Saturday, December 10, 2005

RAND Press Release 11/10/2005

Undocumented immigrants are far less likely than any other group to have health insurance, accounting for up to one-third of the growth in the uninsured population in the United States in the past two decades, according to a RAND Corporation study issued today.
Researchers found that 68 percent of the undocumented immigrant adults they studied had no health insurance. This compared with 17 percent of the native-born Americans, 23 percent of immigrants who had become citizens, and 38 percent of immigrants who are permanent legal residents. As a group, four in 10 of those born outside the United States lacked health insurance.
The study, published in the November/December edition of the journal Health Affairs, provides the most detailed analysis to date of undocumented immigrants and health insurance.
“These findings show that if you want to do something that will have a meaningful impact on the problem of the uninsured, then you must talk about undocumented immigrants,” said James P. Smith, a RAND senior economist and co-author of the study. “There are pros and cons of providing insurance to the undocumented that should be debated openly. Undocumented immigrants make up too much of the issue to be ignored or hidden by polite silence.”
Contrary to a commonly held view, undocumented immigrants in the study were less likely than other groups to be covered by public insurance such as Medicaid. This may be because recent rule changes have make it harder for immigrants to obtain such coverage, according to researchers.
Despite their lower incomes, just 8 percent of undocumented immigrants had public insurance such as Medicaid. This compares with 13 percent among native-born Americans, and 10 percent among both immigrant citizens and permanent residents. Most undocumented immigrants who had health insurance were covered through their employers, according to the RAND study.
The report also found that undocumented immigrants are more likely to be chronically uninsured. About 65 percent of undocumented immigrants in the study said they had no insurance in the past two years. This compares with 12 percent of the native-born, 18 percent of citizen immigrants, and 32 percent of permanent residents.
Health policy experts have assumed that undocumented immigrants account for a large number of the medically uninsured in the United States. But relatively little detailed information about the undocumented and health insurance has been available because survey participants are rarely asked their legal status.
RAND researchers analyzed information from the Los Angeles Family Neighborhood Study (LAFANS), which interviewed nearly 2,400 English- or Spanish-speaking adults throughout Los Angeles County during 2000 and 2001. Los Angeles has the largest immigrant community in the United States.
Undocumented immigration has grown rapidly in recent years. Among those who reported in 2002 that they had resided in the nation for less than five years, almost half are undocumented immigrants, compared with 5 percent in 1970. Meanwhile, the number of adults in the nation who have no health insurance increased by 8.7 million from 1980 to 2000.
RAND researchers say that when they apply the rates found in their study to the nation at large, undocumented immigrants would account for about a third of the total increase in the number of uninsured adults nationally from 1980 to 2000.
“Since the number of undocumented immigrants has been growing rapidly, we can expect that the uninsured population is going to grow rapidly as well,” said Neeraj Sood, a RAND economist and another study co-author.
Researchers say that the foreign-born were more likely to have socio-economic factors linked to a lower rate of medical insurance among all adults: less education, employment in an industry such as agriculture where workers less often receive health coverage, and low incomes.
“Much of the reason for the low rates of insurance among the foreign-born can be explained by their low socio-economic status,” said Dana Goldman, director of health economics at RAND and another author of the study. “But even when factors such as income are considered, it does not fully explain why the rates are so low among the undocumented.”
Funding for the study was provided by the Robert Wood Johnson Foundation through its support of the Economic Research Initiative on the Uninsured.
The study was done through RAND Labor and Population, which examines issues involving U.S. labor markets, the demographics of families and children, social welfare policy, the social and economic functioning of the elderly, and economic and social change in developing countries.

