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Income, Poverty and Health Insurance Coverage in the United States: 2013

September 19, 2014 Comments off

Income, Poverty and Health Insurance Coverage in the United States: 2013
Source: U.S. Census Bureau

The U.S. Census Bureau announced today that in 2013, the poverty rate declined from the previous year for the first time since 2006, while there was no statistically significant change in either the number of people living in poverty or real median household income. In addition, the poverty rate for children under 18 declined from the previous year for the first time since 2000. The following results for the nation were compiled from information collected in the 2014 Current Population Survey Annual Social and Economic Supplement.

The nation’s official poverty rate in 2013 was 14.5 percent, down from 15.0 percent in 2012. The 45.3 million people living at or below the poverty line in 2013, for the third consecutive year, did not represent a statistically significant change from the previous year’s estimate.

Median household income in the United States in 2013 was $51,939; the change in real terms from the 2012 median of $51,759 was not statistically significant. This is the second consecutive year that the annual change was not statistically significant, following two consecutive annual declines.

The percentage of people without health insurance coverage for the entire 2013 calendar year was 13.4 percent; this amounted to 42.0 million people.

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Quality of Health Care After Adopting a Full-Replacement, High-Deductible Health Plan With a Health Savings Account: A Five-Year Study

September 18, 2014 Comments off

Quality of Health Care After Adopting a Full-Replacement, High-Deductible Health Plan With a Health Savings Account: A Five-Year Study
Source: Employee Benefit Research Institute

Executive Summary

  • This study reports use of health care services related to health care quality over five years among over 18,000 individuals from a single large employer in the Midwestern United States that adopted an HSA-eligible health plan for all employees. It represents one of the longest observation periods reported with a full-replacement CDHP, and it is one of the few studies with a matched control group.
  • The introduction of the HSA-eligible health plan had a negative impact on office visits for annual physicals, well-child visits, and preventive visits in the year that the plan was adopted. In the second year, office visits increased for HSA-eligible health plan enrollees, but were mostly unchanged for the comparison group. By the fourth year in the HSA-eligible health plan, office visits for annual physicals, well-child visits, and preventive visits were down slightly relative to the comparison group.
  • Rates of LDL testing for adults with cardiovascular disease were reduced only in the first year of the HSA-eligible health plan. However, the introduction of the HSA-eligible health plan had a negative effect on medication monitoring for adults on select maintenance drugs not only in the first year that the new health plan was introduced, but in the following three years as well. • The HSA-eligible health plan reduced avoidance of both antibiotics for adults with acute bronchitis and imaging services for adults diagnosed with low back pain. Both services are often considered unnecessary.
  • Adoption of the HSA-eligible health plan was associated with a reduction in breast cancer, cervical cancer, and colorectal cancer screening in year one, although screenings for breast cancer and cervical cancer rebounded in year two. By year four, breast cancer screening was higher among enrollees in the HSA-eligible health plan than in the comparison group. In contrast, cervical cancer screening was lower among HSA-eligible health plan enrollees than the comparison group in year four. Throughout all of the study years, colorectal cancer screening was lower among HSA-eligible health plan enrollees than in the comparison group.
  • The HSA-eligible health plan was not associated with a change in the percentage of adults receiving HbA1c testing until the fourth year. LDL testing was lower as a result of the introduction of the HSA-eligible health plan in all years.

New From the GAO

September 17, 2014 Comments off

New From the GAO
Source: Government Accountability Office

Reports

1. 8(a) Subcontracting Limitations: Continued Noncompliance with Monitoring Requirements Signals Need for Regulatory Change. GAO-14-706, September 16.
http://www.gao.gov/products/GAO-14-706
Highlights – http://www.gao.gov/assets/670/665828.pdf

2. Health Insurance Exchanges: Coverage of Non-excepted Abortion Services by Qualified Health Plans. GAO-14-742R, September 15.
http://www.gao.gov/products/GAO-14-742R

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1. Land-Use Agreements: Department of Veterans Affairs Needs to Improve Data Reliability and Monitoring. GAO-14-501, August 18.
http://www.gao.gov/products/GAO-14-501
Highlights – http://www.gao.gov/assets/670/665331.pdf

2. Healthcare.gov: Actions Needed to Address Weaknesses in Information Security and Privacy Controls. GAO-14-730, September 17.
http://www.gao.gov/products/GAO-14-730
Highlights – http://www.gao.gov/assets/670/665841.pdf

