This is the Health Chairs e-bulletin for December 2005.
Resources on Line
Access and Costs
One group that is particularly likely to lack insurance is people in their late teens and early twenties. To help bridge the transition from coverage under family plans, several legislatures have followed Utah’s lead and called on insurers to include certain older dependents or other family members in family coverage. NCSL staff has published an overview of the changing insurance definition of “dependent” at http://www.ncsl.org/programs/health/dependentstatus.htm
Three recent reports on coverage trends are available through Kaiser webcasts. Highlights from the National Survey of Employer-Sponsored Health Plans conducted annually by Mercer Health & Benefits LLC show continued slowing in premium growth, very little use of health savings accounts by small employers but strong support by very large employers, and increased use of care management and similar strategies. You can see some of the highlights at http://www.mercerhr.com/pressrelease/details.jhtml/dynamic/idContent/1202305
Source: Mercer Health & Benefits LLC
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These findings update and extend the results of a similar study that is conducted annually by Kaiser in partnership with the Health Research and Educational Trust. http://www.kff.org/insurance/7315/index.cfm
Early Experience With High-Deductible and Consumer-Driven Health Plans: Findings From the EBRI/Commonwealth Fund Consumerism in Health Care Survey showed some positives—more cost-conscious purchasing—but the down side included high levels of dissatisfaction and wish to change plans, more out of pocket spending even with health savings accounts, and necessary care delayed or foregone when compared with a group in conventional coverage. The survey results are available at http://www.ebri.org/publications/ib/index.cfm?fa=ibDisp&content_id=3606 and a Kaiser webcast of the release can be heard at http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=1575
This trio of coverage webcasts and reports is rounded out by the results of a survey of 300 large firms and their plans for Retiree Health Benefits. “Four in five businesses (79%) that now provide retiree health benefits will accept government subsidies for continuing to provide retiree drug coverage at least as good as Medicare’s coverage when the new drug benefit starts in 2006.” Although looking ahead they are increasingly uncertain how long they will continue to do so. “Most employers are accepting government subsidies and taking a wait and see attitude on the drug law,” said Kaiser Family Foundation President and CEO Drew E. Altman. Other reported findings include an average increase of 10 percent in total retiree health costs between 2004 and 2005. A fifth of firms offered a plan with no subsidy whatsoever, and most increased what retirees paid for their coverage. http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=1604
People with less than full-time work are particularly likely to be uninsured. Unfortunately, such so-called “unconventional” work arrangements are becoming more common. On the Fringe: The Substandard Benefits of Workers in Part-Time, Temporary, and Contract Jobs studies the problem. Access this and related reports from the Commonwealth Fund at http://www.cmwf.org/publications/publications_show.htm?doc_id=324095&#doc324095
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Two recent reports from the California Healthcare Foundation describe that state’s long-standing experiment with a small employer purchasing pool, and what they learned about the limits of such an effort. http://www.chcf.org/topics/healthinsurance/index.cfm?itemID=117081
Medicaid
Some news-making Medicaid Section 1115 waivers have been approved this year. For quick overviews of a handful of the most important ones, and links with more information on others, see http://www.ncsl.org/programs/health/1115waivers.htm
Our site also has last summer’s meeting of Health Chairs, which included some detailed briefings on how states have reformed their Medicaid programs. For a pre-session review, http://www.ncsl.org/programs/health/forum/chairs/healthchairsmtgb.htm
Children
First National Survey of School Mental Health Services
The Substance Abuse and Mental Health Services Administration (SAMHSA) just released a national survey that found that one-fifth of students receive some type of school-supported mental health services during the school year. School Mental Health Services in the United States, 2002-2003 addresses a continuum of common, relatively mild problems—such as difficulty adjusting to a new school—through more serious psychiatric and developmental disorders as reported by 83,000 public elementary, middle school and high school students. Topics examined include types of mental health problems encountered in school settings; types of mental health services that schools are delivering; numbers and qualifications of school staff providing mental health services; types of arrangements for delivering mental health services in schools; and major sources of funding for school mental health services.
To access the full report, go to http://www.mentalhealth.samhsa.gov/publications/allpubs/sma05-4068/
State Approaches to Promoting Young Children's Healthy Mental Development: A Survey of Medicaid, and Maternal and Child Health, and Mental Health
The National Academy of State Health Policy survey identified opportunities to promote the healthy development of children from birth to age three, with screening, detection and treatment opportunities. http://www.cmwf.org/usr_doc/rosenthal_CW12_final.pdf
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Public Health
Health, United States, 2005 has just been issued by the US CDC. This annual compilation of health data focuses on the 55-64 year-olds this year. Most tables and charts can be downloaded as spreadsheets, to allow comparisons and analysis by you. It is available on the web at http://www.cdc.gov/nchs/hus.htm
The 16th annual report comparing the state of states’ health, America’ s Health Rankings 2005 Edition has just been issued by United Health Foundation, American Public Health Association and Partnership for Prevention. The report measures four kinds of factors: personal behavior, environment, public policies and clinical care. While health has improved in many measures, growing rates of obesity and uninsurance drag down the overall rate of positive change. Click on the link and click the button that says “close frame” to see the report. http://www.unitedhealthfoundation.org/shr2005/ahr05_email.pdf
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From the States
Health Affairs Web Exclusives offers an intriguing interview with Vicky Gregg, CEO of BlueCross BlueShield of Tennessee. The interview offers insight on Tenncare, Medicaid expansion, cost control, disease management and Blue Cross reserving practices. http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.558/DC1
New State reports on insurance coverage and other state issues, using state data from Wisconsin and Washington are now available at http://dhfs.wisconsin.gov/stats/healthinsurance.htm and http://www.ofm.wa.gov/economy/healthins/2005/ehidb2005.pdf .
Several months worth of past Chairs e-bulletins are archived at http://www.ncsl.org/programs/health/forum/chairs/ebull/index.htm
Tell us about your favorite on-line resources, and what issues you want to see us cover with an e-mail to Kala.ladenheim@ncsl.org
Have any questions you'd like answered? A topic for which you’d like us to gather resources? Do you have a report of your own you'd like to share with your peers? Drop us a line…
Donna Folkemer, Group Director
Forum for State Health Policy Leadership
National Conference of State Legislatures
ph: 202-624-8171 fx: 202-737-1069
Donna.Folkemer@ncsl.org
Kala Ladenheim, Ph. D. Program Director
Forum for State Health Policy Leadership
National Conference of State Legislatures
ph: 202-624-3557 fx: 202-737-1069
kala.ladenheim@ncsl.org
 Health Chairs Project
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