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Covering Health Issues 2006

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Stateside September 2007 Newsletter
Features reports on State Health Reforms in California and Colorado, Health Insurance Information, and other initiatives.
Source: State Coverage Initiatives
Date:September 2007
Findings from the 2006 Current Population Survey (CPS) SHADAC Conference Call Highlights
On August 29, 2007, the State Health Access Data Assistance Center (SHADAC) organized a conference call featuring Charles T. Nelson, Assistant Division Chief for Income, Poverty and Health Statistics, Housing and Household Economic Statistics Division at the U.S. Census Bureau. Nelson discussed the recently issued findings from the Current Population Survey, published in an August 2007 report, Income, Poverty and Health Insurance Coverage in the United States: 2006 by Carmen DeNavas-Walt, Bernadette D. Proctor, and Jessica Smith.
Source: SHADAC
Date: August 29, 2007
Kaiser Commission on Medicaid and the Uninsured Updates Medicaid Benefits: Online Database With 2006 Data
The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured has issued its latest update (October 2006) of the interactive Medicaid Benefits: Online Database, available at http://www.kff.org/medicaid/benefits/index.jsp. Using this tool, Medicaid benefits can be compared across the 50 states, the District of Columbia and the US Territories or by specific service.
Source: Kaiser Family Foundation
Date: August 16, 2007
Take Control: Paying Your Health Care Bills (also available in Spanish)
This brochure will explain your role in paying for your health care services and how to get information and/or help with your bill. Available in English and Spanish.
Poll: Most Americans favor initiatives to expand health insurance
A new Wall Street Journal Online/Harris Interactive poll indicates that more than three-quarters of Americans are in favor of efforts to expand health insurance coverage, ranging from tax credits to help people purchase insurance to government subsidized plans. The poll also found that affordability and security of benefits was a concern.
Source: The Wall Street Journal
Date: April 25, 2007
Most workers view health insurance as top benefit, survey finds
Three-quarters of workers view health coverage as the most important employee benefit, according to a new poll by the National Business Group on Health. At least 60% of respondents said it was important to have a health plan that’s easy to manage, lets them choose their doctors, and limits their cost for doctor visits and prescriptions. Three-quarters would prefer to receive health benefits through their employer than additional salary to purchase their own, and six in 10 would oppose having their employer’s contribution to their health plan premium treated as taxable income. “The fact that so many employees are opposed to giving up any aspect of their health benefits, even in return for an improvement in other benefits, speaks volumes as to just how important they are from a worker and employer perspective,” said NBGH President Helen Darling.
Source: National Business Group on Health
Date: April 12, 2007
Census Bureau Revises 2004 and 2005 Health Insurance Coverage Estimates
The Census Bureau today issued revised figures on health insurance coverage showing that more Americans have health insurance coverage than previously reported.

The revised estimates show that, in 2005, 44.8 million people, 15.3 percent of the population, were without health insurance – about 1.8 million fewer than the Census Bureau reported in August 2006. Based on the Current Population Survey, the original 2005 estimate was 46.6 million, or about 15.9 percent of the population .

For both 2004 and 2005, the original and revised estimates differ by less than one percent – 0.6 percent for 2005 and 0.7 percent in 2004.

Conversely, an estimated 249 million Americans had coverage, up from the 247.3 million reported in August.
Source: US Census Bureau
Date: March 23, 2007
Updates on State Reform Initiatives
St@teside provides updates on health care reform initiatives in Illinois, Massachusetts, and Oregon.
Source: St@teside
Date: March 21, 2007
Fewer low-income parents offered health insurance on the job
Just 47% of working parents who earn less than $40,000 a year are offered health insurance through their employer, 9% fewer than in 1997, according to a study released today by the Robert Wood Johnson Foundation. In comparison, 78% of parents in families who earn $80,000 or more are offered health insurance through their employer. Most uninsured children have parents who work, the study found. As Congress prepares to reauthorize the State Children’s Health Insurance Program, Foundation President and CEO Risa Lavizzo-Mourey said legislators “must ensure that children whose parents work hard, but cannot afford health insurance for their kids can get the health care they need to thrive.” The study by the State Health Access Data Assistance Center provides a state-by-state look at uninsured children.
Source: Robert Wood Johnson Foundation
Date: March 2007
New State Reform Proposals
The recent surge in state activity addressing health reform and the uninsured has been remarkable. According to the National Conference of State Legislatures, even while “health care reform was hot in legislatures…in 2006, the forecast for [the 2007] session may be even hotter.” At least nine states have introduced health reform plans. Seven others have established commissions that will develop recommendations for health reform and coverage expansions.

