Privatization of Public Hospitals

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Privatization of Public HospitalsReport

Sex In The 90s:Kaiser Family Foundation/ABC Television 1998 National Survey of Americans on Sex and Sexual Health

Methodology:The Kaiser Family Foundation and ABC Television 1998 National Survey of Americans on Sex and Sexual Health is a random-sample telephone survey of 1,204 adults 18 and older living in the United States. It was designed by staff at the Foundation and Princeton Survey Research Associates (PSRA) and conducted by PSRA between April 24 and May 10, 1998. The margin of sampling error is plus or minus 3 percentage points.

Questionnaire and Toplines

INTRODUCTION: Hello, my name is _______ and I’m calling for Princeton Survey Research of Princeton, New Jersey. We are conducting a national opinion survey about some important social issues, like health and family.

First, I have some questions about some social issues in this country . . .

1. Unplanned pregnancy and sexually transmitted diseases are bigger problems in the United States than in many other Western countries, and people have many different explanations for why this is so. Please tell me whether YOU think each of the following contributes a lot, some, only a little or not at all to these problems in the U.S.

A lot Some Only a little Not at all DK/Ref. a. A lack of openness about sex and sexual issues 35 34 15 12 4 =100 b. Poverty and poor education 46 29 15 8 2 =100 c. A decline in moral values 65 20 8 5 2 =100 d. Too much casual sex in the movies and on TV 55 25 13 6 1 =100 e. Inadequate sex education in the schools 32 32 20 13 3 =100 2. Do you think the way TV programs show sex and nudity tends to ENCOURAGE irresponsible sexual behavior, DISCOURAGE irresponsible sexual behavior, or don’t you think it has much effect on people’s sexual behavior?

74 Encourages irresponsible sexual behavior 3 Discourages irresponsible sexual behavior 20 No effect 3 Don’t know/Refused 100 3. In your opinion, if TV characters in entertainment programs are talking about or engaging in sexual activity, should they talk about condoms or make other references to “safer sex,” or NOT?

77 Should 18 Should not 5 Don’t know/Refused 100

4. How well do you think the way sex is usually shown on TV and in the movies reflects your own sex life?Would you say . . .

3 Very well 16 Somewhat well 23 Not too well 50 Not well at all 8 Don’t know/Refused 100

5. To what extent do you think TV and movies send the message that. . . (INSERT). Do you think TV and movies send this message a lot, somewhat, only a little, or not at all?

A lot Some Only a little Not at all DK/Ref. a. To have a great sex life you must changepartners often 41 29 14 14 2 =100 b. You can have spontaneous sex without worryingabout the consequences 53 25 11 9 2 =100 c. Only thin, beautiful people can have great sex 53 22 8 14 3 =100 d. Older adults can have great sex 14 31 33 19 3 =100 e. To have a “normal” sex drive means alwaysbeing in the mood for sex 41 31 13 12 3 =100 READ: On a different topic . . .

6. Do you have any children — either adult children or children who are still growing up?

70 Yes, have children 30 No children * Refused 100

7. Are any of your children age 18 or under?

40 Yes, have children age 18 or under 30 No children under 18 0 Don’t know/Refused 30 Have no children at all/DK/Ref 100

8. Starting with the older, please tell me the ages of your children who are age 18 or under.RESULTS NOT REPORTED

AGE OF TARGET CHILD:

49 8-12 51 13-18 100 READ: Please answer the next few questions thinking about your (AGE) year old . . .

9. Have you ever had a conversation about a sexual issue with your (AGE) year old because of something one or both of you saw . . .

Based on parents with at least one child age 8 to 18, (target child chosen randomly for those with more than one child in age range); n=329

Yes No DK/Ref. a. On the news 63 36 1 =100 b. On a television show 70 30 0 =100

10. Thinking about the last time you had a conversation because of something you saw on television, which comes closer to how you felt …

Based on parents who had a conversation about a sexual topic with target child because of something on TV; n=257

65 It was a good opportunity for you and your child to talk about sexual issues 31 It raised a sexual issue you did not want to talk about with your child at that time 4 Don’t know/Refused 100 11. Thinking about sexual content on television. . . Have you ever (INSERT) because of sexual content you saw (on TV)?

