation.
News Release: Star India and the Heroes Project Announce Extension of Media Partnership at the 2006 International AIDS Conference
NEWS CONFERENCEWednesday, August 16, 2006 at 16:00 –16:45 – Room 3, Media Center, Metro Toronto Convention CenterCaribbean Broadcast Media, together with partners from the Ford Foundation, the Elton John AIDS Foundation and Kaiser, made a major announcement to support HIV prevention efforts in the Caribbean. Participants included Dr. Allyson Leacock, General Manager, Caribbean Broadcasting Corporation; Jacob Gayle, Deputy Vice President, Ford Foundation; Scott Campbell, Executive Director, Elton John AIDS Foundation; and, Matt James, Senior Vice President, Kaiser Family Foundation.
REPORTS AND RESOURCES
JOURNALIST BRIEFINGSKaiser hosted more than 50 journalists from Africa, India, the Caribbean, Russia, Ukraine, and the United States of America for three days of special briefings on HIV/AIDS. The sessions were designed as a precursor to the AIDS Conference and to spur more in-depth reporting on the epidemic, and were held in collaboration with CBC/Radio-Canada’s Canadian Institute for Training in Public Broadcasting, and with the International AIDS Vaccine Initiative (IAVI).
These toplines highlight key data which was taken from the June 2006 Kaiser Health Poll Report and focuses on the public’s views about the response to Hurricane Katrina.
Toplines (.pdf)
This chartpack highlights key data which was taken from the June 2006 Kaiser Health Poll Report and focuses on the public’s views about the response to Hurricane Katrina.
Chartpack (.pdf)
This report provides key findings from interviews with low-income Katrina survivors about their health care experiences after the storm to provide insight into how they fared and to highlight ways to improve the response to this and future disasters. The report also includes several in-depth, individual profiles of survivors’ health care experiences and highlights some specific experiences of individuals with HIV/AIDS.
The report is based on in-person interviews conducted with more than 40 survivors and seven providers serving survivors, which took place in January and February 2006 (five to six months after the storm) in New Orleans, Baton Rouge and Houston. Follow-up interviews were conducted in June 2006 (by phone or in-person) with eight survivors.
Full Report (.pdf)
Executive Summary (.pdf)
Survivor Experiences (.pdf)
Individual Survivor Stories:
Gertrude (.pdf)
Mack (.pdf)
Dawn (.pdf)
Linda (.pdf)
Melissa (.pdf)
Michelle (.pdf)
Sharonda (.pdf)
Lynn (.pdf)
Individuals with HIV/AIDS (.pdf)
Embargoed for release until:Thursday, July 27, 2006
For further information contact:Craig Palosky, KFF, (202) 347-5270Larry Levitt, KFF, (650) 854-9400
MOST SENIORS ENROLLED IN MEDICARE DRUG PLANS SAY THEY ARE SATISFIED WITH THEIR PLANS
Nearly Two In 10 Who Have Used Their Drug Plan Say They Experienced A Major Problem
Nearly Half In Medicare Drug Plans Say They Are Saving Money Compared To Last Year
More than eight in 10 seniors who are enrolled in a Medicare drug plan are satisfied with their plan, although almost two in 10 say they encountered a major problem in using it, according to the latest Kaiser Family Foundation tracking survey of seniors’ experiences under the new Medicare drug benefit.
The survey of 1,585 seniors, including 623 who are enrolled in a new Medicare Part D drug plan, reveals that, for most seniors, initial experiences under the drug benefit have been positive. About three in four seniors who are enrolled in a drug plan would choose the same plan again.
The survey also finds that about a third (34%) of seniors who have used their plan had experiences that they perceived as a problem — with 18% describing it as a “major problem” and 16% describing it as a “minor problem.” The experiences cited as problems include having to pay unexpected costs, leaving the pharmacy without being able to fill a prescription, not receiving their enrollment card and having to switch drugs because one wasn’t covered. Some seniors also cited having to switch from a brand-name to a generic drug as a problem, though others who reported such an experience did not consider it to be a problem.
Nearly all (90%) of those reporting minor problems say that the problem was resolved to their satisfaction. Slightly more than half (55%) of those reporting a major problem say that it had been resolved, with the rest (44%) saying it was unresolved.
