Most studies of health coverage expansion policies focus on their potential national impact. Variations in the Impact of Health Coverage Expansion Proposals across States finds that federal strategies have greatly varied effects on different states. This report examines the variability among states with regard to economic characteristics, health care markets, and numbers of uninsured.

Some contend that Medicaid has stretched beyond its original purpose of providing a safety net for the poor and has evolved into an asset shelter for the rich. Medicaid’s Coverage of Nursing Home Costs: Asset Shelter for the Wealthy or Essential Safety Net? reviews the empirical evidence and finds that asset transfers are not significant contributors to Medicaid costs now, and implementing policies designed to further limit them is unlikely to significantly reduce Medicaid costs.

Beginning in January 2006, open enrollment period limitations (also known as enrollment lock-in provisions) will restrict the number of times (and the times of the year) that Medicare beneficiaries can change health plans. Estimating Medicare Advantage Lock-In Provisions Impact on Vulnerable Medicare Beneficiaries examines Medicare managed care enrollment and disenrollment of vulnerable beneficiaries from 1999 to 2001 to estimate the impact of these upcoming restrictions.

Beginning in 2006, 42 million elderly and disabled Medicare beneficiaries will have access to prescription drug coverage through Part D of the Medicare program, including an estimated 14.4 million beneficiaries who will be eligible for low-income subsidies. Low-Income Assistance under the Medicare Drug Benefit provides an overview of the drug benefit and the low-income subsidies, including participation and eligibility.

With discussions on restructuring Medicaid occurring in state capitols and Washington, DC, two new reports provide the latest data on how much of Medicaid's spending is used to cover mandatory versus optional populations and services. The issue paper, Medicaid: An Overview of Spending on "Mandatory" vs. "Optional" Populations and Services, offers a brief summary of the data and a discussion of the practical implications of policy changes. The background report, "Medicaid Enrollment and Spending by ‘Mandatory’ and ‘Optional’ Eligibility and Benefit Categories” (same page) offers a more detailed examination of the methodology and results.

Financing for the nation’s health care safety net is fragmented, and providers must knit together resources from many different funding sources to cover the costs of providing a broad range of services. Stresses to the Safety Net: The Public Hospital Perspective describes those sources of revenue, documenting that nearly 40 percent of all safety net revenues come from Medicaid.

Over the past few years, a number of states have implemented new or increased existing out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public programs. Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences reviews the key findings from this activity, including the impact on enrollment in public coverage programs, on providers, and on access to care.

In January 2006, Medicare will begin providing coverage for outpatient prescription drugs, and many low-income beneficiaries will have to meet both an income and asset test to receive assistance. Low-Income Subsidies for the Medicare Prescription Drug Benefit: The Impact of the Asset Test estimates that in 2006, 2.37 million low-income Medicare beneficiaries will not qualify for subsidized coverage because they will fail the asset test. The report also examines how the low-income asset test works and the characteristics of people likely to be excluded.

Health Insurance, Health Costs, Healthcare Reform, Budget

Administration Defense of Health Savings Accounts Rests on Misleading Use of Statistics

This brief report from Center on Budget and Policy Priorities examines three specific claims regarding Health Savings Accounts that the President and other Administration officials have made in recent days.

Center on Budget and Policy Priorities recent Budget Analysis reports:

The Cost and Coverage Impact of the President’s Health Insurance Budget Proposals finds that the Administration's proposals to expand tax breaks for Health Savings Accounts (HSAs) would cause a net increase in the number of uninsured Americans. Press Release  Full Report

 

Analysis of Medicaid Provisions in the Bush Administration 2007 Budget explains how most of the provisions in the budget, which include both legislative proposals and regulatory changes that the Administration is planning to make without legislative action, will shift Medicaid costs to the state: net federal Medicaid funding cuts equal to $14 billion over the next five years and $35.5 billion over ten years.  These funding cuts are on top of the significant federal Medicaid cuts ($4.9 billion over five years and $26.5 billion over ten years) enacted as part of the budget reconciliation bill signed into law on February 8.

 

The Administration’s Medicaid Proposals Would Shift Federal Costs to States finds that more than four-fifths of the Medicaid savings proposals in the Administration’s new budget would reduce federal Medicaid expenditures by shifting costs directly to the states.  The proposals would save the federal government $35 billion over the next decade, most of which would represent new costs for states. That likely would lead some states to scale back their Medicaid programs significantly by restricting eligibility and reducing coverage. Full Report  Press Release 

 

Hidden Budget Cuts in Domestic Programs Found in OMB Computer Files Withheld From Public; documents provided by the Office of Management and Budget omitted information about proposed funding levels for discretionary programs after 2007. But these proposal cuts for 2008-2011 — against which the cuts proposed for 2007 pale by comparison — have now come to light. The Center on Budget and Policy Priorities has assembled information on the proposed cuts (or increases) for all domestic program categories for years from 2008-2011, using Administration computer runs that were not widely distributed and a series of tables scattered throughout the OMB budget documents. In addition, a key OMB computer run detailing proposed program-by-program cuts for discretionary programs for each year after 2007 — which the Administration never intended to release — has surfaced. A key finding from this computer run, other OMB documents, and the Center's analysis of them is that many programs that would be cut only slightly in 2007 (or even expanded) would face significant cuts in 2008-2011.

 

President Greatly Reduced his Health Proposals for Lower-Income Families while Expanding Health Benefits for the More Affluent finds that the size of the health tax proposal for lower-income households has been scaled back by two-thirds from last year, while the health tax proposals disproportionately benefiting high-income households have more than quadrupled in size.

