Benefits of Medical Insurance to the Poor

  • First study of its kind shows benefits of providing medical insurance to poor, By Gina Kolata, July 7, 2011, New York Times: “When poor people are given medical insurance, they not only find regular doctors and see doctors more often but they also feel better, are less depressed and are better able to maintain financial stability, according to a new, large-scale study that provides the first rigorously controlled assessment of the impact of Medicaid. While the findings may seem obvious, health economists and policy makers have long questioned whether it would make any difference to provide health insurance to poor people. It has become part of the debate on Medicaid, at a time when states are cutting back on this insurance program for the poor. In fact, the only reason the study could be done was that Oregon was running out of money and had to choose some people to get insurance and exclude others, providing groups for comparison…”
  • Medicaid makes ‘big difference’ in lives, study finds, By Julie Rovner, July 7, 2011, National Public Radio: “As high-level budget talks drag on in Washington, the Medicaid program for the poor remains a prime candidate for cuts. In recent months, Republicans have criticized Medicaid for badly serving its target population. But a new study – the first of its kind in nearly four decades – finds that Medicaid is making a bigger impact than even some of its supporters may have realized. The study, being published as a working paper by the National Bureau of Economic Research, has a distinctly bipartisan flavor. Among its authors are Katherine Baicker of Harvard, who was an economic adviser to President George W. Bush, and MIT economist Jonathan Gruber, who has advised the Obama administration…”

Workplace Health Insurance Coverage – Minnesota

Fewer families get health coverage from workplace, By Jackie Crosby, June 28, 2011, Minneapolis-St. Paul Star Tribune: “The number of Minnesotans who get health insurance through employers has dropped 10 percentage points in the past decade, outpacing the decline nationwide, according to a study released Tuesday by the University of Minnesota. A decade ago, about 8 in 10 workers and their families received health benefits from a company-offered plan. By 2009, the most recent year available, 71 percent of Minnesotans were covered through the workplace. The shift parallels a trend in which growing numbers of Minnesotans earn lower wages and the ranks of those living in poverty swells…”

State Medicaid Programs – New Jersey, Massachusetts

  • Christie proposal to slash Medicaid by $540 million puts NJ at center of national debate, By Josh Lederman (AP), June 11, 2011, Washington Post: “As states across the country look for ways to trim billions off their spending on Medicaid, New Jersey is garnering particular attention for a proposal that opponents characterize as an unprecedented and draconian attempt to balance the state’s precarious budget on the backs of society’s most vulnerable populations. The debates taking place in statehouses, clinics and living rooms crystalize the unfortunate truth about economic recessions: Citizens rely most on public services just when the government has the least money to spend on those services. In New Jersey’s case, changes would mean a parent of two earning more than $103 per week would be ineligible…”
  • Human Services officials release details on N.J. Medicaid program cuts, changes, By Susan K. Livio, June 10, 2011, Star-Ledger: “The Christie administration released a long-anticipated outline today of how the state proposes to drastically restructure New Jersey’s Medicaid program and cut more than $300 million to help close a deficit. In the most controversial element of the proposal, the Department of Human Services expects to save as much as $32.5 million by sharply limiting who is eligible for coverage. It was the first time that the state disclosed estimates of what each change would save. For instance, parents in a family of three earning more than $422 a month, or $5,000 a year, would be disqualified for earning too much money, according to a document summarizing the proposal. Currently the income cut-off is $24,600 for a family of three…”
  • Advocates: ‘glitches’ keep Mass. kids uninsured, By Johanna Kaiser (AP), June 11, 2011, Boston Globe: “Forgotten paperwork, returned mail, and a lack of information are keeping thousands of Massachusetts children from receiving stable health care coverage in a state known for its far-reaching health care initiative. Although Massachusetts has the highest rate of insured children in the county — more than 99 percent — health care advocates and lawmakers say thousands of eligible children still go on and off the state’s Medicaid program, known as MassHealth, during the year because of administrative issues and other paperwork problems…”