Among seniors who have used their drug plans, those in fair or poor health were significantly more likely to report experiencing major problems with their plan (27%) than seniors in excellent or very good health (12%). Higher rates of problems were also reported by seniors who take six or more prescriptions each day (29%) and seniors with incomes of less than $20,000 annually (26%).
“Most seniors say they are satisfied with their drug plans, but it bears close monitoring that the sickest seniors are most likely to report problems,” said Foundation President and CEO Drew E. Altman, Ph.D.
The nationally representative tracking poll — the 13th in a series that comprises three large surveys and 10 smaller tracking polls — was conducted from June 8 to June 18.
The survey shows that among seniors who have used their Medicare drug plan, nearly half (46%) say they are saving money on their prescription drugs. Most of the others say they are paying about the same as they did last year for their drugs (34%), though one in six (17%) say they are paying more.
Overall, seniors who are enrolled in Medicare plans have mixed views about whether changes are needed to improve the program. About as many say that the program “is working well and no real changes are needed” (24%) as say that the program “is not working and needs major changes” (27%). Most others say that the program “could be improved with some minor changes” (35%).
The survey also captures seniors’ overall attitudes toward the drug benefit, their knowledge about it, and their reasons for enrolling or not enrolling in a plan. Among all seniors, roughly equal numbers view the drug benefit favorably (32%) as unfavorably (30%). The share reporting unfavorable views has dropped substantially since the first weeks of the initial enrollment period in December, when most seniors needed to decide whether to enroll in a plan and, if so, which plan.
Among all seniors, relatively few consider prescription drugs to be the driving issue in the upcoming elections. When asked to identify the “single most important” issue in the 2006 Congressional election, seniors ranked prescription drugs ninth on a list of 12 issues, behind such issues as the situation in Iraq; the U.S. campaign against terrorism; gas prices; immigration; and health care overall. The poll was taken before the current conflict in Israel and Lebanon began.
“With the ongoing turmoil in the Middle East and Iraq, high gas prices and other problems on their minds, it certainly doesn’t look like the prescription drug law will be a significant factor when older voters cast their ballots in the fall,” Dr. Altman said.
The survey tested seniors’ knowledge about the Medicare drug benefit’s coverage gap, or “doughnut hole,” in which most plans stop paying for medications and seniors must pay the full cost of their prescriptions. One- third of seniors in a Medicare drug plan say that their plan has a coverage gap (34%); about as many say that their plan does not have a gap (36%); and the others say they did not know or refused to answer (30%). Nearly all plans have such a gap, though seniors receiving low-income assistance, including those receiving Medicaid, do not experience the gap due to government subsidies.
Nearly two in three seniors overall are also unaware of the special assistance available to low-income seniors. Even among the group most likely to qualify for low-income assistance — those with incomes of less than $20,000 — 32% say they were aware of the program, administered by Social Security, which helps low-income seniors with premiums and cost-sharing requirements under the Medicare drug benefit.
“Despite an intense outreach effort by the Administration and advocates alike, there are still large numbers of eligible seniors who are simply unaware of the extra help available to them,” said Foundation Vice President Mollyann Brodie, Ph.D., the director of the Foundation’s Public Opinion and Media Research program.
The full survey results, including charts of key data, are available online.
Methodology
Seniors’ Early Experiences with Their Medicare Drug Plans – the 13th in a series that comprises three large surveys and ten smaller tracking polls – was conducted and analyzed by researchers at the Kaiser Family Foundation. Fieldwork by PSRAI occurred between June 8 and June 18, 2006, among a nationally representative random sample of 1,585 adults ages 65 and older. Interviews were conducted in English and Spanish.
We report on several different groups of seniors including: 1) seniors enrolled in Medicare drug plans, including those who reported being in stand-alone prescription drug plans, Medicare and Medicaid enrollees (i.e. dual eligibles), and Medicare HMO enrollees (40% of all seniors, unweighted n=623), and 2) seniors who have used their Medicare drug plans (28% of all seniors, unweighted n=443).
The margin of sampling error for the survey is plus or minus 3 percentage points for all seniors, and plus or minus 4 points for seniors enrolled in Medicare drug plans. For results based on smaller subsets of respondents the margin of sampling error is 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.
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