MHA Press Room

Survey: 26 states expand access to health coverage in 2009

Twenty-six states expanded access to health coverage for low-income children, parents or pregnant women in 2009, according to a survey released Dec. 8 by the Kaiser Commission on Medicaid and the Uninsured. Children were the chief beneficiaries of the expansions, with 19 states improving access to coverage for children by increasing eligibility, simplifying procedures and eliminating premiums.

“The renewal of [the Children’s Health Insurance Program] and the fiscal relief and eligibility and enrollment protections for Medicaid in the American Recovery and Reinvestment Act proved critical to enable states to continue their commitment to providing coverage to millions of low-income families,” said KCMU Executive Director Diane Rowland. “However, even with signs of economic recovery, state revenues are still mired in a severe slump and, faced with the end of enhanced federal money after 2010, fiscal shortfalls are likely to cause states to consider significant cuts to Medicaid and CHIP.”

GAO: Many eligible people not enrolled in state high-risk pools

Fewer than 200,000 of the estimated 4 million people eligible to enroll in state high-risk health insurance pools did so in 2008, according to a report released Aug. 21 by the Government Accountability Office. Thirty-five states offer the health insurance pools to residents who have been rejected by private health insurers or are charged higher premiums due to preexisting health conditions.

In the 34 pools reviewed by GAO, the average annual deductible for the most popular health plan was nearly three times higher than the average deductible for employer-sponsored plans. According to the report, the pools received about $286 million in federal grants between 2003 and 2008.

In 2008, the pools paid claims totaling $1.9 billion. About half of the funding for the pools came from premium revenues and about one-quarter from insurance carrier assessments.

The report was requested by leaders of the House Energy and Commerce Committee.

Survey: Large employers less confident in future of health benefits

Sixty-two percent of large employers are confident they will continue to offer health care benefits in 10 years, down from 73% last year, according to a new survey by Watson Wyatt and the National Business Group on Health.

“This is the first time in the 14 years that we have conducted this survey that employer confidence has declined, and it is not related to an increase in cost trends,” said Ted Nussbaum, North America director of group and health care consulting at Watson Wyatt. “This clearly reflects the uncertainty among large employers over the impact that the fragile economy is having on their ability to stay competitive in the face of health care costs that persistently rise at double the rate of general inflation.”

Report: Budget shortfalls threaten state health coverage efforts

Nearly half of states proposed expanding coverage for the uninsured in their fiscal year 2009 budgets, but many of those efforts may have to be scaled back or abandoned due to mounting budget shortfalls, according to a new report by the Robert Wood Johnson Foundation. Last year, 41 states and the District of Columbia reported a combined budget shortfall of $43 billion, and that number is only expected to grow as state revenues continue to decrease, the report notes.

“[C]urrent economic conditions will increase pressure on states to contain costs,” the report states. “For many states, controlling costs may prove more difficult than expanding access.”

9% of Qualified Unemployed Workers Use COBRA To Extend Health Care Coverage, Study Finds

Nine percent of unemployed workers who are eligible to continue their health coverage under COBRA do so, but most workers cannot afford the coverage, according to a recent report by the Commonwealth Fund. COBRA allows recently laid-off workers to remain on their employer-sponsored health plan for up to 18 months.

Workers are responsible for the full cost of the coverage as well as a 2% administrative fee. COBRA costs an average of $13,000 annually for family coverage, compared with the average annual employee contribution of $3,200 for family coverage.

The report found that 66% of all current workers would be eligible to extend their health coverage through COBRA if they are laid off. However, according to the report, laid-off employees would need assistance paying 75% to 85% of COBRA premiums to allow their premium contributions to remain at the same level as when they were employed.

The report found that millions of eligible workers could retain health insurance under COBRA if they receive premium assistance. In addition, the report found that 38% of low-wage workers are eligible for COBRA because they are uninsured, do not receive employer-sponsored health insurance or work for small businesses that are not required to offer COBRA.

Two House committees last week approved portions of an economic stimulus package that would subsidize 65% of COBRA premiums for 12 months for recently laid-off workers. In addition, the legislation would allow laid-off people ages 55 and older and those with 10 or more years of tenure at their jobs to continue COBRA coverage until they find new employment or reach age 65. The Senate Finance Committee's stimulus measure would provide premium assistance for nine months.

Commonwealth Fund President Karen Davis in a release said, "Americans are losing their jobs at an alarming pace and this report clearly shows that many people cannot afford to take on the expense of COBRA just as they lose their income." The report states that Congress should consider subsidizing three-quarters of COBRA's cost for unemployed workers and extending the eligibility from 18 months to 24 months. In addition, the report recommends extending Medicaid and SCHIP eligibility, along with premium assistance, to unemployed, low-income adults.

