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Implementing The ACA: Medicaid Spending & Enrollment Growth For FY 2014 And FY 2015

October 16, 2014 Comments off

Implementing The ACA: Medicaid Spending & Enrollment Growth For FY 2014 And FY 2015 (PDF)
Source: Kaiser Family Foundation

Medicaid spending and enrollment growth are affected by both the economy and policy decisions determining who is covered under the program, the services provided and payments for care. For more than a decade, economic conditions, including two major recessions, were the primary driver of changes in Medicaid spending and enrollment. In FY 2014 and in budgets adopted for FY 2015, enrollment and spending have grown with implementation of the major coverage provisions in the Affordable Care Act (ACA), including the federally financed Medicaid expansion. This report provides an overview of Medicaid spending and enrollment growth with a focus on state fiscal years 2014 and 2015 (FY 2014 and FY 2015) and an overview of Medicaid financing. Findings are based on interviews and data provided by state Medicaid directors as part of the 14th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured (KCMU) with Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth and compare expansion and non-expansion states.

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What’s In and What’s Out? Medicare Advantage Market Entries and Exits for 2015

October 15, 2014 Comments off

What’s In and What’s Out? Medicare Advantage Market Entries and Exits for 2015 (PDF)
Source: Kaiser Family Foundation

During the debate over the Affordable Care Act (ACA), some questioned whether the Medicare Advantage market would shrink in response to the reductions in payments to Medicare Advantage plans included in the ACA,1 expressing concern that plans would exit markets across the country, leading to a drop in enrollment, similar to what occurred after the Balanced Budget Act of 1997 (BBA97).2 Since 2010, enrollment has far exceeded expectations, increasing by nearly 5 million beneficiaries, continuing a steady upward climb that started a decade ago.3 Between 2010 and 2014, the total number of plans has declined modestly, but beneficiaries in 2014 still had the option to choose among 18 Medicare Advantage plans, on average.

Medicare Advantage plans enter and exit markets for a number of reasons related to business strategies, local market conditions, and profitability. When Medicare Advantage plans make a decision to exit markets, beneficiaries have the option to switch to another Medicare Advantage plan offered in their area or get coverage under traditional Medicare. If they choose traditional Medicare following termination of their plan, they have a special open enrollment period for Medigap policies. In this sense, traditional Medicare serves as a back-up for beneficiaries affected by Medicare Advantage plans terminations.

This Data Note examines the availability of plans nationwide and by state in 2015, and changes in plan availability since 2011. It documents the number and share of Medicare Advantage enrollees affected by plan withdrawals each year, the characteristics of plans that will be entering the market and characteristics of those exiting the market in 2015, and also assesses the potential implications of these changes for Medicare Advantage enrollees. While the availability of Medicare Advantage plans varies within states by county, this Data Note compares plan participation at the state-level to provide a snapshot of changes in the Medicare Advantage market in 2015. Plans that consolidate (withdraw from the certain counties, but remain in others) are counted among the exiting plans for areas where they will no longer offer plans in 2015. The analysis excludes group Medicare Advantage plans, Special Needs Plans (SNPs) and other plans not available for general enrollment.

See also: Medicare Part D: A First Look At Plan Offerings In 2015 (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.

Survey of Non-Group Health Insurance Enrollees

June 22, 2014 Comments off

Survey of Non-Group Health Insurance Enrollees
Source: Kaiser Family Foundation

January 1, 2014 marked the beginning of several provisions of the Affordable Care Act (ACA) making significant changes to the non-group insurance market, including new rules for insurers regarding who they must cover and what they can charge, along with the opening of new Health Insurance Marketplaces (also known as “Exchanges”) and the availability of premium and cost-sharing subsidies for individuals with low to moderate incomes. Data from the Department of Health and Human Services and others provide some insight into how many people purchased insurance using the new Marketplaces and the types of plans they picked, but much remains unknown about changes to the non-group market as a whole. The Kaiser Family Foundation Survey of Non-Group Health Insurance Enrollees is the first in a series of surveys taking a closer look at the entire non-group market. This first survey was conducted from early April to early May 2014, after the close of the first ACA open enrollment period. It reports the views and experience of all non-group enrollees, including those with coverage obtained both inside and outside the Exchanges, and those who were uninsured prior to the ACA as well as those who had a previous source of coverage (non-group or otherwise).