Safety Net Hospitals and Charity Care

2 Illinois hospitals on brink of closure illustrate pressures on US health care safety net, By Carla K. Johnson (AP), May 9, 2011, Washington Post: “Two charity hospitals in Illinois are facing a life-or-death decision. There’s not much left of either of them – one in Chicago’s south suburbs, the other in impoverished East St. Louis – aside from emergency rooms crowded with patients seeking free care. Now they would like the state’s permission to shut down. The institutions, which have served low-income people in the state for more than 100 years, represent a significant development that’s gone largely unnoticed as the nation climbs out of the recession. Many charity hospitals, already struggling with rising costs, are on the brink of failure because of looming budget cuts, increasing numbers of uninsured patients and a slow economic recovery…”

Unemployment and Health Insurance Coverage

  • Report: Unemployment adds 9 million uninsured in U.S., By Steven Reinberg, March 16, 2011, US News and World Report: “The millions of Americans who lost their jobs and their health benefits during the recession often had no way to regain affordable health coverage, leaving them and their families at risk of financial ruin, according to a new report from The Commonwealth Fund. The spate of layoffs during the recession catapulted 9 million more Americans — or 57 percent of those who had had health insurance in a job that evaporated over the last two years — into the ranks of the millions already uninsured. In addition, 19 million people anxiously seeking private coverage over the last three years were either turned down or could not find a plan that was affordable and met their needs, the report found. The Biennial Health Insurance Survey also found a whopping 60 percent increase in skipped care due to cost in the past decade. The survey reported that medical debt problems and out-of-pocket spending costs were on the rise as well, with 29 million Americans using up their entire life savings to pay for medical bills and millions more unable to afford food, heat and rent due to medical payments…”
  • Job loss, health costs pushed uninsured to 52 million in U.S., March 16, 2011, San Francisco Chronicle: “Unemployment and rising expenses caused 9 million Americans to lose health insurance during the past two years, according to researchers backed by a group advocating access to health care. Losses of coverage helped swell the ranks of uninsured adults in the U.S. to 52 million in 2010, according to a study released today by the Commonwealth Fund, a New York-based foundation that says it backs research aimed at expanding and improving care. An additional 73 million adults had difficulties paying for health care and 75 million deferred treatment because they couldn’t afford it, researchers said. President Barack Obama’s health overhaul will provide access to insurance to almost all of the currently uninsured through expansion of the Medicaid program for the poor and through private health plans, said Sara Collins, a study author. Federal subsidies and rules on affordability and mandated benefits will allow many to buy coverage by 2014 when the law is due to take full effect, she said. The law is being challenged in court cases questioning its constitutionality…”

Ohio Family Health Survey

1.5 million Ohioans among the uninsured, By Suzanne Hoholik, March 8, 2011, Columbus Dispatch: “More Ohioans are uninsured, fewer businesses offer health benefits to workers and almost 250,000 people joined the state Medicaid rolls from 2008 to 2010, according to a survey released yesterday. The 2010 Ohio Family Health Survey found that the number of uninsured grew by almost 160,000 – including 15,283 children – during the two-year period. In all, there are about 1.5 million uninsured Ohioans. ‘These are preliminary numbers. They raise more questions than they answer at this point,’ said William Hayes, an adjunct assistant professor at Ohio State University’s College of Public Health. The survey also found that being uninsured is the second-largest category of health-coverage status, behind employer-sponsored health plans, for working adults 18 to 64 years old…”

Health Insurance Coverage in the US

  • Number of uninsured U.S. adults hits record high, By Steven Reinberg, November 10, 2010, USA Today: “Nearly 50 million Americans have gone without health insurance for at least part of the past year – up from 46 million people in 2008, federal health officials reported Tuesday. Those people included not only those Americans living in poverty, but an increasing number of middle-income people, according to a report from the U.S. Centers for Disease Control and Prevention. ‘The bottom line is that uninsurance of young and middle-class adults increased by 4 million people from 2008 to the first quarter of 2010,’ CDC Director Dr. Thomas R. Frieden said during a news conference Tuesday. What’s more, the number of people without insurance for a year or more increased from 27.5 million in 2008 to 30.4 million in the first quarter of 2010, Frieden said. ‘That’s an increase of 3 million of chronically uninsured adults…'”
  • Report: 59 million Americans lack health care, By Joshua Norman, November 10, 2010, CBS News: “More than 59 million Americans had no health insurance for at least part of 2010, an increase of 4 million from the previous year, the U.S. Centers for Disease Control reported Tuesday. While the worsening economic conditions did have a direct impact on the number of Americans with coverage, the situation also meant that a far greater number of Americans are forgoing needed medical care because of costs…”