While Maine, Massachusetts, and Vermont implement their reforms, and observers follow new proposals from states including California, Pennsylvania, Oregon, Wisconsin and Indiana through the legislative process, still more states are coming forward with reform proposals. States appear particularly interested in covering all uninsured children and establishing entities similar to the Massachusetts Connector. Many also include a strong emphasis on promoting healthy behavior. Maryland, Minnesota, New York, and Washington are among the states in the proposal stage. Details are provided below, although modifications made during the legislative process may alter them substantially.

Full article available at St@teside Website.
Source: St@teside
February 27, 2007
Uninsured in America: Problems and Possible Solutions
In an article published today in BMJ, Commonwealth Fund president Karen Davis examines current roadblocks to universal health coverage in the U.S. and offers possible pathways to a health system in which affordable care is accessible to every American. The complete article, Uninsured in America: Problems and Possible Solutions, is available for free download from BMJ.
Source: Commonwealth Fund
February 16, 2007
Uninsured in America: Problems and Possible Solutions
In an article published today in BMJ, Commonwealth Fund president Karen Davis examines current roadblocks to universal health coverage in the U.S. and offers possible pathways to a health system in which affordable care is accessible to every American.
Source: The Commonwealth Fund
Date: February 16, 2007
New Online Report Examines Implication Of Basing Eligibility For Subsidized Health Coverage On The Federal Poverty Level
Federal and state health care programs often base income eligibility for subsidies for health insurance coverage on how an individual’s or family’s income compares to the federal poverty level (FPL). Rather than a set income limit, this measure provides annual updates for cost of living and is adjusted for family size. However, a new paper from the Kaiser Family Foundation illustrates how linking income-related eligibility requirements for subsidized health coverage this way may not provide a consistent level of financial protection over time because health insurance costs are increasing more rapidly than poverty levels. The paper can be found online at: http://www.kff.org/insurance/snapshot/chcm021507oth.cfm
Source: Kaiser Family Foundation
February 15, 2007
Senators outline goals for expanding access to private health coverage
A bipartisan group of senators yesterday offered to work with the administration on legislation to expand access to private health coverage. In a letter to President Bush, the 10 senators said the legislation should ensure that all Americans have "affordable, quality, private health coverage, while protecting current government programs." They also called for changes to federal tax rules for health coverage that "disproportionately favor the most affluent, while promoting inefficiency." Sens. Jim DeMint (R-SC), Ron Wyden (D-OR), Kent Conrad (D-ND), Robert Bennett (R-UT), Ken Salazar (D-CO), Trent Lott (R-MS), Maria Cantwell (D-WA), Mike Crapo (R-ID), Herb Kohl (D-WI) and John Thune (R-SD) signed the letter.
Source: Senator DeMint press release
Date: February 13, 2007
Mass. may drop drug coverage from health insurance requirement
Massachusetts is considering whether prescription drug coverage should be part of the basic health insurance required of everyone in the state by July 1. A state board seeking ways to keep insurance premiums affordable asked insurance companies for bids on plans with and without drug coverage.
Source: The Boston Globe
Date: February 9, 2007
New Resources And Webcast About Children's Coverage And The Reauthorization Of SCHIP
With the release of the President’s fiscal year 2008 budget proposal and the beginning of congressional hearings, the debate about the reauthorization of the State Children’s Health Insurance Program (SCHIP) has begun. To aid in understanding the policy issues and challenges surrounding children’s health coverage, the Foundation’s Kaiser Commission on Medicaid and the Uninsured has released new resources on children’s coverage and cosponsored a Capitol Hill policy briefing. These resources are available online at: http://www.kff.org/medicaid/kcmu020907pkg.cfm

