The independent source for health policy research, polling, and news.
This issue brief describes Medicare drug benefit policy issues for residents of nursing homes and other long-term care settings, such as assisted living facilities and board and care facilities. The brief addresses differing rules for nursing home and non-nursing home settings, as well as for dual eligibles residing in long-term care facilities.
Issue Brief (.pdf)
Still keeping in mind that many employers are trying to find ways to deal with the rising cost of health insurance… Suppose your employer gave you the following two options. Which option would you choose?
Based on those who have health insurance through their or their spouse’s employer (n=1542)
76 OPTION ONE: You continue to receive the same health care coverage you have now, but you are required to pay a higher monthly premium
19 OPTION TWO: Your employer switches to a health plan that is more restrictive and offers fewer benefits, but you continue to pay the same monthly premium you pay now
5 Don’t know
1 Refused
Would you prefer to have your employer pay for all or part of your health insurance at work, or would you rather buy health insurance yourself, with your employer giving you the cash amount they would have contributed – or doesn’t it make much difference to you?
Based on those who have health insurance through their or their spouse’s employer (n=1542)
55 Employer pay for all or part of your health insurance at work
7 Buy health insurance yourself, with your employer giving you the cash amount they would have contributed
37 Doesn’t it make much difference to you
1 Don’t know
* Refused
What if your employer gave you the cash amount they would have contributed to your insurance, and you had to buy health insurance on your own. Do you think purchasing your own coverage would make it EASIER or HARDER for you to …, or wouldn’t it make much difference?
Based on those who have health insurance through their or their spouse’s employer (n=1542)
Asked of one-half of sample (n=755):
a get a good price for health insurance
6 Easier
81 Harder
10 Would not make a difference
3 Don’t know
b find or keep health insurance if you are sick
4 Easier
79 Harder
15 Would not make a difference
2 Don’t know
Asked of one-half of sample (n=787):
c handle administrative issues, such as filing a claim or signing up for a policy
4 Easier
73 Harder
21 Would not make a difference
2 Don’t know
d find a plan that matches your needs well
9 Easier
71 Harder
17 Would not make a difference
2 Don’t know
This fact sheet summarizes the early and periodic screening, diagnostic, and treatment (EPSDT) Medicaid benefit for children and the current issues and debates that could impact the benefit.
Fact Sheet (.pdf)
Dual eligible beneficiaries who participate in Medicaid home and community-based waiver programs usually do not have a centralized care provider to manage their health care benefits and services. For the new Medicare prescription drug benefit, no individual is designated to assist participants with their prescription drug plan selection, comparison of formularies, and if necessary, management of their exceptions and appeals should a medication be denied by their plan.
This paper offers state and federal policymakers ideas for what to monitor to ensure that waiver participants maintain equal access to prescription drugs as their institutionalized peers, and can remain in waiver programs without increased physical harm or financial hardship
Issue Brief (.pdf)
Executive Summary (.pdf)
Health Care Coverage and Financing Issues in California: An October 2005 Update
This brief summarizes recent health insurance coverage trends in California and the Medi-Cal program, provides an overview of the state’s newly adopted FY 2005-06 budget agreement, and discusses key issues driving the current health policy agenda. The brief concludes with a discussion on Medicaid reform actions at the federal level and the potential implications for California.
Issue Brief (.pdf)
This survey conducted jointly by the Washington Post, the Kaiser Family Foundation and the Harvard School of Public Health assesses the views and attitudes of DC-area teens and their parents on priorities involving career, child-rearing and family; their personal hopes and fears; their outlook towards the nation’s future; and generational differences in experiences and expectations. The survey also includes comparative data from a national survey of teens.
The was conducted among 800 pairs of parents and teenagers in the region, including the District of Columbia, Maryland, and Virginia. Interviews were conducted by telephone between April 26 and May 29, 2005 by ICR/International Communication Research. Not all questions were asked of parents. Teenagers were defined as those between 14 and 18 years of age. The survey also includes additional questions asked of a national sample of 570 teenagers between 14 and 18 years of age.
Survey (.pdf)
This Kaiser Family Foundation study estimates the potential impact in monthly Medicare drug premiums if enrollment does not reach 29 million in 2006 as the Congressional Budget Office (CBO) assumed, and if those who do enroll have relatively high total prescription drug costs.
The study, prepared by Avalere Health LLC and based on a model developed by Actuarial Research Corporation, looks at various participation scenarios for the beneficiaries who are projected by the Congressional Budget Office (CBO) to enroll in a Medicare drug plan in 2006. The paper examines the effects of varying enrollment on monthly premiums and federal costs of the Medicare prescription drug benefit, particularly if beneficiaries with relatively low drug spending do not enroll.
This analysis solely focuses on the impact of various participation scenarios, based on beneficiaries’ prescription drug costs, on average Medicare prescription drug plan premiums. The analysis holds constant other factors that also could affect average plan premiums in the future, including drug prices and utilization, and other market dynamics that could affect plan participation. These factors were held constant to illustrate the implications of various beneficiary participation scenarios on Medicare drug plan premiums.
The study was prepared for the Kaiser Family Foundation by Jonathan Blum, Jennifer Bowman, and Chiquita White of Avalere Health LLC.
Report (.pdf)
In recent years states have been trying to shift resources from institutional to home and community based long-term care services. This report examines “transition” and “diversion” policies and practices in eight states. It provides a sense of what state Medicaid programs are doing or could be doing to promote diversion.
Report (.pdf)
Executive Summary (.pdf)
Three KCMU state surveys indicate improving economy and sustained state cost-containment actions have improved the outlook for Medicaid and SCHIP, but long-term challenges remain due to factors affecting overall health care system.
Summary of Findings (.pdf)
Medicaid Budgets, Spending and Policy Initiatives in State Fiscal Years 2005 and 2006
State Medicaid Outpatient Prescription Drug Policies: Findings from a National Survey, 2005 Update
In a Time of Growing Need: State Choices Influence Health Coverage Access for Children and Families
News on State Medicaid Programs: July through September 2005 Update