Employment and Health Insurance Coverage

  • Health care becomes optional for people who are underemployed, By Aziza Jackson, October 11, 2010, Anniston Star: “It is no surprise that uninsured and underinsured Americans cannot afford to get sick nowadays. Obtaining affordable health care has indeed become a growing problem for many Americans, and, for the residents of Calhoun County, the problem hits even harder. According to a study headed by Dr. Samuel Addy, director and associate research economist at the Center for Business & Economic Research at the University of Alabama, Calhoun County has the highest number of underemployed workers out of all the other counties that make up the region known as ‘Region 5.’ Underemployed Calhoun County residents are considered employed because they do hold jobs. However, their jobs do not equal stability and do not provide them or their families with healthcare coverage. The underemployed are finding it difficult to make ends meet and afford medication and preventative care. Simply put: They can’t afford to get sick…”
  • High-risk insurance pool accepts patients with pre-existing conditions, By Patricia Anstett, October 11, 2010, Detroit Free Press: “Deri Mick is left to wonder whether the health insurance he just got through Michigan’s new program for the hard-to-insure came in time to help. Mick, 46, of Swartz Creek was set to have kidney cancer surgery last week at the University of Michigan. But tests found more cancer than expected. He awaits further tests and possibly chemotherapy. Through Michigan’s new high-risk insurance pool, Mick, who hasn’t had insurance for nine years, was able to get coverage that will cost him $350 a month. The program, which began offering coverage Oct. 1, is open to any adult 19-64 who has been rejected for insurance in Michigan. It will accept the first 3,500 applicants. Mick was turned down earlier in September by Blue Cross Blue Shield of Michigan, which can legally refuse to offer insurance to people with a pre-existing condition for a period of six months from the time of the request. But the company referred Mick to the new pool. ‘I’m going to be high risk all my life,’ said Mick, a divorced father of two who earns $38,000 a year. He hopes he will qualify for some financial help in 2014, when broader health reforms begin, including subsidies for lower-income people, particularly those earning less than $40,000 a year…”

Health Care Reform and Children’s Coverage

  • For many, health care relief begins today, By Kevin Sack, September 22, 2010, New York Times: “Sometimes lost in the partisan clamor about the new health care law is the profound relief it is expected to bring to hundreds of thousands of Americans who have been stricken first by disease and then by a Darwinian insurance system. On Thursday, the six-month anniversary of the signing of the Patient Protection and Affordable Care Act, a number of its most central consumer protections take effect, just in time for the midterm elections. Starting now, insurance companies will no longer be permitted to exclude children because of pre-existing health conditions, which the White House said could enable 72,000 uninsured to gain coverage. Insurers also will be prohibited from imposing lifetime limits on benefits…”
  • Some insurers to halt new child-only policies, By N. C. Aizenman, September 21, 2010, Washington Post: “Some of the country’s most prominent health insurance companies have decided to stop offering new child-only plans, rather than comply with rules in the new health-care law that will require such plans to start accepting children with preexisting medical conditions after Sept. 23. The companies will continue to cover children who already have child-only policies. They will also accept children with preexisting conditions in new family policies. Nonetheless, supporters of the new health-care law complain that the change amounts to an end run around one of the most prized consumer protections…”
  • New healthcare law kicks in today, By Todd Ackerman, September 23, 2010, Houston Chronicle: “Tens of thousands of Texas children will be directly affected by the 11th-hour decision of a number of major health insurance companies to stop selling child-only policies rather than comply with the new federal law that requires they cover youngsters with pre-existing conditions. All insurance companies starting today will accept children in family plans regardless of medical history, but Texas insurers United Healthcare, Aetna Inc. and Cigna Inc. are among the ones that will no longer offer policies just for individuals under 19. Such plans have grown in popularity in recent years as employee-based policies have cut coverage of dependents…”