The Capitol Hill briefing, “SCHIP: Let the Discussions Begin,” featuring Diane Rowland, executive vice president of the Foundation; Genevieve Kenny, principal research associate with the Urban Institute; Gayle Lees Sandlin, director of the Alabama Children’s Health Insurance Program; and Senators Jay Rockefeller and Susan Collins can be viewed online after 4:00 pm ET today at: http://www.kaisernetwork.org/healthcast/alliance/09feb07.
Source: Kaiser Family Foundation
February 9, 2007
Georgia to stop enrolling children in health coverage plan for poor
Facing a $131 million shortfall, Georgia plans to stop enrolling new children in its PeachCare for Kids health insurance program for low-income families. The freeze takes effect March 11, and state officials say the program could run out of money as soon as then.
Source: The Atlanta Constitution
Date: February 8, 2007
New Maryland plan targets health care at small businesses
Maryland lawmakers have unveiled a sweeping initiative designed to insure nearly 250,000 residents. The $603 million plan would give small businesses with fewer than 50 employees $140 million in funding to help provide health insurance for their employees and would expand health care access to 140,000 children throughout the state.
Source: American City Business Journals/Washington
Date: February 8, 2007
State Strategies to Expand Health Insurance Coverage: Trends and Lessons for Policymakers
Frustrated by the lack of federal response to the nation's growing uninsured crisis, state leaders are taking matters into their own hands. Some are attempting bold reforms that aim for near-universal coverage. Others are taking a targeted, incremental approach--for example, fostering public-private partnerships to insure low-income workers.

The new Commonwealth Fund report, State Strategies to Expand Health Insurance Coverage: Trends and Lessons for Policymakers, describes in detail the latest round of state coverage expansion efforts. Prepared by researchers at AcademyHealth for the Fund's Commission on a High Performance Health System, the report covers:
- the comprehensive reform initiatives of California, Maine, Massachusetts, Pennsylvania, and Vermont;
- children's coverage expansions, including Illinois's Covering All Kids program;
- employer-based initiatives in Arkansas, New Mexico, and Oklahoma; and
- federal proposals to support state coverage initiatives.

State Strategies to Expand Health Insurance Coverage summarizes the recently released annual report of the Robert Wood Johnson Foundation's State Coverage Initiatives program, State of the States 2007, available at www.statecoverage.net.
Source: The Commonwealth Fund
February 2007