3. Broadcast Television and Radio: Disclosure Requirements for Broadcasted Content. GAO-14-738, September 17.
http://www.gao.gov/products/GAO-14-738
Highlights – http://www.gao.gov/assets/670/665859.pdf

Statement for the Record

1. Individual Retirement Accounts: Preliminary Information on IRA Balances Accumulated as of 2011, by James R. McTigue, director, strategic issues, and Charles A. Jeszeck, director, education, workforce, and income security issues, to the Senate Committee on Finance. GAO-14-878T, September 16.
http://www.gao.gov/products/GAO-14-878T
Highlights – http://www.gao.gov/assets/670/665805.pdf

Testimony

1. Financial Stability Oversight Council: Status of Efforts to Improve Transparency, Accountability, and Collaboration, by A. Nicole Clowers, director, financial markets and community investment team, before the Subcommittee on Oversight and Investigations, House Committee on Financial Services. GAO-14-873T, September 17.
http://www.gao.gov/products/GAO-14-873T
Highlights – http://www.gao.gov/assets/670/665852.pdf

Employer-Sponsored Family Health Premiums Rise 3 Percent in 2014

September 17, 2014 Comments off

Employer-Sponsored Family Health Premiums Rise 3 Percent in 2014
Source: Kaiser Family Foundation

Average annual premiums for employer-sponsored family health coverage reached $16,834 this year, up 3 percent from last year, continuing a recent trend of modest increases, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2014 Employer Health Benefits Survey released today. Workers on average pay $4,823 annually toward the cost of family coverage this year.

This year’s increase continues a recent trend of moderate premium growth. Premiums increased more slowly over the past five years than the preceding five years (26 percent vs. 34 percent) and well below the annual double-digit increases recorded in the late 1990s and early 2000s. This year’s increase also is similar to the year-to-year rise in worker’s wages (2.3 percent) and general inflation (2 percent).

Annual premiums for worker-only coverage stand at $6,025 this year. Workers on average contribute $1,081 toward the cost of worker-only coverage this year.

After Midnight: A Regression Discontinuity Design in Length of Postpartum Hospital Stays

September 17, 2014 Comments off

After Midnight: A Regression Discontinuity Design in Length of Postpartum Hospital Stays (PDF)
Source: Columbia University (Almond), MIT (Doyle)

Estimates of moral hazard in health insurance markets can be confounded by adverse selection. This paper considers a plausibly exogenous source of variation in insurance coverage for childbirth in California. We find that additional health insurance coverage induces substantial extensions in length of hospital stay for mother and newborn. However, remaining in the hospital longer has no effect on readmissions or mortality, and the estimates are precise. Our results suggest that for uncomplicated births, minimum insurance mandates incur substantial costs without detectable health benefits.

Taking Stock: Health Insurance Coverage for Parents under the ACA in 2014

September 16, 2014 Comments off

Taking Stock: Health Insurance Coverage for Parents under the ACA in 2014
Source: Urban Institute

Nationally, between September 2013 and June 2014, the estimated uninsured rate for parents fell 2.4 percentage points from 16.7 percent to 14.3 percent, a drop of 14.4 percent. In June 2014, the uninsured rate for nonelderly parents was estimated to be 14.3 percent (95% CI [12.5, 16.2]) for the nation (figure 1, table 1).7 The uninsured rate declined for parents by 2.4 percentage points (95% CI [0.2, 4.6]) between September 2013 and June of 2014, a drop of 14.4 percent. This compares with the decline of 22.3 percent found in the uninsured rate for all nonelderly adults over this time frame (Long, Kenney, Zuckerman, Wissoker, Shartzer, Karpman, Anderson, and Hempstead 2014).

See also: A First Look at Children’s Health Insurance Coverage under the ACA in 2014

CRS — Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress( August 26, 2014)

September 15, 2014 Comments off

Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The 2010 Patient Protection and Affordable Care Act (ACA, P.L. 111-148) requires certain health insurers to provide consumer rebates if they do not meet a set financial target known as a medical loss ratio (MLR). At its most basic, a MLR measures the share of health care premium dollars spent on medical benefits, as opposed to company expenses such as overhead or profits. For example, if an insurer collects $100,000 in premiums and spends $85,000 on medical care, the MLR is 85%. In general, the higher the MLR, the more value a policyholder receives for his or her premium dollar. The ACA requires an annual, minimum 80% MLR for individual and small group insurance plans, and an annual, minimum 85% MLR for large group plans. Congress imposed the MLR to provide “greater transparency and accountability around the expenditures made by health insurers and to help bring down the cost of health care.”

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