Children’s Health Insurance Coverage

  • Health care program aims to cover uninsured children, By Patricia Anstett, September 3, 2010, Detroit Free Press: “As millions of children return to school, health leaders today launched an unprecedented national campaign to enroll 5 million uninsured children nationwide – including 172,000 in Michigan – in free or low-cost health insurance programs. Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, said the Connecting Kids to Coverage Challenge was timed to coincide with the opening of schools because ‘no child should be unable to read a book because their vision was not checked’ or be unable to participate in school sports because he or she didn’t have affordable coverage to pay for a sports physical. The federal Centers for Medicare and Medicaid is giving grants to states to help enroll more children in insurance programs…”
  • Participation in Children’s Health Insurance Program varies widely across country, By Phil Galewitz, September 3, 2010, Kaiser Health News: “The hunt for the nearly 5 million uninsured U.S. children who are eligible for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program just got a road map. A new study published today in Health Affairs shows that 39 percent of the uninsured but eligible kids live in three states: California, Texas and Florida. Another 22 percent live in Georgia, New York, Arizona, Illinois, Ohio, Pennsylvania and North Carolina. That’s not a big surprise, because those states have more than half of all children in the country, according to the researchers at the Urban Institute, a non-partisan think tank in Washington. The study’s real value was showing that the states with the lowest participation rates in Medicaid and CHIP were largely in the Rocky Mountain region and Florida. While the national participation rate in Medicaid/CHIP was 82 percent, five states had participation rates below 70 percent: Nevada (55.4 percent), Utah (66.2 percent), Colorado (68.9 percent), Montana (69.3 percent) and Florida (69.8 percent). In contrast, the study showed the states with highest participation rates are Massachusetts (95 percent), Vermont (94 percent) and Maine (92 percent)…”

Free Health Clinics – Wisconsin

At these clinics, income no object, By David Wahlberg, August 29, 2010, Wisconsin State Journal: “They assembled in a parking lot on a hot afternoon: diabetics, men with toothaches and chest pain, a woman with torn cartilage, workers whose low wages or job losses left them uninsured. Mary Lyons waited for the free clinic to open so she could refill her nine medications. A diabetic with heart disease and a persistent cough, she works nights cleaning meat processing machines, making enough to get by but not enough to buy insurance, she said. She relies on the clinic for medical care. ‘I don’t know what I’d do without it,’ said Lyons, 61. Free clinics have become a prominent safety net in rural Wisconsin, especially in the southwest part of the state, where clinics have opened in the past four years in Boscobel, Dodgeville and Richland Center. Another, in Prairie du Sac, has been around for more than a decade. Volunteer doctors at the clinics care for the uninsured without charge and offer drugs at deep discounts. The need for free care around the state and the country could drop once the new federal health care reform law fully kicks in by 2014, some say. But Robin Transo, who opened Boscobel’s free clinic in the walk-out basement of a hearing clinic run by her husband, isn’t so sure…”

Recession and Rural Hospitals – Georgia

Rural hospitals face challenges across the state, By Charles Oliver, August 22, 2010, Dalton Daily Citizen: “The economic downturn, cuts in state and federal health care programs, and attempts by private businesses to rein in their own health care costs have combined to create a ‘perfect storm’ that threatens small rural hospitals across the state, according to Jimmy Lewis, CEO of HomeTown Health, which represents 55 rural hospitals in Georgia including Murray Medical Center. ‘We could wake up tomorrow and have 10 hospitals about to close,’ said Lewis. Forty-one Georgia hospitals have closed since 1980, according to the Georgia Hospital Association, many of them small rural hospitals. The problem that rural hospitals face is that their ‘payer mix’ is typically heavy in patients on Medicare and Medicaid and those without insurance…”