Yes No DK/Ref. a. Q11a based on parents with at least one child age 18 or under; n=491Not allowed (one of your children/your child) to watch a certain show 76 24 * =100 b. Q11b-f based on totalTurned off the television 60 39 1 =100 c. Talked to a health care provider about a sexual topic 46 52 2 =100 d. Talked to a health care provider about a sexual topic 9 91 0 =100 e. Had a conversation with a sexual partner about a sexual topic 44 54 2 =100 f. Tried something new sexually 13 85 2 =100

READ: Next I have some questions about sex education . . .

12. In general would you say that young people today get information about sex and birth control at…

22 About the right time 24 Too soon 47 Too late 7 Don’t know/Refused 100

13. In general do you SUPPORT or OPPOSE sex education courses being taught to . . .

Support Oppose DK/Ref. a. High school age students — that is children age 15 to 18 85 12 3 =100 b. Junior high school age students — that is children age 12 to 14 76 21 3 =100 c. Elementary school age students — that is children 6 to 12 35 60 5 =100

14. If sex education is taught in HIGH SCHOOLS, do you think it should or should not…

Should Should Not DK/Ref. Sex education should not be taught at all a. Tell young people NOT to have sexualintercourse before marriage? 68 27 4 1 =100 b. Tell young people who ARE sexually activeto use protection, such as condoms, to prevent against pregnancy and disease? 92 5 2 1 =100 c. Teach the basic facts of human reproduction? 94 4 4 1 =100 d. Discuss how to know when you are readyto have sex? 74 19 6 1 =100 e. Discuss how to talk about sex with a partner? 74 21 4 1 =100

15. Some people believe that whether or not young people are sexually active, they should be given information to protect themselves from unplanned pregnancies and sexually transmitted diseases. Others believe that telling young people about birth control and sexually transmitted diseases only encourages them to have sex. Which come closer to your view?

83 They should be given information 14 Information only encourages them to have sex 3 Don’t know/Refused 100

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Sex In The 90s:Kaiser Family Foundation/ABC Television 1998 National Survey of Americanson Sex and Sexual Health:Survey Part One Part Two Part Three ABC Television

This survey takes an in-depth look at Americans’ attitudes about sex and sexual health issues in the 90s, including sex education, sex in the media, sexually transmitted disease and unintended pregnancy, and how we talk (or not) about sexual issues with children and partners.

This paper examines Medicaid enrollment and its relation to the rise and fall of enrollment in Aid to Families with Dependent Children (AFDC) or Temporary Assistance to Needy Families (TANF) programs.

