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Medicaid Expansion in Texas: What's at Stake? 德州医疗补助扩张:什么是关键?
LDI issue brief Pub Date : 2016-04-07 DOI: 10.15868/socialsector.25070
B. Sommers
{"title":"Medicaid Expansion in Texas: What's at Stake?","authors":"B. Sommers","doi":"10.15868/socialsector.25070","DOIUrl":"https://doi.org/10.15868/socialsector.25070","url":null,"abstract":"Texas is one of nearly 20 states yet to expand its Medicaid program under the Affordable Care Act (ACA), and is home to the largest number of uninsured Americans of any state in the country. For many of the state's 5 million uninsured, this decision has left them without an option for affordable health insurance. A comparison with other Southern states that have expanded Medicaid shows how this decision has left many low-income Texans less able to afford their medical bills, to pay for needed prescription drugs, and to obtain regular care for chronic conditions. These problems have been compounded by the state's opposition to outreach and enrollment assistance for many Texans who are eligible for coverage under the ACA. Ongoing efforts from stakeholders and consumer groups to persuade state leaders to expand coverage have significant implications for the well-being of millions of low-income adults in Texas.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"26 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2016-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82358772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Improving the Lives of Fragile Newborns: What Does Nursing Have to Offer? 改善脆弱新生儿的生活：护理能提供什么？
LDI issue brief Pub Date : 2016-04-01
Eileen Lake, Jeannette Rogowski, Janet Weiner
{"title":"Improving the Lives of Fragile Newborns: What Does Nursing Have to Offer?","authors":"Eileen Lake, Jeannette Rogowski, Janet Weiner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This brief summarizes evidence of nursing's effects on NICU outcomes and recommends policies to bolster and support nursing practice in NICUs. Adequate staffing and a supportive work environment are associated with better outcomes for very low birth weight infants.</p>","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"20 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34510863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Will the Affordable Care Act's Cost-Sharing Reductions Affect Consumers' Out-of-Pocket Costs in 2016? 《平价医疗法案》的费用分摊削减将如何影响2016年消费者的自付费用?
LDI issue brief Pub Date : 2016-03-17 DOI: 10.15868/SOCIALSECTOR.25068
S. Collins, Munira Z. Gunja, S. Beutel
{"title":"How Will the Affordable Care Act's Cost-Sharing Reductions Affect Consumers' Out-of-Pocket Costs in 2016?","authors":"S. Collins, Munira Z. Gunja, S. Beutel","doi":"10.15868/SOCIALSECTOR.25068","DOIUrl":"https://doi.org/10.15868/SOCIALSECTOR.25068","url":null,"abstract":"Health insurers selling plans in the Affordable Care Act's market­places are required to reduce cost-sharing in silver plans for low- and moderate-income people earning between 100 percent and 250 percent of the federal pov­erty level. In 2016, as many as 7 million Americans may have plans with these cost-sharing reductions. In the largest markets in the 38 states using the federal website for marketplace enrollment, the cost-sharing reductions substantially lower projected out-of-pocket costs for people who qualify for them. However, the degree to which consumers' out-of-pocket spending will fall varies by plan and how much health care they use. This is because insurers use deductibles, out-of-pocket limits, and copayments in different combinations to lower cost-sharing for eligible enrollees. In 2017, marketplace insurers will have the option of offering standard plans, which may help simplify consumers' choices and lead to more equal cost-sharing.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"34 1","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2016-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89887870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Implementing the Affordable Care Act: Promoting Competition in the Individual Marketplaces. 实施平价医疗法案:促进个人医疗市场的竞争。
LDI issue brief Pub Date : 2016-02-04 DOI: 10.15868/socialsector.25065
David Cusano, Kevin W Lucia
