SHADAC inJournal of Public Health Management and Practice: Health Reform and the Virgin Islands
SHADAC researchers Lynn Blewett, Kathleen Call, and Schelomo Marmor published an article in the most recent issue of the Journal of Public Health Management and Practice. “Health Reform and the US Virgin Islands: High-Need-Limited Impact,”assesses the potential impact of health reform on the US Virgin Islands (USVI) and considers how the results of aSHADAC-administered USVI household surveyconducted in 2003 and 2009 might be used as a baseline for future monitoring of national reform’s impact. The authors find that 28.7 percent of USVI residents were uninsured in 2009--twice the US average of 15.4 percent—and point out the abbreviated parameters of the ACA’s territorial coverage expansions do not fully address the high need for affordable health insurance coverage in the territories.
Lindsey Leininger to Present at 26th Annual State Health Policy Conference
Dr. Lindsey Leininger, Assistant Professor of Health Policy and Administration at the University of Illinois at Chicago, will present findings from herSHARE-funded researchat the26th Annual State Health Policy Conference, hosted by the National Academy for State Health Policy (NASHP). Dr. Leininger will be speaking on a panel titled, “The State Buzz from AcademyHealth’s Annual Research Meeting,” about the utility of self-reported health measures gathered at the time of Medicaid enrollment for predicting health care utilization and thereby informing Medicaid benefit design. The conference will take place on October 9-11, 2013, in Seattle Washington. Registration isnow open, with early bird rates available until August 30th.
News from the States
Barriers to Affordable Care for the Undocumented in California
Areportfrom the UCLA Center for Health Policy Research considers access to affordable care for undocumented immigrants in California, where this population is projected to account for up to two-fifths (41%) of the remaining uninsured after the ACA is fully implemented. The report uses data from the 2009 California Health Insurance Survey (CHIS), noting that over half (57%) of undocumented adults in the state had household incomes below the Federal Poverty Level and 51 percent were uninsured at the time of the survey. The authors point to a number of policy levers that could alleviate access-to-care barriers for this group under reform, including providing comprehensive coverage to some or all undocumented immigrants, providing coverage for specified services, and decreasing out-of-pocket costs by increasing direct funding to providers who offer free or low-cost services.
Related: SeeSHADAC Brief #35for 50-state estimates of the low-income uninsured who are ineligible for the ACA Medicaid expansion due to their immigration status.
Massachusetts Annual Health Care Market Report
The Massachusetts Center for Health Information and Analytics released the 2013“Annual Report on the Massachusetts Health Care Market,”which includes information on health care costs and quality with in-depth analyses of the commercial health care market, including premiums, coverage, and spending. The report notes that in 2011, an estimated 62 percent of the Massachusetts population was enrolled in employer-sponsored-insurance, down three percentage points from 2010 and five percentage points from 2009. Commercial market premiums (calculated per member per month) rose by 9.7 percent from 2009 to 2011, with enrollees contributing about 25 percent of premium costs in 2011 (exceeding the national average of 21 percent). The analysis relies on a number of data sources, including the 2011 and 2012 Medical Expenditure Panel Survey Insurance Component (MEPS-IC) and the 2011 Massachusetts Household and Employer Insurance Surveys.
Coverage in Michigan: Current Levels and Potential ACA Impacts
The Center for Healthcare Research and Transformation (CHRT) at the University of Michigan released a series of three issue briefs on health insurance coverage in the state.
“The Uninsured in Michigan,”describes trends in uninsurance in Michigan and the United States from 2008 to 2011 and considers levels of uninsurance by age, race/ethnicity, and income. The report notes that 11.8 percent of Michigan’s nonelderly residents (ages 0 to 64) were uninsured in 2011, up slightly from 11.1 percent in 2008 but down from 12.4 percent in both 2009 and 2010. The state’s percentage of nonelderly uninsured fell below national levels each year from 2008 to 2011.
“Regional Variation of the ACA’s Coverage of the Uninsured in Michigan,”examines the regional variation in the impact of the ACA on Michigan’s uninsured depending on whether the state expands Medicaid under the ACA. The report estimates that 92.9 percent of the state’s uninsured adults (ages 19 to 64) would qualify for Medicaid or Exchange tax credits, with nearly all of 33 county-based regions having eligibility rates of over 90 percent, if the state expands Medicaid. Without expansion, only 46.4 percent of uninsured adults would quality for exchange tax credits, with rates varying considerably according to geography.
“The ACA’s Coverage Expansion in Michigan: Demographic Characteristics and Coverage Projections,”estimates the impact of the ACA coverage expansion in Michigan with and without a Medicaid expansion. With an expansion, the report estimates that the state’s rate of uninsured adults (ages 19 to 64) would drop from its 2011 rate of 13.6 percent to a 2019 rate of six percent; without an expansion, the rate would fall to 10 percent in 2019. Ninety-three percent of the state’s uninsured adults would be eligible for Medicaid or exchange-based tax credits under an expansion scenario; 40 percent of the uninsured will not have an affordable cover option without expansion.
The Health Foundation of Greater Cincinnati released abriefexamining insurance status among nonelderly adults (ages 18 to 64) in Ohio based on the 2013 Ohio Health Issues Poll (OHIP), a random-sample landline and wireless telephone survey of adults throughout Ohio. Nearly two in 10 Ohio adults (17%) did not have health insurance at the time of the survey, a rate that is unchanged since 2012. However, nearly one in 10 nonelderly adults (9%) who reported having insurance at the time of the survey reported having been uninsured at some point the 12 months preceding the survey, meaning that nearly 3 in ten nonelderly adult Ohioans (27%) lack stable health insurance coverage. View data tables for the briefhere.
2013 Kaiser Family Foundation/HRET Employer Health Benefits Survey Now Available
Findings from the2013 Kaiser Family Foundation/Health Research & Educational Trust (HRET) Employer Health Benefits Survey, an annual survey of private and public employers throughout the United States, are now available. The survey found that the portion of all firms offering coverage in 2013 is statistically unchanged, at 57 percent, from 2012; the percentage of workers covered by their employers' health benefits (among all offering firms) was also statistically stable from 2012 to 2013, at 80 percent. Employers reported modest year-over-year increases in premiums for both single coverage (up 5% from $5,615 to $5,884) and family coverage (up 4% from $15,745 to $16,351) but no significant change in employee premium contributions and cost-sharing requirements. Additionally, while a greater percentage of employees were enrolled in a plan with a general annual deductible in 2013 than in 2012 (78% vs. 72%), the percent of covered workers enrolled in a high-deductible health plan in 2013 was unchanged from 2012, at 20 percent.
MEPS Statistical Brief: State Differences in Costs of Employer-Sponsored Coverage
Abrieffrom the Agency for Healthcare Research and Quality (AHRQ) examines state differences in the cost of employer-sponsored health insurance in 2012, based on the most recent data available from the Insurance Component of the Medical Expenditure Panel Survey (MEPS-IC), an annual federal survey of US private and public sector employers throughout the country. The brief considers the average premiums and employee contributions for private-sector establishments in 2012 in the 10 most populous states based on the 2010 Decennial Census. Of these states, New York had the highest average annual health insurance premiums for single coverage ($6,033), employee-plus-one coverage ($11,956), and family coverage ($16,924); at the same time, the average annual employee premium contribution in New York as a percentage of the premium price was below the national average for employee-plus-one coverage (22.3% vs. 26.6%) and family coverage (25.3% vs. 27.4%).
The State Health Access Data Assistance Center (SHADAC) is a program of the Robert Wood Johnson Foundation and a part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota.