This report analyzes the administrative and implementation issues associated with expanding tax subsidies for the purchase of private health insurance.

• Tax Reform to Expand Health Coverage

Findings from a National Survey

This national telephone survey of low-income parents represents a major effort to better understand the barriers to Medicaid enrollment and to test the usefulness of ideas to facilitate enrollment in a quantitative way. Examining both parents of uninsured children who appear eligible for Medicaid and parents with children currently enrolled in Medicaid, the survey findings present: a profile of low-income, Medicaid-eligible children; parents’ Medicaid knowledge and perceptions; key barriers to enrollment; and preferred strategies for improving enrollment. The findings suggest that most low-income parents value the Medicaid program and want to enroll their children. However, gaps in knowledge of program eligibility and information and a difficult enrollment process prevent many parents from successfully enrolling their children.

• Report

Health News Index November/December, 1999

The November/December 1999 edition of the Kaiser Family Foundation/Harvard Health News Index includes questions about major health stories covered in the news, including questions about Medical Errors and UnitedHealth Group’s Policy Change. The survey is based on a national random sample of 1,515 Americans conducted December 3-13, 1999 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 November-December 1999
• Topline/Survey

This report updates a 1997 Foundation report to assess how states are implementing financial protections for the 16 million Medicare beneficiaries who are low-income. These protections, generally referred to as “buy-in programs,” help low-income Medicare beneficiaries meet Medicare’s cost-sharing requirements by using state Medicaid programs to pay either all or some portion of premiums, deductibles, and coinsurance amounts. Using information collected through a survey of state Medicaid directors and consumer advocates, the update seeks to explain current programs and policies and to document variations in practices across the states through state profiles. State profiles include information on outreach, enrollment, eligibility, Qualified Individual program implementation, managed care enrollment, and program administration, and analysis examines recent federal activity on buy-in programs, participation levels, and the impact of related provisions in the Balanced Budget Act of 1997.

This issue paper explores the potential for increasing enrollment in children’s health insurance programs through “Express Lane Eligibility.” Express Lane Eligibility is the accelerated enrollment of low-income uninsured children already participating in other income-comparable publicly funded programs, such as WIC or school lunch, into Medicaid or CHIP. The paper reviews Express Lane Eligibility’s potential impact on Medicaid and CHIP enrollment, analyzes different models, discusses key challenges with implementation, and suggests steps states and localities can take to initiate the implementation of Express Lane Eligibility.

This report, Managed Care and Low-Income Populations in Texas: 1996-1998 Update, updates our 1996 case study of Texas’ Medicaid managed care initiatives and their affect on low-income populations. The authors conclude that Medicaid managed care in Texas has had mixed results. It is one of a series of reports from the Kaiser/ Commonwealth Low-Income Coverage and Access Project. This project examines how changes in the Medicaid program have affected health insurance coverage and access to care for the low-income population in eight states: California, Florida, Maryland, Minnesota, New York, Oregon, Tennessee and Texas. (Package Code 2168)

• Report

This report, Managed Care and Low Income Populations in Florida: 1996-1998 Update, updates our 1996 case study of Florida’s Medicaid managed care initiatives and their effect on low-income populations. The focus of this report is on how the program has matured and how it has affected access to care and the safety net. It is one of a series of reportsfrom the Kaiser/ Commonwealth Low-Income Coverage and Access Project. This project examines how changes in the Medicaid program have affected health insurance coverage and access to care for the low-income population in eight states: California, Florida, Maryland, Minnesota, New York, Oregon, Tennesses and Texas. (Package Code 2170)

• Report

Are Schools Just Saying No

Are Schools “Just Saying No?”

Is Abstinence-Only the Trend in Sex Education?

And, Who Influences Policy?

Tuesday, December 14

9:30 am-11:30 am

National Press Club First Amendment Room

529 14^th Street NW, 13^th Floor

Washington, D.C.

9:30 amRegistration

9:50 amWelcome/Introductions

10:00 amNew Research: Findings from Two New National Surveys of Public School Administrators about Sex Education Today

• Cory L. Richards, Vice President for Public Policy, The Alan Guttmacher Institute, will provide an overview of sex education legislation across the nation and how sex education policy is set, and discuss the findings from a national survey of superintendents about school district policy and approaches to sex education.

• Tina Hoff, Director of Public Health Information and Communications, Kaiser Family Foundation,

will present the results from a national survey of public secondary school principals about the nature and outcome of debates over sex education in their schools, and who influences what gets taught.

10:30 amPolicy & Politics: What are the Major Debates Over Sex Education?

And, Are They Changing Curricula? (Moderator: Tina Hoff)

• Monica Rodriguez, Director of Education, Sexuality Information and Education Council of the United States (SIECUS), will give an overview of how the first two years of federal funding for abstinence-only programs has affected sex education as well as discuss public opinion on sex education.

• Doug Bailey, President & CEO, FreedomChannel.com,

will talk about the politics of sex education, to what extent it is an issue for voters in local and state elections, as well as how it is being raised in the upcoming presidential election.

• Brenda Z. Greene, Director, School Health Programs, National School Boards

Association, will discuss how state and federal legislation, local politics, community pressure, and other factors influence school boards’ decisions about sex education.