{"title":"Implementing the Affordable Care Act: Promoting Competition in the Individual Marketplaces.","authors":"David Cusano, Kevin W Lucia","doi":"10.15868/socialsector.25065","DOIUrl":"https://doi.org/10.15868/socialsector.25065","url":null,"abstract":"A main goal of the Affordable Care Act is to provide Americans with access to affordable coverage in the individual market, achieved in part by pro­moting competition among insurers on premium price and value. One primary mechanism for meeting that goal is the establishment of new individual health insurance marketplaces where consumers can shop for, compare, and purchase plans, with subsidies if they are eligible. In this issue brief, we explore how the Affordable Care Act is influencing competition in the individual marketplaces in four states--Kansas, Nevada, Rhode Island, and Washington. Strategies include: educating consumers and providing coverage information in one place to ease decision-making; promoting competition among insurers; and ensuring a level playing field for premium rate development through the rate review process.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"3 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88093279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
COMPREHENSIVE E-CIGARETTE REGULATION AS A STEP TOWARD HARM REDUCTION. 全面的电子烟监管是减少危害的一步。
LDI issue brief Pub Date : 2016-02-01 DOI: 10.1002/PAM.21899
K. Ribisl, A. Seidenberg, Elizabeth N Orlan
{"title":"COMPREHENSIVE E-CIGARETTE REGULATION AS A STEP TOWARD HARM REDUCTION.","authors":"K. Ribisl, A. Seidenberg, Elizabeth N Orlan","doi":"10.1002/PAM.21899","DOIUrl":"https://doi.org/10.1002/PAM.21899","url":null,"abstract":"","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"11 1","pages":"492-5"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PAM.21899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50873001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Mortality Trends Among Working-Age Whites: The Untold Story. 工作年龄白人的死亡率趋势:不为人知的故事。
LDI issue brief Pub Date : 2016-01-29 DOI: 10.15868/SOCIALSECTOR.25064
D. Squires, D. Blumenthal
{"title":"Mortality Trends Among Working-Age Whites: The Untold Story.","authors":"D. Squires, D. Blumenthal","doi":"10.15868/SOCIALSECTOR.25064","DOIUrl":"https://doi.org/10.15868/SOCIALSECTOR.25064","url":null,"abstract":"Recent research has called attention to an unexpected rise in death rates among middle-aged, white Americans between 1999 and 2014. The full extent of the phenomenon may be underappreciated, however. If one assumes, based on historical trends, that mortality rates should have declined by 1.8 percent per year, then whites in 2014 had higher-than-expected mortality rates from age 19 to age 65. Furthermore, while increased substance abuse and suicides explain the elevated mortality rates for younger adults, middle-aged whites also seem to be experiencing stalled or rising mortality rates for most ailments and diseases. While a national phenomenon, middle-aged whites face much more adverse mortality trends in certain states and regions. The especially broad reach of these negative mortality trends suggests there is an urgent need for further investigation of its causes and potential remedies.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"53 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2016-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86534223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 17
Consumer Cost-Sharing in Marketplace vs. Employer Health Insurance Plans, 2015. 消费者成本分担市场vs.雇主健康保险计划，2015。
LDI issue brief Pub Date : 2015-12-21 DOI: 10.15868/socialsector.25058
J. Gabel, H. Whitmore, Matthew Green, Sam T Stromberg, Rebecca Oran
{"title":"Consumer Cost-Sharing in Marketplace vs. Employer Health Insurance Plans, 2015.","authors":"J. Gabel, H. Whitmore, Matthew Green, Sam T Stromberg, Rebecca Oran","doi":"10.15868/socialsector.25058","DOIUrl":"https://doi.org/10.15868/socialsector.25058","url":null,"abstract":"Using data from 49 states and Washington, D.C., we analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. We examined eight vehicles for cost-sharing, including deductibles, copayments, coinsurance, and out-of-pocket limits, and compared findings with cost-sharing under employer-based insurance. We found cost-sharing under marketplace plans remained essentially unchanged from 2014 to 2015. Stable premiums during that period do not reflect greater costs borne by enrollees. Further, 56 percent of enrollees in marketplace plans attained cost-sharing reductions in 2015. However, for people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average, while cost-sharing under gold plans is similar employer-based plans on average. Marketplace plans are far more likely than employer-based plans to require enrollees to meet deductibles before they receive coverage for prescription drugs.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"242 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2015-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75100126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 14
Rethinking the Affordable Care Act's "Cadillac tax": A More Equitable Way to Encourage "Chevy" Consumption. 重新思考平价医疗法案的“凯迪拉克税”:以更公平的方式鼓励“雪佛兰”消费。
LDI issue brief Pub Date : 2015-12-18 DOI: 10.15868/socialsector.25057
S. Nowak, C. Eibner