• Issue Paper
• Issue Paper

Part 5

Appendix Table 1: Medicaid Eligibility Levels for Pregnant Women and Children Pregnant Women, Infants and Children(as of May 20, 1998) Other Eligibility Categories Pregnant Women and Infants Children Under Age 6 Children Ages 6 to 14 Children Ages 14 to 19 Asset Test Required for Children (4) Max. AFDC Payments (7/16/96) (5) Medically Needy, 1996 (percent of Federal Poverty Level) United States 133 133 100 45 49 Alabama 133 133 100 100 No 15 N/A Alaska 133 133 100 90 No 76 N/A Arizona 140 133 100 30 No 32 N/A Arkansas (2,3,4) (133) (200) 200 200 200 Yes 19 25 California (1) 200 133 100 100 No 56 86 Colorado (1,4) 133 133 100 37 Yes 39 N/A Connecticut 185 185 185 185 No 81 71 Delaware 185 133 100 100 No 31 N/A District of Columbia 185 133 100 37 No 37 N/A Florida (1) 185 133 100 100 No 28 28 Georgia 185 133 100 100 No 39 35 Hawaii 185 133 100 100 No 57 57 Idaho (4) 160 160 160 160 Yes 29 N/A Illinois 200 133 130 133 No 35 45 Indiana 150 133 100 100 No 27 N/A Iowa (4) 185 133 100 37 Yes 39 52 Kansas 150 133 100 100 No 40 44 Kentucky 185 133 100 46 No 49 28 Louisiana 133 133 100 17 No 18 N/A Maine 185 133 125 125 No 51 42 Maryland (2) 185 185 185 33 No 34 40 Massachusetts (1) 185 133 133 133 No 52 72 Michigan 185 150 150 150 No 45 52 Minnesota (3) 275 275 275 275 No 49 66 Mississippi 185 133 100 32 No 34 N/A Missouri 185 133 100 100 No 27 N/A Montana (4) 133 133 100 48 Yes 41 46 Nebraska 150 133 100 100 No 34 45 Nevada (4) 133 133 100 31 Yes 32 N/A New Hampshire 300 185 185 185 No 51 60 New Jersey (1) 185 133 133 133 No 41 52 New Mexico 185 185 185 185 No 36 N/A New York (1) 185 133 100 51 No 61 76 North Carolina 185 133 100 100 No 50 34 North Dakota (4) 133 133 100 100 Yes 40 47 Ohio 150 150 150 30 No 32 N/A Oklahoma 185 185 185 185 No 28 42 Oregon (4) 133 133 100 100 Yes 43 57 Pennsylvania (1) 185 133 100 37 No 39 43 Rhode Island (3,4) 250 250 250 250 Yes 51 69 South Carolina 185 150 150 150 No 18 N/A South Dakota 133 133 100 100 No 47 N/A Tennessee (3) 400 400 400 400 No 54 23 Texas (4) 185 133 100 17 Yes 17 25 Utah (4) 133 133 100 100 Yes 53 53 Vermont (3) (200) (225) 225 225 225 No 59 81 Virginia 133 133 100 100 No 22 33 Washington (185) (200) 200 200 200 No 50 62 West Virginia 150 133 100 100 No 24 27 Wisconsin 185 185 100 45 No 48 64 Wyoming (4) 133 133 100 52 Yes 55 N/A SOURCE: Center on Budget and Policy Priorities. 1998 and National Governors’ Association. 1996 and 1997. N/A: No medically needy programNote: The 1998 Federal poverty guideline for a family of three was $13,650; for Alaska $17,070 and Hawaii $15,700.(1) The state operates separate child health insurance programs for children not eligible for Medicaid. Such Programs may provide benefits similar to Medicaid or they may provide a limited benefits package and may include premiums and cost-sharing.(2) Children covered under Medicaid expansion programs in Arkansas and Maryland receive reduced benefits package pursuant to federal waivers.(3) The Medicaid programs in AR, MN, RI, TN, and VT may impose some cost-sharing-premiums and/or co-payments for some children pursuant to federal waivers.(4) The states noted count assets, in addition to income, in determining Medicaid eligibility for children; Utah does not consider assets for young children. An assets test in NOT required in Arkansas for its Medicaid expansion program.(5) The United States figure represents the median maximum AFDC payment level.

Appendix Table 2: Expansion Population Eligibility in State Medicaid Programs Operating Under Statewide Section 1115 Demonstration Waivers*State ExpansionPopulation FamilyIncomeRequire-ment ResourceRequire-ment CategoricalRequire-mentWaived Premium/Cost-Sharing EnrollmentCap Alabama Children aged 6-19 < 133% FPL N/A Change in income requirement No premium/cost-sharing No Women for 24 months post-partum^a < 133% FPL Pregnancy Arizona Children up to age 14 < 100% FPL N/A Change in income requirement $1-5 copay, depending on service. No copay for prescription drugs, prenatal care, EPSDT care, nursing facility services, and primary care visits not scheduled by the patient. No Pregnant women and infants < 140% FPL N/A Change in income requirement Arkansas Children up to age 19 < 200% FPL No resource test Change in income requirement $5 copay for prescriptions, $10 copay for outpatient services, percentage copay for hospital per diem No Delaware Low-income children and adults < 100% FPL N/A Changes income requirement for children, waives requirement of pregnancy, disability, or dependent children No premium/cost-sharing No Hawaii Low-income children and adults < 300% FPL < $2,000 for single person, < $3,000 for couple Changes income requirement for children, waives requirement of pregnancy, disability, or dependent children All persons (except pregnant women) making over 100% FPL pay 100% of medical, dental, and catastrophic care premiums. Sliding payment scale for children under 200% FPL. No Kentucky No eligibility expansion Maryland No eligibility expansion Massachusetts Low-income employed < 200% FPL No resource test Dependent child, pregnancy, disability Cost-sharing on a sliding scale based on income No Low-income unemployed < 133% FPL No resource test Dependent child, pregnancy, disability Unemployed persons receiving state or federal unemployment benefits < 400% FPL No resource test Dependent child, pregnancy, disability State ExpansionPopulation FamilyIncomeRequire-ment ResourceRequire-ment CategoricalRequire-mentWaived Premium/Cost-Sharing EnrollmentCap Minnesota Pregnant women and children up to age 19 < 275% FPL No resource test Changes income requirement Premiums range from 1.5 to 8.8% gross income, $4/month premium for families with children < 150% FPL, non-pregnant adults pay 10% of inpatient hospital costs with $1,000 maximum No Planned extension to low-income adults N/A N/A Dependent child, pregnancy, disability New Jersey Low-income individuals < 200% FPL < $7,500 for individual, < $15,000 per family Dependent child, pregnancy, disability Individuals with income below 200% FPL receive fully subsidized care; individuals with income below 300% FPL receive partially subsidized care. No Low-income individuals < 300% FPL < $7,500 resources for individual, < $15,000 per family New York Home Relief population N/A Dependent child, pregnancy, disability No premium/cost-sharing No Women for 24 months post-partum^a< 185% FPL Pregnancy Ohio No eligibility expansion Oklahoma No eligibility expansion Oregon Low-income children and adults < 100% FPL < $5,000 Dependent child, pregnancy, disability Cost-sharing on sliding scale for adult, non-pregnant new eligibles. No Rhode Island Pregnant women and children under age 8 < 250% FPL N/A Change in income requirement Individuals with family incomes between 185-250% FPL subject to cost-sharing requirements. No Women for 24 months post-partum^a < 250% FPL Pregnancy Tennessee Uninsurable individuals N/A No resource test Dependent child, pregnancy Individuals with family incomes > 100% FPL subject to cost-sharing requirements on sliding scale based on income. Enrollment capped at 1,775,000^b Persons ineligible for employer- or government-sponsored health plans No resource test Dependent child, pregnancy, disability Vermont Low-income children and adults < 150% FPL N/A Dependent child, pregnancy, disability No premium/cost-sharing *Based on data collected by the George Washington University Center for Health Policy Research. N/A indicates that this information was not clear based on the information reviewed.a. Only family planning services are covered under this extension.b. Tennessee does not cap enrollment of traditional eligibles meeting the state’s 1993 Medicaid eligibility criteria and uninsurable persons. The enrollment of uninsured persons is limited by the difference between 1,775,000 and the sum of traditional eligibles and uninsurable persons.

