Because over seven million elderly and disabled individuals are entitled to benefits under both Medicare and Medicaid, policy changes in one program not only affect both coverage and spending in the other but also impact access to services by individuals eligible for both programs. This primer summarizes two key policy interactions and includes a quick reference table of the most significant linkages between the two programs.

Issue Brief (.pdf)

This chartpack reviews the President’s FY 2007 budget request to Congress and highlights overall budget assumptions and funding for major health programs. It begins with a description of the federal budget process, followed by summary information on the overall composition of the Administration’s budget. Overall, the budget includes net reductions for Medicare, Medicaid, and other health programs administered by the Department of Health and Human Services. The budget also includes additional expenditures for proposals to promote health savings accounts.

Issue Brief .pdf)

With the enactment of the Deficit Reduction Act of 2005, states have gained increased flexibility over benefits and cost sharing for certain currently eligible Medicaid populations without having to obtain a waiver of Medicaid rules. New findings from the Kaiser Family Foundation’s 2004 survey of the experiences of Medicaid beneficiaries under Utah’s 2002 waiver provide insights into the implications of limited benefits for the low-income population. The results are featured in the March/April edition of Health Affairs.

Under a waiver, Utah expanded coverage for primary care services to low-income uninsured parents and adults, offsetting costs by limiting benefits and raising cost sharing for poor parents, most with incomes below 54 percent of the federal poverty level, already covered by Medicaid.

The study suggests that a coverage expansion approach that relies on savings from reducing coverage for current beneficiaries and provides a limited benefit has important limitations. Although the primary care expansion helped fill a critical need for low-income uninsured adults, more than three-fourths of primary care enrollees needed services beyond the scope of their coverage. Similarly, more than two-thirds of the Medicaid beneficiaries subject to coverage reductions needed care beyond their coverage. The limited coverage or the cost associated with services, led one in three newly insured people to miss or postpone care and over half reported difficulty paying for medical expenses. Among the parents with coverage reductions, nearly a quarter reported missing or postponing care and over a third said they had difficulty paying medical expenses.

A case study report examining the creation and implementation of Utah’s waiver through interviews with key stakeholders and an analysis of state enrollment data and quarterly reports is also available.

Health Affairs article, Can States Stretch The Medicaid Dollar Without Passing The Buck? Lessons From Utah (Free Access)Abstract Full Text

A Case Study of the Utah Primary Care Network Waiver: Insights into Its Development, Design, and Implementation

Should physicians be required to tell patients if a preventable medical error resulting in serious harm is made in their OWN care, or not?

88

Yes

9

No

2

(DO NOT READ) Don’t know

1

(DO NOT READ) Refused

If a preventable medical error that resulted in serious harm were made in your care, how likely do you think the doctor would be to tell you– very likely, somewhat likely, not very likely, or not at all likely?

23

Very likely

31

Somewhat likely

25

Not very likely

19

Not at all likely

2

(DO NOT READ) Don’t know

*

(DO NOT READ) Refused

Did the doctor or the health professionals involved tell you that a medical error had been made in your or your family member’s treatment, or didn’t they tell you?

Based on those involved with a preventable medical error (n=685)

28

Told you

70

Did not tell you

2

Don’t know/Refused

Survey by Henry J. Kaiser Family Foundation, Agency for Healthcare Research and Quality, Harvard School of Public Health. Methodology: Fieldwork Conducted by Princeton Survey Research Associates International, July 7-September 5, 2004 and based on telephone interviews with a national adult sample of 2,012. 

Assuming that medical errors are reported, should hospital reports of serious medical errors be confidential and only used to learn how to prevent future mistakes or should they also be released to the public?