 

Federal Grants to States and Localities Cut Deeply in Fiscal Year 2007 Federal Budget, with state-by-state rankings, finds that the new budget continues to significantly erode grants to state and local governments. This leaves states and localities the option of either curtailing services or increasing their own taxes to compensate for declining federal funds.

 

The President's Budget: A Preliminary Analysis

The 2005 National Healthcare Quality Report (NHQR) and 2005 National Healthcare Disparities Report (NHDR) are now available on AHRQ's Web Site. The 2005 NHQR is a comprehensive national overview of quality of health care in the United States. The 2005 NHDR tracks disparities in both quality of and access to health care in the United States for both the general population and for congressionally designated priority populations.

Health and Well-Being of Children: A Portrait of States and the Nation 2005

The National Survey of Children's Health, conducted (by the National Center for Health Statistics of the CDC) for the first time in 2003, addresses multiple state and national aspects of child health as well as aspects of the family and the neighborhood that can affect children's health. 

Low-Income Children in the United States: National and State Trend Data, 1994-2004

After nearly a decade of decline, the number of children living in low-income families has been steadily increasing since 2000. This data book provides national and 50-state trend data on the characteristics of low-income children over the past decade: parental education, parental employment, marital status, family structure, race and ethnicity, age distribution, parental nativity, home ownership, residential mobility, type of residential area, and region of residence. 

Health Care Reform: 2006 Perspectives

In his annual address to the nation, President Bush outlined a number of health reform strategies. The Commonwealth Fund-supported research provides perspective on approaches to addressing the issues of health care costs, quality and coverage, and details promising innovations to help the U.S. move toward a truly high-performance health care system. 

Kaiser Health Poll Report: Findings on 2006 State of the Union Address and Health Care

A new poll from the Kaiser Family Foundation examines what the public took away from President Bush's State of the Union address, finding that the health messages in the speech have yet to register with most Americans. Despite extensive news coverage both before and after the speech giving information about the President's proposals for expanding the use of Health Savings Accounts (HSAs), seventy-one percent of

Cover California's Kids: Three New Reports Highlight Optimal Outreach and Enrollment Strategies

New research finds that while California has made strides in expanding health coverage to children of low-income families, improving the confusing and onerous enrollment process of health insurance programs is needed to reach the significant number of kids who remain uninsured. The Path to Accessing Health Coverage finds that more uninsured kids would have health coverage if there were a single point of entry for children who may be eligible for different health programs for low-income children. Reaching Out and Reaching In: Understanding Efforts to Identify and Enroll Uninsured Children into Health Insurance Programs examines and assesses the different methods used to identify and enroll kids in health coverage programs, recommending that a variety of outreach methods and strategies are needed. Increasing Enrollment and Retention in Children's Health Insurance Programs Through Trained Assistors finds that a standardized, comprehensive approach to training would improve the ability of Certified Application Assistors (CAAs) to help parents get and keep their kids enrolled in public health coverage programs. adults have not heard the term "health savings account."

State of the States: Finding Their Own Way on Health Coverage, a Robert Wood Johnson Foundation program that works with states to expand health insurance coverage, today issued its latest annual "State of the States" report, summarizing strategies states are implementing or considering to expand health coverage.

The Center for American Progress and American Progress Action Fund have a new initiative to help build momentum around health care reform and to support progressive policymakers committed to with SEIU's Americans for Health Care, they fielded a national poll to create and test health care messages with the public. In brief, the public believes the health care system is broken and understands that policymakers have failed to address this issue. With American families feeling increasingly helpless in the face of skyrocketing

Health Coverage for Aging Baby Boomers

Rising out-of-pocket health care costs and sluggish wage growth threatens workers' ability to save for retirement. This is particularly true for adults ages 50 to 64, or "baby boomers," whose per capita health care expenditures are more than twice those of younger adults. In this January 2006 published analysis of The Commonwealth Fund Survey of Older Adults, the authors explore the extent and quality of health insurance coverage for baby boomers in the workforce. Among their key findings: older adults have high rates of chronic health conditions; many have unstable insurance coverage; those who have low income, individual coverage, or no insurance spend a substantial share of their income on coverage and health care and have reduced access to care.

A recent Urban Institute report, Lowering Financial Burdens and Increasing Health Insurance Coverage for Those with High Medical Costs, reviews evidence that the health care system is doing a poor job of ensuring care for those who most need it and offers options for subsidizing health care coverage for high-cost, high-risk populations. 

 STATE HEALTH EVENTS AND NOTICES

March 3, 2006 

 NORTH FLORIDA

Walk for the Minds of America
Tuesday, April 4 in Tallahassee

NAMI Florida is holding this event to raise awareness about mental illness and to raise funds for NAMI. For more information, call 850/671-4445 or 877/626-4352.

CENTRAL FLORIDA

Medicare Part D - “The Storm is Here”
March 7, 2006,  9:00 am – 4:15 pm  First Presbyterian Church of Orlando

Free of charge; $9 for lunch with drink.

For attorneys and other advocates interested in Elder Law, Aging, and recent changes in Medicare and Medicaid law and benefits. Interactive, informal training for beginning and advanced learners. This Program normally qualifies for Continuing Legal Education Credits in Florida.  Register online; walk-ins welcome. For information call 850/385-7900 or 904/768-8561, or  email Layne@floridalegal.org or Sharon@floridalegal.org