¹ Thomas Selden, Jessica Banthin, and Joel Cohen, “Medicaid’s Problem Children: Eligible but not Enrolled,” Health Affairs. May/June 1998: 192-200.

² Medicaid eligibility policy vis-a-vis the disabled and the elderly will be the focus of subsequent analyses.

³ See Lake Snell Perry & Associates, Barriers to Medi-Cal Enrollment and Ideas for Improving Enrollment: Findings from Eight Focus Groups with Parents of Potentially Eligible Children. Kaiser Family Foundation, September 1998.

⁴ See Kaiser Commission on Medicaid and the Uninsured, “Medicaid Eligibility and Enrollment Projects,” September 1998; Donna Cohen Ross, Child Health Outreach Handbook , Center on Budget and Policy Priorities, July, 1998; Sarah Shuptrine, Vicki Grant, and Genny McKenzie, Southern Regional Initiative to Improve Access to Benefits for Low-income Families with Children, Southern Institute on Children and Families, February 1998.

⁵ Congressional Budget Office, Behind the Numbers: An Explanation of CBO’s January 1997 Medicaid Baseline, April 1997, p. 7.

⁶ For detailed state-by-state data on the number and type of beneficiaries covered, see David Liska, Brian Bruen, Alina Salganicoff, Peter Long, and Bethany Kessler, Medicaid Expenditures and Beneficiaries: National and State Profiles and Trends, 1990-1995, Third Edition, Kaiser Commission on the Future of Medicaid, November 1997.

⁷ Statement of Bruce C. Vladeck, Administrator, Health Care Financing Administration, “1998 Budget for Medicaid and Medicare Part B” presented to the House Commerce Committee, Subcommittee on Health and Environment, February 12, 1997.

⁸Choices Under the New State Child Health Insurance Program: What Factors Shape Cost and Coverage? Kaiser Commission on Medicaid and the Uninsured, January 1998.

⁹MCH Update: State Medicaid Coverage of Pregnant Women and Children, National Governors’ Association, September 1997, www.nga.org.

¹⁰ See David Super, Sharon Parrott, Susan Steinmetz, Cindy Mann, The New Welfare Law, Center on Budget and Policy Priorities, August 14, 1996, http://www.cbpp.org.

¹¹ For a discussion of eligibility rules relating to two-parent families, see Jocelyn Guyer and Cindy Mann, Taking the Next Step: States Can Now Take Advantage of Federal Medicaid Matching Funds to Expand Health Care Coverage to Low-Income Working Parents, Center on Budget and Policy Priorities, July 1998, www.cbpp.org.