Survey: State budget pressures threaten access to children’s coverage

One-third of states increased access to health coverage for low-income children, pregnant women and parents during the past year, while 10 states enacted at least one measure to restrict coverage, according to a new survey released by the Kaiser Commission on Medicaid and the Uninsured. The most common restriction was imposing new or higher premiums in the State Children’s Health Insurance Program.

While many states expanded children’s coverage in their current budgets, they now face mounting funding shortfalls and pressure to cut Medicaid and SCHIP just as workers lose their jobs and health coverage in the recession, the report notes. In a separate survey of parents, the Commission found that many low- and middle-income working families with an uninsured child do not have access to employer-sponsored coverage. In addition, low-income citizen children whose parents are not citizens are at significant risk of being uninsured, the survey found.

New Reports Examine Trends And Issues In Children's Health Coverage

With the nation's recession and rising unemployment, more families and children are turning to Medicaid and the State Children’s Health Insurance Program (SCHIP) for health coverage, and Congress is poised to reauthorize SCHIP with a substantial increase in its federal funding. Against this backdrop, the Foundation’s Commission on Medicaid and the Uninsured (KCMU) on Jan. 23 released a package of new reports and other resources that examine the trends in children's health coverage and future challenges for efforts to reduce the nation's roughly 9 million children without health insurance.

These resources include the eighth annual 50-state survey of eligibility rules, enrollment and renewal procedures, and cost-sharing practices in Medicaid and SCHIP for children and families, which finds that state efforts to expand coverage to children slowed last year amid uncertainty about SCHIP's future. In addition, the Foundation releasd two new issue briefs based on the Kaiser Survey of Children’s Health Coverage, a telephone survey of parents that was conducted in 2007 to learn more about children’s access to coverage and care and the health care cost-related pressures facing their families.

The first provides key findings from the survey, including that many low- and middle-income working families with an uninsured child do not have access to employer-sponsored health insurance, while the other examines health insurance coverage for low-income citizen children whose parents are not citizens and some of the specific barriers to enrolling these children in Medicaid and SCHIP. The materials were released at a policy briefing, featuring John G. Folkemer, Deputy Secretary, Health Care Financing, Maryland Department of Health and Mental Hygiene; Susan Johnson, Director, King County Health Action Plan; Dr. Jay Berkelhamer, Past President of the American Academy of Pediatrics and Chair of the Academy's Access Committee; Donna Cohen Ross of the Center on Budget and Policy Priorities; and Kaiser researchers Julia Paradise and Caryn Marks. A webcast of the briefing, moderated by Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the KCMU, will be available later this afternoon.

The new reports and other resources are available online here.

Study urges action to help unemployed keep health coverage

Extending COBRA eligibility, providing premium assistance to make such coverage affordable, and opening public programs to unemployed adults with low incomes would provide critical support to workers who lose their jobs, according to a study released Jan. 23 by the Commonwealth Fund. Such actions also would provide revenues to community health resources, including physician prac­tices, clinics and hospitals, thereby preventing loss of jobs in the health care field, the report notes.

"The number of uninsured Americans could grow markedly during this recession unless we take action to help unemployed Americans keep their health care coverage,” said Commonwealth Fund President Karen Davis.

Report: Economy threatens progress on children’s coverage

Ten years of progress on children's health care coverage is threatened by increasing unemployment, declining state revenues and a growing gap between family income and the cost of health care coverage, according to a recent report by Georgetown University's Health Policy Institute. The report by the Institute’s Center for Children and Families estimates that 4.1 million Americans, including 1.2 million children, have lost employer-based coverage over the past year.

“The nation is at a critical juncture in its commitment to coverage for America’s families,” the report concludes. “It must decide whether it will sustain and strengthen this commitment or allow it to fall victim to the fiscal pressures confronting states and the federal government.”

Potential federal actions to address the crisis include temporarily increasing federal support for Medicaid and promptly reauthorizing the State Children’s Health Insurance Program, set to expire in April 2009, to soften the impact of the economic downturn on uninsured children, the report adds.

Survey: Employers cite cost as key barrier to offering coverage

Most employers who don’t offer health coverage would not be willing to spend more than $50 per employee to offer a health plan to their workers, according to a new survey by benefits consultant Mercer. When asked their primary reason for not offering health coverage, 43% said they can’t afford it. Asked how much they would be willing to contribute to offer a health plan, 59% cited $50 or less. According to Mercer, almost all employers who do not sponsor health coverage have fewer than 500 workers.

“This finding highlights how tough it’s going to be to ask very small employers to voluntarily take on the expense of providing health coverage,” said Mercer partner Linda Havlin. “It also helps explain why even relatively low-cost catastrophic plans like HSAs have not made great inroads with small employers that find it financially challenging to offer coverage.”