New Survey Documents Women’s Health Care, Coverage and Early Experiences with the Affordable Care Act

June 4, 2014 Comments off

New Survey Documents Women’s Health Care, Coverage and Early Experiences with the Affordable Care Act
Source: Kaiser Family Foundation

A comprehensive survey released today by the Kaiser Family Foundation provides a snapshot of women and their health coverage and care during a time of transition as important Affordable Care Act insurance market changes began to take root. These include many changes that affect women including a prohibition on using gender in setting premiums, as well as broadening access to a more comprehensive range of preventive services benefits without cost sharing.

The Kaiser Women’s Health Survey, conducted from Sept. 19 to Nov. 21, 2013, provides a national overview of women’s health experiences regarding health care coverage, access, and affordability among nonelderly women (ages 18 to 64) in the United States more than a year after the ACA requirements for preventive and contraceptive coverage affecting women took effect and shortly before the coverage expansions in the law took full effect in January 2014.

Key findings include:

  • Among women ages 18 to 64, more than a quarter of women (26%) delayed care in the past year because of cost, compared to 20 percent of men. About one fifth of women also reported skipping recommended tests or treatment (20%), forgoing or skipping prescription medicines (22%), higher rates than men (14% and 12%, respectively). And 28 percent of women say they had problems paying medical bills, compared to 19 percent of men.
  • While most women (82%) report a recent checkup or well woman visit, 6 in 10 know that insurance plans must now cover check-ups at no out-of-pocket cost, and 57 percent know that mammograms and pap tests are covered without cost sharing. Most women (70%) report discussing diet and nutrition with a provider in the past 3 years, but rates are lower for talking to a provider about smoking (44%), alcohol or drug use (31%), and mental health (41%).
  • Coverage under a parent’s plan is now the leading way that women under age 26 get their coverage, with 45 percent of women ages 18-25 reporting that they were covered on a parent’s plan as a dependent. According to the survey few women in this age group are aware that private insurers can send documentation to the primary policy holder (often a parent) that details the services they have used, raising privacy concerns for young adults who want their use of health services to be confidential.

New Data Spotlight Tracks Rising Enrollment in Medicare Advantage Plan

May 12, 2014 Comments off

New Data Spotlight Tracks Rising Enrollment in Medicare Advantage Plan
Source: Kaiser Family Foundation

A new brief from the Kaiser Family Foundation documents the continuing climb in Medicare Advantage plan enrollment, even at a time when payments to such plans are being reduced under the Affordable Care Act. Despite spending reductions enacted in the ACA to reduce historical overpayments to Medicare Advantage plans, from March 2013 to March 2014 enrollment in Medicare Advantage plans grew by 9 percent, or 1.4 million people, to reach a total of 15.7 million Medicare beneficiaries. The Medicare Advantage 2014 Spotlight: Enrollment Market Update highlights that 30 percent of the Medicare population is now enrolled in such plans, up from 24 percent in 2010, and analyzes trends in Medicare Advantage enrollment, premiums, out of pocket limits, prescription drug coverage and related topics.

After the Wars: Survey of Iraq and Afghanistan Active Duty Soldiers and Veterans

March 30, 2014 Comments off

After the Wars: Survey of Iraq and Afghanistan Active Duty Soldiers and Veterans
Source: Kaiser Family Foundation

This partnership poll from The Washington Post and the Kaiser Family Foundation explores the views and experiences of adults who served in the Iraq or Afghanistan wars as members of the U.S. military in the period after the terrorist attacks of Sept. 11, 2001. The majority of veterans of these conflicts say that Americans appreciate their service and that gestures of support are genuine, but many report a number of challenges, including economic struggles, worse physical and mental health than prior to their engagement, and feeling disconnected from civilian life. The survey also includes findings on attitudes towards the government and the military, views on women serving in combat roles, and insight into the physical and mental toll the war has taken on these soldiers.

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