¹² 63 Fed. Reg. 42270 (August 7, 1998.)

¹³ Jeff Harris and Jane Horvath, The Administrative Impact of the Medicaid Eligibility Resource Test, Kaiser Commission on the Future of Medicaid, April 1993.

¹⁴ Marilyn Moon, The Urban Institute, Asset Limits and Medicaid, Kaiser Commission on the Future of Medicaid, April 1993.

¹⁵ See Leighton Ku and Bethany Kessler, The Number and Cost of Immigrants on Medicaid: National and State Estimates, Urban Institute, December 1997. For a discussion of the impact of the welfare law changes on elderly legal immigrants, see Robert B. Friedland and Veena Pankaj, Welfare Reform and Elderly Legal Immigrants, Henry J. Kaiser Family Foundation, July, 1997. For a review of the options remaining to states with respect to coverage of this population through either federally-funded or state-funded programs, see Kelly Carmody, State Options to Assist Legal Immigrants Ineligible for Federal Benefits, Center on Budget and Policy Priorities, February 1998, http://www.cbpp.org.

¹⁶ Sara Rosenbaum, Medicaid and Migrant Farmworker Families: Analysis of Barriers and Recommendations for Change, National Association of Community Health Centers, 1991.

¹⁷ Guyer and Mann. July 1998.

¹⁸www.hcfa.gov/init/chip-map.cfm

¹⁹ Guyer and Mann. July 1998.

²⁰ For a summary of the expansion populations covered by some states under section 1115 waivers, see Sara Rosenbaum and Julie Darnell, Statewide Medicaid Managed Care Demonstrations under Section 1115 of the Social Security Act: A Review of the Waiver Applications, Letters of Approval, and Special Terms and Conditions, Kaiser Commission on the Future of Medicaid, May 1997.

²¹ Under section 1931 of the Social Security Act, States have the option of liberalizing their financial eligibility standards for adults in one-parent and certain two-parent families by adopting “less restrictive” income or resource methodologies. They do not, however, have the option to liberalize the non-financial eligibility rules. In order to receive federal Medicaid matching funds for the coverage of childless non-disabled adults who do not meet these family composition requirements, states must obtain a waiver from the Secretary of HHS under section 1115.

²² Schoen, C., B. Lyons, D. Rowland et al, “Insurance Matters for Low-Income Adults: Results from a Five-State Survey” Health Affairs, Sept/Oct 1997.

²³ Selden, Banthin, and Cohen, May/June 1998.

²⁴ See Alina Salganicoff and Patricia Seliger Keenan, Child Health Facts: National and State Profiles of Coverage, Kaiser Commission on Medicaid and Uninsured, January 1998. Return to top

Policy Brief Part 1 Part 2 Part 3 Part 4 Part 5Library Index

This paper describes the nature of employer coverage; its decline, especially among low-wage workers and low-income families; and the factors that are undermining its reach.

• Issue Paper
• Issue Paper

This 1998 partnership survey between KFF and Glamour explores experiences with and knowledge of STIs among men and women in the U.S.

HIPAA Compliance Strategies In California: Reforming the State’s Individual Health Insurance Market — Policy Brief

A policy brief on reform of the individual insurance market and implementation of the Health Insurance Portability and Accountability Act (HIPAA) in California. The brief is based, in part, on discussion at a California Health Policy Roundtable held in Sacramento, California on March 12, 1998.

Note: This publication is no longer in circulation. However, a copy may still exist in the Foundation’s internal library that could be reproduced. Please email order@kff.org if you would like to pursue this option.

This policy paper describes key requirements of consumer protection regulation under Medicare, Medicaid and federal and state laws as they apply to private health insurance. These include choice and availability of plans, disclosure of information, marketing, access, quality, and the grievance and appeals process. The discussion highlights differences and similarities across public programs and private insurance and compares public and private insurance protection with provisions of the Consumer Bill of Rights (CBRR) developed by the President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry.

• Report: Protection For Consumers In Managed Care Plans: A Comparison

Health News Index July/August, 1998

The July/August 1998 edition of the Kaiser Family Foundation/Harvard Health News Index includes questions about major health stories covered in the news, including questions about Patients’ Rights and Medicare. The survey is based on a national random sample of 1,200 Americans which measures public knowledge of health stories covered by the 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.