Friday, December 09, 2005

Kaiser Family Foundation Press Release 11/4/2005

The South is Home to More than Half of Uninsured Growth; Immigrants Not Driving Recent Growth
WASHINGTON, D.C. - At a policy briefing examining the latest health coverage trends and the implications for the nation’s health care safety net, the Kaiser Commission on Medicaid and the Uninsured (KCMU) highlighted five reports that profile the growing uninsured population and portray the health care safety net as increasingly straining to meet uninsured people’s needs.
“In the absence of providing health insurance coverage for our nation’s growing uninsured population, some have said that the uninsured can receive care when they need it through the nation’s health care safety net. The new studies and personal stories released today document the increasing burden health providers are facing in delivering needed care,” said Diane Rowland, executive director of KCMU.
New analysis highlighted today found that, as the number of uninsured Americans increased by 4.6 million from 2001 to 2004, federal safety net spending per uninsured person fell from $546 to $498 during the same period. After adjusting for inflation, total federal spending for care for the uninsured increased by 1.3 percent from 2001-2004 while the number of uninsured increased by 11.2 percent. These trends resulted in an 8.9 percent decline in spending by the federal government per uninsured person. See Figure below.
The analysis of federal spending on the health care safety net, authored by Jack Hadley and colleagues at The Urban Institute, describes the patchwork of federal money dedicated to care for the uninsured. The report documents that federal support for community health centers increased by more than 50 percent over the past four years, but still only accounts for less than 3 percent of total federal spending on the health care safety net. The authors noted that because more than 70 percent of federal support for the uninsured flows through Medicare and Medicaid, which are both under budgetary pressures, “it is unlikely that future funding will be able to close the gap or make up the difference” in the increase in the uninsured and funding for their care.
Another Commission study highlighted today, authored by John Holahan and Allison Cook of The Urban Institute, was published by Health Affairs this week. The study finds that all of the six million increase in the number of uninsured from 2000-2004 was among adults and two-thirds of the increase was among people with incomes below 200 percent of poverty (about $39,000 for a family of four in 2004). Both adults and children were affected by the 4.6 percentage point drop in the share of the nonelderly with employer coverage (67.8% to 63.3%), but children were able to obtain alternative coverage through Medicaid and the State Children’s Health Insurance Program.
When examined in even greater detail, about half of the growth in the uninsured was among young adults (ages 19-34) who experienced sharp declines in employer coverage rates. Fifty four percent of the growth occurred in the Southern region of the country which experienced the greatest growth in both the general population and low-income population combined with the largest decrease in employer coverage. This contributed to the 3.2 million increase in uninsured people in the South alone.
A third Commission study, also authored by John Holahan and Allison Cook, investigated the extent to which immigrants contribute to the growth in the uninsured population. Immigrants are disproportionately likely to be uninsured due to their employment in low-wage jobs that are less likely to offer health coverage and restrictions on their eligibility for public coverage. However, examining the period between 1994 and 2003, the study found that apart from the brief 1998 to 2000 period--years of unusually strong economic growth and tight labor markets-- the growth in the number of uninsured has largely been among native citizens. Between 1998 and 2000 native citizens experienced a decrease in the number of uninsured, while the number of uninsured non-citizens increased by 800,000. However, in the periods preceding and following this, the picture is much different. From 1994 to 1998 native citizens accounted for 3.1 million of the 4.2 million growth in the number of uninsured. During the 2000 to 2003 period, when the economy slowed, native citizens comprised 3.6 million of the 5.1 million more uninsured.

Thursday, December 08, 2005

WA Office of Insurance Commissioner Press Release

Kreidler Targets Illegal Health Plans - Seeks Legislation to Increase Penalties

Olympia, Wash. — The Office of the Insurance Commissioner (OIC) is launching an education campaign to warn consumers of the perils of illegal health insurance plans and urge them to "verify before you buy." The agency is seeking legislation to increase both the civil and criminal penalties for the unauthorized sale of insurance or health coverage. House Bill 1676 and Senate Bill 5641 were introduced this week.
"Today's tight health insurance market is ripe for scam artists, and I understand how tempting the promises of cheap insurance can be," said Insurance Commissioner Mike Kreidler. "I can't emphasize enough the old adage, 'if it sounds too good to be true, it probably is.'"
People who buy into illegal health plans may find themselves with mounting medical bills and no real insurance benefits to pay the bills. Employers who sign up for these illegal plans may be liable for their employees' medical bills. Anyone shopping for health insurance should contact the Office of Insurance Commissioner at 1-800-562-6900 to ensure that a plan is legitimate and that the insurance agent is licensed.
"Verify before you buy, especially if you don't recognize the name of the health plan or if you suspect the plan may not be legitimate," he said. "To the marketers of these illegal plans, I issue this warning: If you sell in Washington you will be prosecuted."
Health insurance scams are surfacing throughout the country, and while the problem is worse in many other states, Kreidler wants to avoid an influx here.
Under the commissioner-request legislation, a person transacting insurance or health coverage without authorization would be subject to a Class B felony and a civil fine up to $25,000 per violation.
A typical illegal health plan attempts to recruit as many local insurance agents as possible to market the plan and seeks to collect a large amount of premiums as quickly as possible. Consumers are falsely told that the plan is an "ERISA plan" governed by federal law or a "union plan" exempt from state law.
While these illegal plans may initially pay some claims, often they delay payment or refuse to pay altogether, and suddenly they vanish. There is no recourse for the consumer through state insurance laws when a company is not licensed.
Some 10,000 people throughout the country - including in Washington - bought phony insurance in 2001 from Employers Mutual. Left with no recourse, they are now suing to collect more than $50 million in unpaid claims that mounted up in the span of a single year.
"Unfortunately, by the time we hear from consumers who bought illegal health insurance it's too late," Kreidler said. "That's why it's critical that we educate consumers before they purchase these fraudulent plans and find themselves not only without coverage, but with huge medical bills they can't afford."

