More than one-third of all reported AIDS cases in the United States have occurred among injection drug users, their partners, and their children. Public health experts have identified access to sterile syringes as one component of a comprehensive HIV prevention strategy designed to reduce HIV transmission among injection drug users. However, others strongly oppose needle exchange, feeling that it promotes drug use and debates about syringe access continue, as does a federal ban on the use of federal funding for syringe exchange programs. This ban, combined with the fact that laws governing syringe access are generally the purview of the states, places the state and local policy role concerning syringe access at the center of the policy debate.

A new report by the Kaiser Family Foundation, Syringe Exchange and AB 136: The Dynamics of Local Consideration in Six California Communities, provides a qualitative assessment of California’s Assembly Bill (AB) 136, which authorizes the operation of syringe exchange programs within the state after a local declaration of emergency. The study is based on interviews with key stakeholders in six California county and city jurisdictions.

As policymakers consider a range of approaches to providing prescription drug coverage to the Medicare population in today s tight budgetary environment, one proposal that has been put forth by the Bush Administration is that of a Medicare-endorsed prescription drug discount card program. This report describes the range of existing discount card programs run by both private sponsors and state governments and provides background information on the implications of this approach to assisting Medicare beneficiaries with their prescription drug bills.

• Report

Health News Index January/February, 2002

The January/February 2002 edition of the Kaiser Family Foundation/ Harvard School of Public Health Health News Index includes questions about major health stories covered in the news, including the public s knowledge of the ongoing anthrax investigation and prescription drug discount cards. The Health News Index is designed to help news media and people in the health field gain a better understanding of which health stories Americans are following and what they understand about those issues.

• HNI January-February 2002
• Topline/Survey

Recent Publications on Medicaid and Prescription Drugs

The Kaiser Commission on Medicaid and the Uninsured continues to focus on the role of prescription drugs in the Medicaid program with particular attention on drug spending trends, state reforms to curb spending, and the impact on access to care. Listed below are the most recent publications on these important issues. Check back frequently for new publications.

• Case Study: Michigan’s Medicaid Prescription Drug Benefit
• Medicaid and Prescription Drugs: Fact Sheet
• Medicaid and the Prescription Drug Benefit: A Policy Brief
• States Strive to Limit Medicaid Expenditures for Prescribed Drugs
• Medicaid: Purchasing Prescription Drugs
• Florida’s Medicaid Prescription Drug Benefit: A Case Study
• Medicaid & Prescription Drugs: Findings from a National Survey and Selected Case Study Highlights
• Outpatient Prescription Drug Benefits Under Medicaid: Detailed Case Studies
• Link to “State Variation in Medicaid Pharmacy Benefit Use Among Dual-Eligible Beneficiaries”
• Link to “Prescription Drug Trends: A Chartbook Update”
• Link to “Prescription Drug Discount Cards: Current Programs and Issues”

Florida’s Medicaid Prescription Drug Benefit: A Case Study

A new study summarizes and discusses the state s attempt to reform its Medicaid prescription drug benefit program.

• Background Paper

A new report presenting year 2000 trends on prescription drug spending, summarizing states options in designing their benefit, and reviewing several ways states are using their flexibility to curb the rate of growth of their Medicaid drug budgets.

• Background Paper

Teens and young adults face many pressures and decisions involving alcohol, drugs, and sexual activity decisions that often occur simultaneously. Almost one quarter of sexually active young people aged 15-24 report having sex without a condom because they were drinking or using drugs at the time. These findings are from a new national survey conducted by the Kaiser Family Foundation and released at a conference, Dangerous Liaisons: Substance Abuse and Sexual Behavior, sponsored by the National Center on Addiction and Substance Abuse (CASA) at Columbia University.

• Survey Snapshot
• Toplines/Survey
• Fact Sheet: Substance Use and Sexual Health Among Teens and Young Adults in the U.S.
• Issue Update: Substance Use and Risky Sexual Activity

This report examines a Medicare-based approach to reducing the ranks of the uninsured that would permit early retirees between the ages of 62 and 65 to purchase coverage under Medicare. The paper begins with an overview of the challenges of insuring the near-elderly and explores the potential effects of a Medicare buy-in on coverage of this population. The authors conclude that, unless premiums for such coverage were low or tied to enrollees’ income, this approach would have a relatively small impact on both the number of uninsured near-elderly and retirement decisions.

An Analysis of Reforming Medicare Through a ‘Premium Support’ Program

This report examines one of the leading approaches to reforming the Medicare program, known as premium support. Under this model, the current Medicare program would be replaced by a system of competing public and private health plans, and the federal government would pay a set amount per beneficiary. The authors conclude that, while premium support could potentially improve Medicare’s efficiency and improve quality, traditional Medicare could experience erosion over time, resulting in higher costs and more unstable coverage for seniors.

• Report
• Report Highlights

A brief policy analysis (revised as of January 2002) examines the relationship between the unemployment rate and increases in the uninsured and finds that for every percentage point increase in the unemployment rate, 1.2 million people will become uninsured.