31

Confidential

63

Released to the public

4

(DO NOT READ) Don’t know

1

(DO NOT READ) Refused

Which one of the following statements comes closer to your views on how medical errors that result in serious injury or harm should be handled?  (CATEGORIES READ AND ROTATED)

92

A. Reporting of serious medical errors should be REQUIRED (OR)

6

B. Reporting of serious medical errors should be VOLUNTARY (OR)

2

(DO NOT READ) Don’t know/Refused

Survey by Henry J. Kaiser Family Foundation, Agency for Healthcare Research and Quality, Harvard School of Public Health. Methodology: Fieldwork Conducted by Princeton Survey Research Associates International, July 7-September 5, 2004 and based on telephone interviews with a national adult sample of 2,012

About how many Americans do you think die in hospitals each year as a result of a preventable medical error?  (ANSWER CATEGORIES READ)

18

500

31

5,000

18

50,000

9

100,000 OR

5

500,000 or more

16

(DO NOT READ) Don’t know

Survey by Henry J. Kaiser Family Foundation, Agency for Healthcare Research and Quality, Harvard School of Public Health. Methodology: Fieldwork Conducted by Princeton Survey Research Associates International, July 7-September 5, 2004 and based on telephone interviews with a national adult sample of 2,012. 

2001/2002 Kaiser Mini-Fellows

Constance Alexander, freelance writer and independent producer, WKMS-FM Reporting Area: End-of-life issues in rural western Kentucky.

Jenni Bergal, reporter, The Sun-Sentinel, Fort Lauderdale, FLReporting Area: The Broward County mental health court – a model way to address cases involving mentally ill defendants?

Jill Brown, managing editor, Managed Care WeekReporting Area: Converting Blue Cross/Blue Shield plans to for-profit companies, and the implications for enrollees.

Dudley Clendinen, authorReporting Area: Growing old in America: life in a geriatric high-rise, a microcosm of coping with the new old age, on the shore of Tampa Bay.

Mary Coffman, co-director, Medill News Service, Washington, D.C.Reporting Area: The impact of direct-to-consumer advertising of prescription drugs.

Barbara Feder, medical reporter, The San Jose Mercury NewsReporting Area: The search for a viable microbicide-the politics, policy, research, and ethical issues surrounding clinical trials.”Slowly, AIDS Spotlight Focuses on Microbicides for Women,” July 23, 2004

Jean Fisher, health/business writer, The News & Observer, Raleigh, NCReporting Area: The impact of managed care on academic medical centers.

Susan Thom Loubet, public radio host, KUNM/Radio, New MexicoReporting Area: Healthcare outreach efforts to special populations in New Mexico – how well do they work?

Camille Mojica Rey, freelance writerReporting Area: Changing the way Americans eat and exercise, with a focus on communities of color.

Ann Pappert, freelance writerReporting Area: Healthcare after welfare reform-the experience of residents in an inner-city New York neighborhood.

Tom Paulson, science/medical reporter, and Mike Urban, photographer, The Seattle Post-IntelligencerReporting Area: Efforts to tackle global health challenges, and transform the health status of communities worldwide.

Julie Reynolds, editor, El Andar magazineReporting Area: The impact of AIDS among migrant workers in California, and in their hometowns in Mexico.

Stephen Smith, managing editor and correspondent, American RadioWorks, Minnesota Public RadioReporting Area: The Cuban health care system.

Jamie Stobie, public television documentary producerReporting Area: How technological advances are being used and adapted by people with disabilities.

Contact Information:

For more information, please email mediafellows@kff.org.

Jide Adeniyi-Jones, All Africa.comReporting Area: Nigeria”HIV in Nigeria: Living on the Edge,” 2003

Raney Aronson, FRONTLINEReporting Area: India “India: The Sex Workers,” FRONTLINE, June 24, 2004

Susan Brink, US News & World ReportReporting Area: Botswana”Dancing in the Dark,” December 15, 2003

Jon Cohen, Science magazineReporting Area: Asia”Asia: The Next Frontier for HIV/AIDS,” September 12, 2003

Liz Doup, South Florida Sun-Sentinel, Fort LauderdaleReporting Area: South Florida”AIDS in South Florida,” June 8, 2003

Roland De Wolk, KTVU/2, San Francisco-OaklandReporting Area: California Bay Area teens

Liz McGregor, freelance reporterReporting Area: Southern Africa

James Nachtwey, photographerReporting Area: Southern Africa

Joe Richman, National Public Radio/Radio DiariesReporting Area: South African teens”Out of Hiding, Into the World: Thembi’s AIDS Diary” April 19, 2006

Will Wright & Curtis Jackson, BET Nightly NewsReporting Area: Alabama women and youth”AIDS in the South,” November 26, 2003

Contact Information:

For more information, please email mediafellows@kff.org.