Wednesday, December 07, 2005

NCHS 6/29/2005

Health Insurance Coverage for Children up in 2004; Number of Uninsured Adults Stable
Wednesday, June 29, 2005
Health Insurance Coverage: Health insurance coverage for children showed continued improvement in 2004, and the percentage of working-age adults without insurance coverage, which had been climbing in recent years, did not increase last year, according to a new report from the Centers for Disease Control and Prevention (CDC).
The data, based on CDC’s National Health Interview Survey, provides estimates of insurance coverage for the United States in 2004. For the first time, the latest survey also includes statistics on insurance coverage for the nation’s 10 largest states.
The report, which tracks insurance coverage since 1997, finds that the improvement in coverage for children reflects an increase in public coverage—including the State Children’s Health Insurance Program--for poor and near-poor children.
Highlights of the report include:
In 2004, over 90 percent of America’s children had health insurance at the time of the interview – a steady rise from the first report in 1997. In 2004, 9.4 percent of children – 7 million children under 18 years of age – were without health insurance. In contrast, in 1997, about 14 percent – 10 million children – lacked coverage.
Among poor and near-poor children, lack of coverage dropped by about a third from 1997. For near-poor children, public coverage almost doubled from 24 percent to 43 percent between 1997 and 2004. Nearly 70 percent of poor children under 18 years of age rely on public coverage.
Overall, 14.6 percent of the population – 42.1 million Americans of all ages – was without current health insurance coverage in 2004, about the same level as in 1997. One in five working-age adults (age 18 to 64) were without insurance in 2004. This number had been steadily rising in recent years but appears to have leveled off in 2004.
One in five working-age adults (age 18-64) were without insurance in 2004. This number had been steadily rising in recent years but appears to have leveled off in 2004.
The survey produced health insurance coverage estimates for the 10 largest states. For the population under age 65, Michigan, New York, Ohio and Pennsylvania had considerably lower rates of uninsured than the national average of 16 percent. In California and Florida, just over 20 percent were without health coverage, and in Texas, about 27 percent lacked coverage.
These findings appear in “Health Insurance Coverage: Estimates from the National Health Interview Survey, 2004,” gathered from the annual household survey with a sample of the nation’s civilian non-institutionalized population. In 2004, the survey, conducted by CDC’s National Center for Health Statistics, added questions to improve the accuracy of the estimates on insurance coverage.

Sunday, December 04, 2005

Assurant Press Release 8/30/2005

New Study Dispels Most Common Myths of Individual Health Insurance
Assurant Health’s Jim Oatman Available for Expert Commentary on AHIP Survey Findings and Market Trends
A new comprehensive study just issued by America’s Health Insurance Plans (AHIP), the national trade association of health insurance providers, finds that individual health insurance is more affordable, accessible, and offers broader benefits than is widely known.

Jim Oatman, a 20+ year veteran of the insurance industry and a Senior Vice President, Chief Actuary, Individual Medical at Assurant Health, is available to provide insights on this survey, the largest study to date of individual insurance markets – particularly survey results that dispel some of the most common myths about individual health coverage.

“Many consumers believe that the type and quality of insurance coverage that they can get through their employer is more comprehensive and less costly than through an individual policy. But, as the study demonstrates, that is not at all the case,” said Oatman.

In reality:
There are choices. Consumers can choose from a wide range of options – from health savings accounts (HSAs) to traditional indemnity plans, as well as a new generation of lower cost major medical offerings. Oatman can discuss the myriad options available and how consumers can work with their agents to determine the best fit for their needs.
It’s broadly accessible to most people. The AHIP study indicates that nearly 90% of applicants are approved for coverage. Research by Assurant Health, which sells HSAs and other health insurance to individuals and small groups, found that 29% of its HSA policyholders had incomes of less than $50,000. Also, 57% were over age 40, and 73% were families with children, closely reflecting purchasers of traditional health plans. In addition to broad accessibility, Oatman notes that the benefits are far more than the “bare bones” coverage consumers may fear.
It’s affordable. The AHIP study shows that the annual premiums for individual coverage are often lower than the average employer-sponsored health plans. Oatman points to the rapid adoption of HSAs – over one million new HSA accounts have been opened in the first half of 2005 – as a proof point for the favorable economics individual plans can offer.