Interesting information someone might want to read.
Dana (C4-5, 31 years post, 51, suburb of KC Johnson County, Kansas)
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Dear Dana,

We've collected information on several new reports and other resources available on the Web that we hope you'll find interesting and useful. Descriptions and links appear below.

From The Commonwealth Fund

Young adults are one of the largest and fastest-growing segments of the U.S. population without health insurance. They often lose coverage under their parents' policies at age 19 or when they graduate from high school or college. The updated Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help suggests several policy changes that could extend coverage to uninsured young adults.

Between 2000 and 2003, the number of Americans without health insurance coverage grew by 5 million, with nearly the entire increase attributed to a decline in employer-sponsored coverage. A Shared Responsibility: U.S. Employers and the Provision of Health Insurance to Employees explores the characteristics of workers who do not receive coverage from their own firms; examines how health care costs are spread across workers, employers, and the government; and recommends policy options to expand and strengthen employer-sponsored coverage.

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.

From Georgetown University

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.

From Health Affairs

In addition to the 45 million uninsured adults in the United States, another 16 million adults were underinsured in 2003, meaning their insurance did not adequately protect them against catastrophic health care expenses. Insured But Not Protected: How Many Adults Are Underinsured? explains that underinsured adults are almost as likely as the uninsured to go without needed medical care and to incur medical debt. (Full article available with subscription.)

From Health Care Financing Review

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.

From the Kaiser Family Foundation

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.

Trends and Indicators in the Changing Health Care Marketplace is an online chartbook that presents up-to-date information on key health care marketplace trends. The chartbook highlights national health expenditures, health care spending and costs, employee and retiree health coverage, HMO enrollment, hospital data, and public views on topics such as managed care, medical errors, and quality information.

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.

From the National Association of Health Underwriters

Healthcare Coverage Options Database: Assistance for Obtaining Health Coverage: This Web site provides information on health insurance options for low-income U.S. residents. The site includes comprehensive information on large-scale programs like Medicaid, the State Children's Health Insurance Program (SCHIP), and the federal Health Care Tax Credit Program, as well as hundreds of smaller state, federal, and private programs.

From the National Conference of State Legislatures

According to 2005 Prescription Drug State Legislation, in 2005, state legislatures have focused more than ever on prescription drug legislation. As of June, more than 600 separate bills and resolutions in all 50 states were proposed to address a wide array of policies affecting access, affordability, payment, and other regulation of prescription drugs.

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