Joanna Breitstein, senior associate editor, Pharmaceutical ExecutiveProject: Tracking pharmaceutical companies’ AIDS drugs donations to patients in Africa.”AIDS in Africa: The Lazarus Effect,” February 1, 2005″AIDS in Africa: The Road Forward,” March 1, 2005

“Broken and Fixed- Images and Ideas Shaping East Africa,” photography event, December 14, 2005

“Breath of Hope: TB in Africa,” February 1, 2006

Geoffrey Cowley, senior editor for health and medicine, NewsweekProject: The World Health Organization’s plan to extend AIDS treatment to 3 million more people by 2005. “Medicine Without Doctors,” June 19, 2004

Sharon Egiebor, executive editor, The Dallas ExaminerProject: The impact of HIV/AIDS on African-Americans in Dallas County, with special focus on teenagers.

Natalia Fedushchak, freelance reporterProject: HIV/AIDS in the Ukraine”CU tracks HIV in Ukranian addicts,” The Denver Post, November 30 2004

Regina McEnery, medical writer, The Plain Dealer (Cleveland)Project: The impact and challenge of collaborative AIDS projects linking university researchers, physicians and anthropologists in Cleveland with those in Kampala, Uganda.Teaming Up Against AIDS is 3-part series on AIDS in Uganda”Case Battles Uganda Crisis,” November 21, 2004″Tracking a Killer’s Helper,” November 22, 2004″Focus turns to Affordable Treatment,” November 23, 2004

Kristi Nelson, health writer, Chandra Harris, staff writer, and Jeannine Hunter, staff writer, The Knoxville News SentinelProject: The changing face of AIDS in Southern Appalachia.”Living Positive: Faces of HIV/AIDS varied in East Tennessee“, Seven-part series, August 14-21, 2005

Judy Nichols, senior reporter, The Arizona RepublicProject: HIV/AIDS in Native American communities.”AIDS takes a growing toll on Native Americans,” July 3, 2005

Sabin Russell, medical writer, The San Francisco ChronicleProject: The complexities and implications of the emerging HIV/AIDS epidemic in India.”AIDS in India,” Five-Part Series, July 4, 2004

Renata Simone, producer, WGBH National Productions (Boston)Project: HIV/AIDS in China”China AIDS Initiative: A Conversation with David Ho,” June 17, 2004

“Age of AIDS,” PBS FRONTLINE, May 30, 2006

Matt Steinglass, correspondent, The Boston GlobeProject: HIV/AIDS and public health attitudes in Vietnam.

Kai Wright, senior editor, City Limits (New York City)Project: HIV/AIDS inside New York State’s prison system.

Ruby Yang and Thomas Lennon, independent documentary filmmakers (New York City)Project: HIV/AIDS in ChinaThe China AIDS Media Project

Contact Information:

For more information, please email mediafellows@kff.org.

Greg Barker, documentary filmmaker, FRONTLINEProject: Age of AIDS: 25 years of the epidemic “Age of AIDS,” PBS FRONTLINE, May 30, 2006

Tim Collie, senior writer, and Mike Stocker, senior photographer, South Florida Sun-SentinelProject: AIDS and children in the Caribbean.

Shereen El Feki, healthcare correspondent, The EconomistProject: AIDS in the Middle East–what are the HIV rates and transmission patterns?

Reese Erlich, freelance journalist, Oakland, CAProject: Brazil’s success in fighting AIDS, and the implications for the U.S.Report on how activists believe the U.S. could learn about AIDS health care from the Brazilian government. (09/2005) Story republished with permisson from Latino USA. “Hard to Swallow,” The Monthly, Vol. 36, No. 4. (01/2006)

Andrew Finlayson, news director, WSMV/4, Nashville, TNProject: AIDS and STDs in Tennessee. “It Can Happen to You: HIV/AIDS in Middle Tennessee,” WSMV/4, Nashville, TN