A Side-by-Side Comparison of Selected Proposals as of February 15, 2000

This document provides a side-by-side comparison of five major federal proposals that have been considered to provide outpatient prescription drug coverage to Medicare beneficiaries. It begins with a summary table comparing key features of each proposal, followed by a detailed comparison of the following major proposals: Breaux/Frist, Clinton, Kennedy/Stark, Snowe/Pallone, and Bilirakis/Peterson.

For more background on the issue of prescription drugs for Medicare beneficiaries, see the Kaiser Family Foundation Fact Sheet, Medicare and Prescription Drugs (document number 1583).

Developed as part of a nonpartisan public education initiative of the Henry J. Kaiser Family Foundation and the League of Women Voters Education Fund, this guide provides basic facts about five key health policy topics candidates are discussing in the 2000 election. These topics include health coverage for the uninsured, managed care and patients’ rights, Medicare reform, prescription drug coverage for seniors, and long-term care. The guide frames each area and describes major proposals that candidates may consider in order to help citizens make informed choices for their families, communities, and the nation.

• Voter Guide

Health coverage is of critical importance to low-income women. This study was undertaken to assess how low-income women with Medicaid, private insurance, or no insurance vary with regard to personal characteristics, health status, and health utilization. Data are from a telephone interview survey of a representative cross-sectional sample of 5,200 low-income women in Minnesota, Oregon, Tennessee, Florida, and Texas. On the whole, low-income women were found to experience considerable barriers to care; however, uninsured low-income women have significantly more trouble obtaining care, receive fewer recommended services, and are more dissatisfied with the care they receive than their insured counterparts. Women on Medicaid had access to care that was comparable with their low-income privately insured counterparts, but in general had significantly lower satisfaction with their providers and their plans. Future federal and state efforts should focus on expanding efforts to improve the scope and reach of health care coverage to low-income women through public or private means.

This article, written by Alina Salganicoff and Roberta Wyn, appeared in the Journal of Health Care for the Poor and Underserved, Vol. 10, No.4, 1999.

Issue Brief (.pdf)

The Kaiser Public Opinion Update -Revised, 2000

This new and revised Public Opinion Update summarizes key findings from surveys conducted between 1997 and 2000, a period in which the intensity of public debate and media attention paid to managed care issues varied substantially. Trends used in this Public Opinion Update are from the following Kaiser Family Foundation/Harvard University, School of Public Health Surveys: September, 1997: Survey of Americans’ Views on Managed Care (11/97, #1328); December, 1997: Survey on Americans’ Views on Consumer Protections in Managed Care (1/98, #1356); April, 1998: Update on Americans’ Views and Experiences in Managed Care (4/98, #1501); August, 1998: Survey of Americans’ Views on the Consumer Protection Debate (9/98, #1438); April, 1999: Update on Americans’ Views on Consumer Protections in Managed Care (4/99 #1502); December, 1999: National Survey on Health Care and the 2000 Elections (1/00, #1572); and Health News Index (2/00, #3004).

This issue paper profiles the role America’s health centers have played in providing care for Medicaid patients and the uninsured. The paper presents information on health center patients and revenue sources and analyzes similarities and differences both between health centers and private practices and among health centers. These centers perform a unique role in the American health care system as nearly 85 percent of their patients are low-income and more than a third of their revenue comes from the Medicaid program, compared with less than 10 percent for most physician practices. This issue paper also reviews trends in health center patients and funding and concludes with an assessment of current challenges facing health centers.

• Issue Paper

This issue paper provides an overview of Medicaid spending in 1997. Beginning with a recap of spending and enrollment trends since the early 1990s, the authors report that Medicaid spending grew by 4.1 percent between 1996 and 1997, continuing the recent trend of slow spending growth. The paper includes detailed national and state-level tables of Medicaid spending and enrollment by numerous categories and over a range of years. It concludes with an analysis of the factors underlying recent spending and enrollment trends and offers some indications of where the program is headed in the near future.

• Issue Paper

Health News Index January/February, 2000The January/February 2000 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 questions about the presidential candidate’s health care proposals and their stands on abortion as well as a report on the declining rate of abortion. The survey is based on a national random sample of 1,006 Americans conducted February 4-8, 2000 which measures public knowledge of health stories covered by news media during the previous month. The Health News Index is designed to help the news media and people in the health field gain a better understanding of which health stories in the news Americans are following and what they understand about those health issues. Every two months, Kaiser/Harvard issues a new index report.

• HNI January-February 2000
• Topline/Survey

The American Bar Association Commission on Legal Problems of the Elderly explored the views of Medicare HMOs on enrolling and delivering services to Medicare beneficiaries with dementia. The Commission conducted detailed interviews with professionals at eight diverse Medicare+Choice organizations. Their report provides background information on health care decision-making law and the Medicare program’s laws and regulations, and focuses on survey findings in six key areas: marketing, enrollment, health assessments, health care delivery, advance directives, and the identification and role of surrogate decision-makers.

• Report

This policy brief (Publication #2180) provides a national profile of Medicaid-dominated managed care plans – those in which Medicaid enrollees make up at least 75 percent of total enrollment. While recent policy and market forces have encouraged the growth of these plans, basic information about them has been lacking, partly because many are not licensed as HMOs by states. As of June 1997, 118 of these Medicaid-dominated plans served 3.4 million Medicaid enrollees across the United States – 36 percent of all Medicaid enrollees in full-risk plans. Using data from a subset of 15 high-volume Medicaid managed care states, the brief also presents analysis indicating that Medicaid-dominated plans tend to serve areas with greater concentrations of ethnic minorities, higher levels of poverty, and fewer health care resources.

Report

Health coverage is of critical importance to low-income women. This study was undertaken to assess how low-income women with Medicaid, private insurance, or no insurance vary with regard to personal characteristics, health status, and health utilization. Data are from a telephone interview survey of a representative cross-sectional sample of 5,200 low-income women in Minnesota, Oregon, Tennessee, Florida, and Texas. On the whole, low-income women were found to experience considerable barriers to care; however, uninsured low-income women have significantly more trouble obtaining care, receive fewer recommended services, and are more dissatisfied with the care they receive than their insured counterparts. Women on Medicaid had access to care that was comparable with their low-income privately insured counterparts, but in general had significantly lower satisfaction with their providers and their plans. Future federal and state efforts should focus on expanding efforts to improve the scope and reach of health care coverage to low-income women through public or private means.

This article, written by Alina Salganicoff and Roberta Wyn, appeared in the Journal of Health Care for the Poor and Underserved, Vol. 10, No.4, 1999.