HEALTH REFORM DEVELOPMENTS

The U.S. Census Bureau on September 10, 2019 released a report on Health Insurance Coverage In The United States: 2018. It revealed that in 2018, 8.5% of individuals, or 27.5 million, did not have health insurance at any point during the year. The uninsured rate and number of uninsured increased from 2017 (7.9% or 25.6 million). The percentage of beneficiaries with health insurance coverage for all or part of 2018 was 91.5%, lower than the rate in 2017 (92.1%). Between 2017 and 2018, the percentage with public coverage decreased 0.4 percentage points, and the percentage with private coverage did not statistically change. In 2018, private health insurance coverage continued to be more prevalent than public coverage, covering 67.3% of the population and 34.4% of the population, respectively. Of the subtypes of health insurance coverage, employer-based insurance remained the most common, covering 55.1% of the population for all or part of the calendar year.

Health insurance coverage is related to the highest level of education attained. Individuals with higher levels of educational attainment are more likely to have health insurance coverage than those with less education. In 2018, 96.6% of the population aged 26 to 64 with a graduate or professional degree had health insurance coverage, compared with 93.8% of the population with a bachelor’s degree, 85.1% of high school graduates, and 71.0% of the population with no high school diploma. Income is another contributing factor in coverage differences. In 2018, individuals in households with lower income had lower health insurance coverage rates than residents of households with higher income. In 2018, 86.2% of those in households with an annual income of less than $25,000 had health insurance coverage, compared with 96.8% of individuals in households with income of $150,000 or more. Inhabitants of households with lower income also had lower rates of private coverage and higher rates of public coverage. Children living in the south are more likely than children living in other parts of the nation to be without health insurance, and Hispanic children are more likely than children of other ethnicities to be uninsured.

Questions Pertaining To Enactment Of Proposed Medicare For All Legislation

Democrats competing to be the nominee by their party in the 2020 presidential election have expressed great enthusiasm for the enactment of proposed Medicare For All legislation. If such a law ever becomes a reality, its advantages include free coverage of benefits for all residents of the U.S. Not especially clear at this juncture, however, is how enough revenue will be generated to pay for such an expansion. Another issue worthy of consideration is how the Medicare program as it currently exists might undergo modification.

One aspect in particular is the Medicare Advantage Program. All baby boomers will be older than age 65 by the year 2030. Because one in every five residents will be at retirement age, Medicare enrollment can be expected to grow. By way of background, Medicare Advantage, the public-private health plan option available to Medicare beneficiaries, presently furnishes coverage for more than 22 million individuals, representing greater than one-third of all participants in Medicare. The Congressional Budget Office (CBO) estimates that current enrollment in Medical Advantage will increase to 29 million by the year 2025. A report from the Centers for Medicare & Medicaid Services in September 2018 indicates that 99% of Medicare beneficiaries have access to at least one Medicare Advantage Plan. The firm Avalere Health estimates that Medicare Advantage beneficiaries have higher rates of clinical and social risk factors than Traditional Medicare beneficiaries: 64% are more likely to be enrolled in Medicare due to disability, 57% have a higher rate of mental illness, and 16% have higher rates of alcohol/drug/substance abuse.

Assuming that existing Medicare is unaffected by the outcome of the 2020 election, as more beneficiaries switch from Traditional Medicare into Medicare Advantage, plans can be expected to become an increasingly important driver of a quest for high-quality care. If Medicare For All becomes a reality instead, whether private insurance coverage will continue to exist remains an open question. If so, plans, providers, community partners, beneficiaries, and policymakers are going to have to cooperate in figuring out how to support current efforts and build new opportunities to improve beneficiary health and quality of life.

UNCERTAINTY IN RELATION TO EXISTENTIALISM

Indicates the importance of conducting more research on the topic of uncertainty, an incompletely understood phenomenon. Read More

PRESIDENT’S CORNER—ASAHP MEMBER FOCUS

Susan Hanrahan offers her thoughts on the upcoming ASAHP Annual Conference from the standpoint of speakers, a leadership panel, and the Business Meeting, along with updated information about the Association’s Institutional Profile Survey. Read More

AVOIDING A GOVERNMENT SHUTDOWN

Describes legislation involving appropriations for fiscal year 2020 that begins on October 1, 2019 and action underway to reduce pharmaceutical costs. Read More

 

DEVELOPMENTS IN HIGHER EDUCATION

Summarizes finalization of stricter rules for student loan claims and trends in the ratio of the Pell Grant to total price of attendance and federal loan receipt. Read More

QUICK STAT (SHORT, TIMELY, AND TOPICAL)

  • Mortality Patterns Between States With Highest Death Rates And States With Lowest Death Rates

  • Comparing Retail Clinics With Other Sites Of Care

  • The Use Of Small-Scale, Soft Continuum Robots To Navigate In Cerebrovascular Areas

  • The Use Of “Phyjamas” In Health Care Read More

AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY

  • Hospital Concentration Index

  • Reducing Inequities In Healthy Life Expectancy

  • Investing In Interventions That Address Non-Medical, Health-Related Social Needs Read More

BALEFUL IMPACT OF WORKPLACE INCIVILITY ON HEALTH

Mentions how dissimilarity in political identity can relate to reducing the quality of interpersonal interactions and subsequent well-being of workers. Read More

 

“BURNOUT” AND EARLIER SOMATIC PHENOMENA

Refers to a possible relationship between burnout in the 21st century and neurasthenia in an earlier century. Read More

 

THE ROLE OF ACCIDENTS ON THE PATHWAY TO INJURY AND DEATH

Examines factors pertaining to death and injury of adolescents from motor vehicle accidents and adult mishaps stemming from attempts to remove an avocado pit with a knife. Read More