Recession and Health Insurance Coverage

  • Economy led to cuts in use of health care, By Robert Pear, August 16, 2010, New York Times: “The economic crisis in the United States has reduced the use of routine medical care, and the cutbacks here are much deeper than in countries with universal health care systems, researchers say in a new report. The study, published by the National Bureau of Economic Research, finds that ‘Americans, who face higher out-of-pocket health care costs, have reduced their routine medical care’ much more than people in Britain, Canada, France and Germany. Individuals and families in all five countries lost income because of unemployment and lost wealth because of steep declines in stock prices…”
  • 8.4 million Californians lack health coverage as the ranks of the uninsured swell, study finds, By Molly Hennessy-Fiske, August 23, 2010, Los Angeles Times: “The number of Californians who lost jobs and health insurance probably increased in every county last year, according to a study released Monday by the UCLA Center for Health Policy Research. The new analysis found that 37 counties — including Imperial, Kern and Shasta — had uninsured rates above the statewide average of 24.3%. ‘Different parts of the state were more adversely impacted than others, but really it is spread across the state,’ said one of the study’s authors, Shana Alex Lavarreda, the center’s director of health insurance studies. ‘You have counties from Kern to Shasta that were hit very hard with averages over what we saw in Los Angeles,’ she added. The report backs up the findings of a previous study the center released in March that showed nearly one in four Californians lack health insurance. According to the latest estimates, the state’s uninsured population has reached 24.3%, or about 8.4 million, up from 6.4 million in 2007…”
  • 85,000 lost health insurance in Sacramento area, UCLA study finds, By Bobby Caina Calvan, August 24, 2010, Sacramento Bee: “Researchers issued yet another grim statistic Monday on the toll of the recession: 2 million additional Californians – 85,000 of them in the capital region – lost their health care coverage during the recent economic slide. As a result, difficult decisions are playing out in living rooms and across kitchen tables as families struggle with joblessness and tighter finances, according to the authors of a new UCLA study that gives a county-by-county account of the state’s swelling numbers of uninsured, now estimated at 8 million. In Sacramento County, 17.6 percent of the non-elderly population went uninsured at some point last year, compared with 13.1 percent in 2007. In two years, the ranks of the county’s uninsured climbed by 63,000 people – bringing the total to more than 224,000, according to the study by the University of California, Los Angeles, Center for Health Policy Research…”

The Homeless and Access to Health Care

For the homeless, federal changes promise better access to health care, By Mary Agnes Carey and Andrew Villegas, August 20, 2010, Washington Post: “Homeless and unemployed, Tianne Hill said she dreads getting mail at the city shelter on Guilford Avenue where she lives because it often includes medical bills she can’t pay. The 40-year-old former waitress and short-order cook owes about $6,000 for abdominal surgery. She’s expecting another bill soon for emergency treatment of a seizure. And she has other conditions that require expensive care: asthma, arthritis, anxiety and depression. Like many other homeless people, Hill is uninsured and ineligible for Medicaid, the state-federal program that covers millions of other poor Americans. But beginning in 2014, Medicaid greatly expands under the new health-care law to include adults without children, who generally have been excluded. The Medicaid expansion also will enable agencies that serve the homeless to divert resources now spent on medical care to other services such as finding housing and jobs. The new law provides another boost through a five-year, $11 billion expansion of the community health center system that treats many in this population…”

Funding for Health Centers

Health centers to get $250 million in grants to build clinics, boost services, By Darryl Fears, August 18, 2010, Washington Post: “Health centers across the country are lining up for a shot in the arm from the Obama administration: $250 million in federal grants to build clinics and bolster services at existing clinics for low-income patients such as public housing residents, the homeless, seasonal farmworkers and others who struggle to pay for care. The administration announced last week that the nation’s 1,100 health centers, which operate nearly 8,000 clinics in medically underserved areas, can apply for the grants through the Health Resources and Services Administration (HRSA)…”

Emergency Room Use in the US

UCSF study finds big jump in ER visits, By Victoria Colliver, August 11, 2010, San Francisco Chronicle: “Emergency room visits to U.S. hospitals increased more than 23 percent from 1997 to 2007 – double what researchers expected the rise would be based on population growth, according to a UCSF study released today. Total annual visits to the country’s emergency departments rose from 94.9 million in 1997 to an estimated 116.8 million over the next decade, the study found. Visit rates for adults on Medicaid accounted for the jump, while rates for adults with private insurance and those on Medicare showed no significant change. Relatively low reimbursements to physicians who care for patients on Medicaid, the federal-state health program for the poor who meet certain criteria, were believed to be a key factor behind the increase…”