{"title":"Rethinking the Affordable Care Act's \"Cadillac tax\": A More Equitable Way to Encourage \"Chevy\" Consumption.","authors":"S. Nowak, C. Eibner","doi":"10.15868/socialsector.25057","DOIUrl":"https://doi.org/10.15868/socialsector.25057","url":null,"abstract":"The Affordable Care Act's \"Cadillac tax\" will apply a 40 percent excise tax on total employer health insurance premiums in excess of $10,200 for single coverage and $27,500 for family coverage, starting in 2018. Employer spending on premiums is currently excluded from income and payroll taxes. Economists argue that this encourages overconsumption of health care, favors high-income workers, and reduces federal revenue. This issue brief suggests that the Cadillac tax is a \"blunt instrument\" for addressing these concerns because it will affect workers on a rolling timetable, does relatively little to address the regressive nature of the current exclusion, and may penalize firms and workers for cost variation that is outside their control. Replacing the current exclusion with tax credits for employer coverage that scale inversely with income might allow for regional adjustments in health care costs and eliminate aspects of the tax exclusion that favor high-income over low-income workers.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"71 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2015-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76571979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
The Changing Landscape of Health Care Coverage and Access: Comparing States' Progress in the ACA's First Year. 医疗保险覆盖范围和可及性的变化:比较ACA实施第一年各州的进展。
LDI issue brief Pub Date : 2015-12-09 DOI: 10.15868/socialsector.25055
S. Hayes, S. Collins, D. Radley, D. McCarthy, S. Beutel, Jordan Kiszla
{"title":"The Changing Landscape of Health Care Coverage and Access: Comparing States' Progress in the ACA's First Year.","authors":"S. Hayes, S. Collins, D. Radley, D. McCarthy, S. Beutel, Jordan Kiszla","doi":"10.15868/socialsector.25055","DOIUrl":"https://doi.org/10.15868/socialsector.25055","url":null,"abstract":"This analysis compares access to affordable health care across U.S. states after the first year of the Affordable Care Act’s major coverage expansions. It finds that in 2014, unin­sured rates for working-age adults declined in nearly every state compared with 2013. There was at least a three-percentage-point decline in 39 states. For children, uninsured rates declined by at least two percentage points in 16 states. The share of adults who said they went without care because of costs decreased by at least two points in 21 states, while the share of at-risk adults who had not had a recent checkup declined by that same amount in 11 states. Yet there was little progress in expanding access to dental care for adults, which is not a required insurance benefit under the ACA. Wide variation in insurance coverage and access to care persists, highlighting many opportunities for states to improve.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"5 1","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2015-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80542908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Increased Transparency and Consumer Protections for 2016 Marketplace Plans. 增加2016年市场计划的透明度和消费者保护。
LDI issue brief Pub Date : 2015-12-01 DOI: 10.15868/socialsector.25059
Chiquita Brooks-LaSure
{"title":"Increased Transparency and Consumer Protections for 2016 Marketplace Plans.","authors":"Chiquita Brooks-LaSure","doi":"10.15868/socialsector.25059","DOIUrl":"https://doi.org/10.15868/socialsector.25059","url":null,"abstract":"The open enrollment period that ends in December 2015 for coverage begin­ning January 2016 marks the third year of the health care exchanges or marketplaces and of coverage through new qualified health plans. This issue brief investigates several key changes to the qualified health plans, with a focus on increased transparency and consumer protections. A new out-of-pocket costs calculator, requirements regarding provider networks, and prescription drug cost-sharing requirements should serve to better inform and improve consumer selection. In addition, several policy changes will help individuals with more severe health needs. These include: improved prescription drug coverage for HIV/ AIDS and other conditions, allowing prescription drugs that are obtained through the \"exceptions\" process to count toward the out-of-pocket spending cap, more comprehensive and consistent habilitative coverage, and an individual out-of-pocket spending cap within the family out-of-pocket maximum.","PeriodicalId":85087,"journal":{"name":"LDI issue brief","volume":"12 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87278851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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