Coverage


State Health Facts is a KFF project that provides free, up-to-date, and easy-to-use health data for all 50 states, the District of Columbia, and the United States. It offers data on specific types of health insurance coverage, including employer-sponsored, Medicaid, Medicare, as well as people who are uninsured by demographic characteristics, including age, race/ethnicity, work status, gender, and income. There are also data on health insurance status for a state's population overall and broken down by age, gender, and income.

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  • How Private Insurance Works: A Primer

    Report

    This primer, prepared by Gary Claxton of the Institute for Health Care Research and Policy at Georgetown University, examines the structure and operation of private health insurance including the types of organizations that provide it, how managed care is delivered, and how risk pools work and describes how private health insurance coverage is regulated under state and federal laws. The primer explains how the current nature of private insurance relates to key issues facing federal…

  • Benefits and Costs of Consumer Protection Proposals in California: An Analysis of Selected Recommendations of the California Managed Care Task Force

    Report

    This report assesses the potential impact of selected recommendations of the Managed Health Care Improvement Task Force in the areas of access to care and specialists, information disclosure, and dispute resolution. The Managed Health Care Improvement Task Force was established in 1998 to inform state leaders about the health industry in California; the impact of managed care on quality, access, and cost of care; issues of special concern to consumers; and the appropriate role of…

  • Protection For Consumers In Managed Care Plans: A Comparison Of Medicare, Medicaid and the Private Insurance Market

    Report

    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…

  • Trends in Health Plans Serving Medicaid — 2000 Data Update

    Report

    An updated study follows trends in commercial health plan participation in Medicaid managed care and includes new analyses on the performance of Medicaid-dominated and commercial plans on measures of effective care and access to care, and on the extent to which plans restrict their Medicaid service areas.

  • Urban Indian Health

    Report

    More than half (57%) of the 2.5 million people who identify themselves solely as American Indian and Alaska Native in the 2000 Census live in metropolitan areas. This issue brief describes the large and growing urban Indian population, their health status, and the major federal health programs and federal-state programs that are available to improve Native Americans' access to needed health services. Report Introductory Letter  

  • Health Centers: An Overview and Analysis of Their Experiences With Private Health Insurance

    Report

    This policy brief provides an overview of health centers, with a special focus on the relationship between health centers and private health insurance. The analysis of 10 years of national data reveals that health centers do not receive adequate reimbursement from private insurers to cover the costs of treating commercially insured patients. The cumulative shortfalls jeopardize the ability of health centers to fulfill their mission of providing access to care for low-income patients. Issue Brief…

  • Medicare: Holes in the Safety Net

    Other Post

    Medicare: Holes in the Safety Net This report discusses findings from focus groups that consisted of those individuals who interact with the Medicare program, including beneficiaries, health professionals, caretakers, and program management staff. A press release summarizing the findings of 15 focus groups conducted nationwide on public attitudes toward and understanding of the Medicare system in the United States is available. Note: This publication is no longer in circulation. However, a few copies may still…

  • Protection in Managed Care Plans: A Side-by-Side Comparison of Proposal Federal Legislation

    Other Post

    Part I: Congressional Budget Reconciliation Proposals A. Entities Regulated Issue H.R. 2015--House Budget Bill(Medicare) S. 947--Senate Budget Bill(Medicare) H.R. 2015--House Budget Bill(Medicaid) S. 947--Senate Budget Bill(Medicaid) Establishes new Medicare managed care program, "MedicarePlus;" MedicarePlus plan options include coordinated care plans (HMOs, PPOs), MSA plans (exceptions for MSA plans from some requirements). (Medicare eligibles can still choose the traditional fee-for-service program.) Medicare; established new "Medicare Choice" program. Medicare Choice plan options include fee-for-service, PPOs, point-of-service plans,…

  • Covering the Low-Income Uninsured: Assessing the Alternatives

    Report

    This issue brief describes and analyzes expansions of Medicaid and SCHIP, tax credits for individually-purchased insurance, and tax credits for employment-based health insurance as options to expand health coverage of the low-income population. Issue Paper

  • Latest Findings on Employer-Based Coverage of Contraception

    Other Post

    This memorandum provides background on the issue of contraceptive coverage and presents new findings from the soon to be released Kaiser/HRET 2002 Annual Survey of Employer-Sponsored Health Benefits. Employer Based Coverage of Contraception