Recession and Access to Health Care – Wisconsin, Colorado

  • No big increase in health charity with job losses, By Guy Boulton, August 8, 2010, Milwaukee Journal Sentinel: “Tens of thousands of people in the Milwaukee area have lost their jobs since the start of the recession, yet the increase has not resulted in a surge in charity care by health care systems in the region. The amount of free and discounted care provided by the health systems has been stable when calculated as a percentage of patient revenue, even as the economy struggles through the worst downturn since the Great Depression. The amount of bad debt also has not risen noticeably. That surprises some health care executives, who expected a sharp increase in charity care and bad debt expense at the recession’s start…”
  • Uninsured patients overwhelm Denver Health clinics, By Jennifer Brown, August 9, 2010, Denver Post: “A rising number of needy patients without health insurance is overwhelming community clinics in Denver, leaving some sick people to wait up to four months to see a family doctor. When new patients call one of Denver Health Medical Center’s eight clinics across the city, they are transferred to a downtown call center where they are put on a waiting list – a list that now contains 3,500 names. Patients can end up on the list ‘even if they are dying of something – that’s the horror,’ said Dr. Lara Penny, a family doctor at Denver Health’s Montbello clinic. The facility is so busy, the hospital system is setting up modular units to accommodate patients until a new building opens in January 2012 with the help of federal stimulus money. The county’s safety-net hospital, Denver Health treats anyone with an emergency, regardless of whether they can pay. That means a person injured in a car wreck or who has a heart attack will get care. But if that person also is diagnosed with diabetes or heart disease, getting a follow-up appointment with a primary-care doctor can take months…”

Census Small Area Health Insurance Estimates

  • Census data reveal broad differences among states in rates of uninsured, By Lena H. Sun, July 28, 2010, Washington Post: “New census data released Tuesday confirm a huge spread in the rate of uninsured from state to state and the big difference in impact that can be expected as a result of the health-care overhaul recently passed by Congress. The statistics are for 2007 and show health insurance coverage by state and for each of the country’s roughly 3,140 counties. The numbers do not include the impact on millions of people who lost their jobs and health insurance after the recession began in December 2007. The 2007 snapshot shows that Massachusetts, which has achieved near-universal coverage, had the lowest rate of uninsured people under age 65, about 7.8 percent. States with the highest rates of uninsured were in the South and West: Texas was at the top, with 26.8 percent, followed by New Mexico (26.7 percent) and Florida (24.2 percent)…”
  • 2007 data show state had 6.5 million uninsured, By Victoria Colliver, July 30, 2010, San Francisco Chronicle: “More than one fifth of Californians went without health insurance in 2007, with Bay Area counties having some of the lowest rates of uninsured people in the state, according to statistics released this week by the U.S. Census Bureau. The Small Area Health Insurance Estimates, which looked at every county in the nation, found that 20.2 percent of Californians were uninsured in 2007. The counties in California with the highest rates of residents without health insurance – Mono, Colusa, Monterey – tended to be smaller, rural or more reliant on agriculture than other regions…”

Uninsured Patients’ Treatment

Serious injuries worse for uninsured, By Henry L. Davis, July 26, 2010, Buffalo News: “Federal law prohibits hospitals from treating uninsured trauma patients any differently than patients with insurance. Yet studies in recent years have exposed a big disparity: Patients who lack insurance are much more likely to die from car accidents, gunshot wounds and other serious injuries than those who arrive at the hospital with coverage. The latest research comes from a University at Buffalo analysis of 191,666 patients, ages 18 to 30, who visited 649 trauma centers from 2001 to 2005 for blunt and penetrating trauma injuries. Blunt trauma includes injuries mainly from motor vehicle accidents, followed by such incidents as falls and assaults, while penetrating trauma consists mainly of gunshot wounds and, to a lesser extent, injuries from stabbings.  For blunt trauma, uninsured patients were 1.8 times more likely to die, even after controlling for age, sex, race and severity of injury, according to the researchers, who presented their results recently at the Society for Academic Emergency Medicine annual meeting. If patients lacked insurance, they were 2.6 times more likely to die from penetrating trauma injuries…”

Uninsured Adults and Dental Care – Virginia

Uninsured Virginians may lose free dental care, By Phillip Lucas, July 6, 2010, Washington Post: “Advocates for uninsured Virginians say slow action from state and federal officials means that thousands of residents who could have received free dental care this summer will go unserved unless Congress intervenes. Virginia received authorization from the U.S. Department of Health and Human Services to use money from the state’s Temporary Assistance for Needy Families fund to provide dental care to uninsured residents. The emergency fund is a federal block grant established by the American Recovery and Reinvestment Act of 2009, and it is supposed to serve as a safety net for families looking for employment opportunities and other types of assistance. Virginia requested permission to use some of the money for dental care for uninsured adults…”