11:00 a.m.Questions and Answers

11:30 a.m. Lunch with participants

Susan Tew/Chris Kirchgaessner

212-248-1111

mediaworks@agi-usa.org

EMBARGOED FOR RELEASE: 9:30 AM, TUESDAY, DECEMBER 14, 1999

U.S. PUBLIC SCHOOL DISTRICTS OVERWHELMINGLY PROMOTE ABSTINENCE, BUT NOT TO THE EXCLUSION OF CONTRACEPTIVE INFORMATION

Still, One-Third Say Instruction Must Be “Abstinence-Only” and Prohibit or Distort Contraceptive Information

Among the seven in 10 public school districts that have a district-wide policy to teach sexuality education, the vast majority (86%) require that abstinence be promoted, either as the preferred option for teenagers (51% have such an abstinence-plus policy) or as the only option outside of marriage (35% have such an abstinence-only policy), according to a new study by The Alan Guttmacher Institute. Just 14% have a comprehensive policy that addresses abstinence as one option in a broader educational program to prepare adolescents to become sexually healthy adults. In almost two-thirds of district policies across the nation those with comprehensive and abstinence-plus policies discussion about the benefits of contraception is permitted. However, in the one-third of districts with an abstinence-only policy, information about contraception is either prohibited entirely or limited to discussion of its ineffectiveness in protecting against unplanned pregnancy and sexually transmitted diseases.

“It is unconscionable for young people who attend schools in one-third of districts to be denied basic yet vital information for preventing unplanned pregnancy and STDs. This should be of deep concern to parents in this country,” comments Cory L. Richards, vice president for public policy with the Institute. “Teaching abstinence as the only option outside of marriage an unrealistic approach in which contraception may not be discussed at all or may only be discussed to highlight its shortcomings is very troubling, particularly given the lack of evidence that this approach is effective in postponing teenagers sexual involvement.”

The study, “Abstinence Promotion and the Provision of Information About Contraception in Public School District Sexuality Education Policies,” by David J. Landry, Lisa Kaeser and Cory L. Richards, is published in the November/December 1999 issue of the Institute s bimonthly professional journal, Family Planning Perspectives. It presents findings from the first nationwide assessment at the local school district level of the extent to which sexuality education policy now focuses on abstinence promotion and whether these policies have affected the provision of contraceptive information. On the basis of a nationally representative survey of 825 school district superintendents (or their representatives) completed in October 1998, it examines existing policies across the country (in districts that teach grade six or higher) and how they vary by district characteristics.

The study, conducted before states began implementing any abstinence-only efforts stemming specifically from the 1996 national welfare reform legislation, also examines school superintendents perceptions of the factors that most influenced their policies. The superintendents were asked to choose, from among 11 possibilities, the single most important factor that influenced their district’s current sexuality education policy. One of three factors state directives, recommendations of special school board advisory committees or task forces, or school board actions was named by at least three-quarters of districts. Overall, regardless of their abstinence policy, almost one-half of the districts (48%) cited state directives as the most influential factor.

Superintendents were also asked how supportive they thought their community is of their district’s current sexuality education policy. About half (53%) said that the community is “generally silent” on the issue, 41% reported that their community “strongly supports” the policy, 5% said that the community is divided and fewer than 1% said that it is “generally opposed.”

Among the superintendents surveyed who knew when their current policy was adopted, only 16% said that the policy predated 1990. Over half (53%) said that it was adopted after 1995, and another 31% said that it was adopted between 1990 and 1995. Superintendents were also asked whether their current policy had replaced a previous one. Among districts that switched from one abstinence policy category to another, most of the change was toward abstinence-plus policies. There was no net change in the number of districts with abstinence-only policies.

Other key findings of the new analysis include the following:

• More than two-thirds (69%) of all U.S. public school districts (covering 86% of students) have a policy to teach sexuality education; almost one-third (31%) of districts (covering just 14% of students) leave policy decisions concerning sexuality education to individual schools within the district or to teachers.
• Among all U.S. students attending school in a district that includes grade six or higher, 9% are in districts that have a comprehensive sexuality education policy, 45% in districts with an abstinence-plus policy, 32% in abstinence-only policy districts and 14% in districts that have no policy.
• Over half (55%) of districts with a sexuality education policy in the South have an abstinence-only policy (20 percentage points higher than the national average), while only 20% of Northeast districts have such a policy (15 percentage points below the national average).

“To maintain the momentum in declining U.S. teenage pregnancy rates since 1990, we must ensure that students receive complete and accurate sexuality education that supports responsible sexual and reproductive decision-making,” comments David J. Landry, senior research associate with the Institute. “The provision of accurate information about contraception while supporting the choice of young people to delay sexual intercourse should continue to be a high national priority.”

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The Alan Guttmacher Institute s Web site address: http://www.agi -usa.org

The Alan Guttmacher Institute is a not-for-profit corporation focused on reproductive health research, policy analysis and public education, with offices in New York and Washington, D.C.

Long-Term Care: Medicaid’s Role and Challenges

This Policy Brief examines Medicaid’s role in providing long-term care services. It describes long-term care services, the population that needs these services, and how people get long-term care services. It provides an overview of health insurance coverage of persons with long-term care needs and describes both Medicare’s and Medicaid’s role in providing these services. It also examines some of the policy issues and challenges involved in providing long-term care services to an aging society.

• Policy Brief