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Issues in Health Reform

Five Basic Facts of the Uninsured

Posted on by rriporte

This Kaiser Family Foundation issue brief is a good, quick resource to understanding who the uninsured are in America.  Among the most salient points is that most (more than 3/4) of the uninsured live in a family with a worker.  This highlights several issues.

  1. that where you are employed, and the type of job you are able to hold, has always affected the type of insurance and health care you can receive.
  2. this is why ACA tried to encourage more employer sponsored insurance first by requiring insurance coverage of employees by employers of over 50 FTE and second by giving tax incentives for those who employed under 25FTEs.
  3. this is also why ACA put into place a new option for employees who couldn’t find insurance at work…these are the online marketplaces (the Exchanges)
  4. finally, because insurance was still going to be unaffordable for many, especially the working poor and their dependents, the feds were going to help states pay for expanding their Medicaid eligibility criteria to include those who would still be unable to afford private insurance.  KanCare has been pivotal in keeping kids in poor and working class families insured (under 225% of FPL, $4416 monthly income family of 4).

What is the impact on the federal budget by allowing businesses to take health insurance as a tax write-off?

Posted on by rriporte

This report analyzes the loss to the federal budget by allowing this practice.  This practice was initiated because it encouraged employers to pay for employees’ insurance plans.  Health insurance has, since World War II, been an important recruiting tool.  Businesses with better health benefits could choose from a larger more skilled employee pool.  It’s been a trade off between higher salaries and more extensive benefit packages.  ACA now requires taxing some of the insurance plans offered.  These are now referred to as “Cadillac” plans with the intonation that these plans are perhaps somewhat lavish and therefore not really necessary.  Those who have come to expect that type of complete coverage of their health care needs don’t think the plans are lavish but rather customary and essential.  That’s not the debate here.  This is just showing by how much the general federal deficit could be reduced if the practice of allowing employers to offer such extensive plans and claim tax exemptions for them were eliminated.  Policy analysts have oft referred to these tax exempt plans as money lost to the federal coffers.

Health care costs increases are slowing

Posted on by rriporte

Spending slowdown: If the current slowdown in healthcare spending persists, the government might save roughly $770 billion over the next decade, according to Harvard University Professor David Cutler. He writes in the latest issue of Health Affairs that the slowdown in health spending was caused in part by the recession, and also by slower advances in medical technology and the growth of health plans that shift more costs to consumers.

“If these trends continue during 2013–22, public-sector health care spending will be as much as $770 billion less than predicted. Such lower levels of spending would have an enormous impact on the US economy and on government and household finances,” Cutler wrote.

Read his study here.

Will the Affordable Care Act lead to more part time workers?

Posted on by rriporte

Interesting reflection on this topic in Washington Post blog.  Survey suggests that perhaps 4% of employers with more than 50 FTE are decreasing workers’ hours to avoid fines if they don’t provide health insurance.  The rest appear to value a higher skilled workforce and need to be attentive to customer satisfaction so that sending workers home mid shift while clients still need services may serve as sufficient deterrent.  It’s curious that some of the largest employers to already impose these cutbacks in workers’ hours are school districts and other county services across the country.

Kaiser Health News Develops Consumer Guide to the Health Reform Law

Posted on by rriporte
To help answer questions that have been on many people’s minds, “How does health care reform affect me (and my family)?”, Kaiser Health News has compiled Q&As related to the Affordable Care Act and how the law will affect people depending on their different situations. This includes questions like: what happens if an individual does not have health insurance now, what if an individual doesn’t qualify for Medicaid but can’t afford insurance through the Health Insurance Marketplace, and what if an individual owns a small business?

To view the answers to these and other questions, view Kaiser Health News’ web page. After The Election: A Consumer’s Guide To The Health Law.

Consumer Guide 300

Planning for community health action: Kansas Health Matters

Posted on by rriporte

Try out this very user friendly data driven website! Kansas Health Matters is a one stop source of non-biased data and information about community health in Kansas. It is intended to help hospitals, health departments, policy makers, community planners and members learn about issues, identify improvements and collaborate for positive change. It, along with the more nationally designed County Health Rankings and its Roadmaps to planning, are excellent tools for community health action.

What does the public know or understand about ACA?

Posted on by rriporte

The Kaiser Family Foundation poll results are detailed in this KFF brief. Their summary highlights why this is a public education challenge for those of us working with communities:

“As government officials, community organizations and advocates gear up the consumer information and assistance efforts that will surround this fall’s open enrollment for the health insurance exchanges created under the Affordable Care Act (ACA), much of the public remains confused about the status of the health law, according to the April Kaiser Health Tracking Poll. Four in ten Americans (42 percent) are unaware that the ACA is still the law of the land, including 12 percent who believe the law has been repealed by Congress, 7 percent who believe it has been overturned by the Supreme Court and 23 percent who don’t know whether or not the ACA remains law. And about half the public says they do not have enough information about the health reform law to understand how it will impact their own family, a share that rises among the uninsured and low-income households. When it comes to where they are getting information about the law, Americans most commonly cite friends and family, “newspapers, radio news or other online news sources”, and cable news. About one in ten report getting information from a health insurer, their doctor, an employer, or a non-profit organization. Similar shares say they have gotten information from “federal agencies such as the Department of Health and Human Services” or “state agencies such as your state Medicaid office”.”