New Analysis Shows How Higher Premiums Lead More Workers To Opt Out Of Employer Health Coverage
As policy discussions to expand coverage for the uninsured consider what is affordable for low-income and moderate-income people, a new analysis by the Kaiser Family Foundation documents how workers are less likely to sign up for health insurance from their employer when they must pay a larger share of its cost. The results suggest that many workers will forego their employer’s coverage and could end up without any health insurance if required to pay too much of its cost.
     About 160 million Americans obtain their health insurance through their employer or a family member’s employer. Premiums for employer-sponsored health coverage averaged $11,480 for family coverage in 2006, with workers required on average to pay $2,973 toward the costs of that coverage. However, workers’ contributions to their health premiums vary greatly across firms, and this new study examines how those variations can affect the likelihood that a worker will accept, or “take up,” their employer’s coverage.
     The study is based on 2005 and 2006 data from the Kaiser Family Foundation/Health Research and Education Trust Employer Health Benefits Survey. It looks at variations in the rate workers take up their employer’s health coverage based on the share of the premium that they are asked to pay broken by size of firm, by industry, and by wage level of the company.
     While some workers do not take up health insurance even when they have to pay nothing or a small share of the costs of coverage, the analysis shows a drop in the take-up rate among workers as their share of premiums increases – with low-wage workers generally less likely to take up coverage across the board. The data does not show what alternative coverage, if any, is available to those workers who opt out of their employers’ coverage. However, it suggests that some firms’ offers for health coverage are considered less affordable to workers in low-wage firms and could lead some to forgo coverage and become uninsured.
     The analysis “Insurance Premium Cost-Sharing and Coverage Take-Up,” is part of Snapshots: Health Care Costs, which is an online series by Kaiser Family Foundation staff that provides insight into key issues affecting the cost of health care in the United States. The Snapshots series is intended to help increase understanding of how rising health costs can be addressed and encourage a well-informed and fact-based discussion as policymakers in Washington and across the country weigh strategies for curbing the rising costs of health care for people, businesses and governments alike.
Source: Kaiser Family Foundation
February 2007
More workers contributing to health plan premiums
The proportion of workers enrolled in a health plan that did not require them to share the premium cost fell to 18% in 2004 from 27% in 1998, the Agency for Healthcare Research and Quality reports. Enrollment in such plans slipped from 35% to 24% for single coverage and from 19% to 15% for family coverage over the six-year period. Companies with fewer than 50 employees continued to have a much higher proportion of workers enrolled in no-contribution plans than did larger companies. The data come from the agency’s Medical Expenditure Panel
Source: Medical Expenditure Panel Survey
Date: January 2007
An Estimated Quarter of Uninsured U.S. Residents Are Eligible but Not Enrolled in Public Health Insurance Programs
About one-quarter of the approximately 46 million uninsured U.S. residents qualify for government-funded health care programs but are not enrolled, the AP/Seattle Post-Intelligencer reports. Some people are unaware that they qualify for public programs, while others might have difficulty with long, complex enrollment forms or face delays in participation approval. About a decade ago, some states including Vermont and Wisconsin tried to encourage enrollment by advertising health care programs, simplifying the application forms and relaxing renewal requirements, according to the AP/Post-Intelligencer. Wisconsin was able to enroll four-fifths of the state's uninsured children and more than half of uninsured adults in BadgerCare as a result of these efforts, one study found. However, when states later began to experience budget crunches, many dropped their outreach programs, according to Rachel Klein, deputy director of health policy at Families USA. "You have to constantly do outreach to the public because they may not know what's there," Klein said (Lohn, AP/Seattle Post-Intelligencer, 1/29).
Source: Kaisernetwork.org
January 29, 2007
State of the States 2007: Building Hope, Raising Expectations
State of the States 2007, Building Hope, Raising Expectations details a variety of factors motivating states to address this thorny problem, including the continued rise in the number of uninsured, steep declines in employer-sponsored health insurance, improved state economies with increased state revenues, and the lack of a national solution.
The report provides details on new and evolving state policies to expand coverage. These range from comprehensive health care reform (Massachusetts, Vermont, Maine) to public-private partnerships (Arkansas, Montana, New Mexico, Oklahoma, Rhode Island, Tennessee, Utah) and initiatives to cover all children (Illinois, Pennsylvania).
Source: State Coverage Initiatives
January 2007
New Publications Examine SCHIP Experience; Trends in Access to Medicaid and SCHIP Coverage
Maintaining and expanding health coverage for children and parents will likely be in the forefront of health care policy debates in Washington and state capitols in 2007. With states generally in better financial shape since the fiscal crisis earlier in the decade, many have expressed interest in improving access to their Medicaid and State Children's Health Insurance Programs (SCHIP). A new 50-state survey shows that one-third of states (17) increased access to health coverage in 2006, and no state cut income eligibility in Medicaid and SCHIP for the first time in four years.
Source: Kaiser Family Foundation
January 9, 2007
State Lawmakers Nationwide Making Health Coverage Expansions Top Priority in 2007
USA Today on Monday examined states' "aggressive and potentially expensive attempt[s]" to expand health care coverage for uninsured residents. According to USA Today, "[g]overnors and state legislators in both parties and most states" have pledged to make health care a priority for upcoming legislative sessions, while Congress has "put health care lower on its agenda." States might find it easier to pass health care reform because state legislatures tend toward greater bipartisanship, "avoiding the deadlock between Democrats and Republicans in Congress," according to USA Today. In addition, states tend to have budget surpluses, flexible federal rules for Medicaid spending and successful reforms in other states to use as models -- all of which "make it easier to expand programs," USA Today reports. Many state health care plans feature proposals including expanded insurance to cover all children; tax incentives to businesses and individuals to increase money available for insurance coverage; medical insurance subsidies for small businesses; improved access to preventive care; and increased price competition for health-related costs. A few state proposals focus on universal health care for all state residents. Missouri Gov. Matt Blunt (R) said, "The states, as we've done on other issues such as welfare reform, are acting as the real innovators and making changes that will affect national policy"
Source: USA Today
February 7, 2007