Source: Kaiser Family Foundation
This policy brief describes the Supreme Court’s decision on the Affordable Care Act and looks ahead to the implementation of health reform now that questions about the constitutionality of the law have been resolved.
American’s Views on the Supreme Court Case Mirror Their Views on the Health Reform Law; The Public Expects Parts Of The Affordable Care Act To Continue Whatever The Court Rules
The requirement that nearly everyone obtain health insurance or pay a fine has long been Americans’ least favorite part of the health reform law, and their views on what the Supreme Court should do about that key provision, known as the “individual mandate,” mirror that sentiment, according to a new Kaiser Family Foundation poll.The poll finds that half of all Americans (51%) think the Court should rule the mandate unconstitutional and about the same number (53%) expect the justices to do so. Those views about what the Court should do reflect public opinion about the Affordable Care Act (ACA) more generally. Those who favor the law say two-to-one (50% to 26%) that the Court should uphold the mandate, and those who oppose the law say twelve-to-one (83% to 7%) that it should strike the mandate down. Americans have not yet tuned in to the high court case, with more than six in ten saying they are not following it closely. And many are confused — 42 percent either think the Court has overturned the law or do not know whether it has.The public also does not see the mandate as the linchpin of the entire law. Sixty-two percent say other parts of the law still will be implemented if the Court rules the mandate unconstitutional, compared to 28 percent who say such a ruling will scuttle the whole effort. The poll also finds substantial public skepticism towards the Court; about as many people say the justices’ ideological views will play a major role in their decision (51%) as say their analysis and interpretation of the law (54%) will play a major role.These and other findings of the March Kaiser Health Tracking Poll come just weeks before the Court is set to hear oral arguments in the legal challenges to the health reform law, which turns two years old on March 23rd and over which public opinion has been chronically divided. At the two year mark the public is almost perfectly split: 41 percent of Americans hold a favorable view of the law this month, while 40 percent hold an unfavorable one — not terribly different from the 46 percent who favored it and 40 percent who did not in April 2010. Opinions divide sharply along partisan lines, with Republicans disliking the law (75% have an unfavorable view this month), Democrats favoring it (66% favorable) and independents more divided (40% favorable vs. 42% unfavorable).
Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2011 and 2012
Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends
Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2011 and 2012
Source: Kaiser Family Foundation
The 11th annual 50-State Medicaid budget survey from the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured finds that Medicaid officials in virtually every state are enacting a variety of cost cutting measures as states’ spending for Medicaid is projected to increase 28.7 percent in fiscal year 2012 to make up for the loss of federal stimulus money.
The temporary increase in the federal share of Medicaid spending under the American Recovery and Reinvestment Act (ARRA) brought about the only declines in state spending on Medicaid in the program’s history, even as the recession increased Medicaid enrollment and overall Medicaid spending. With that money having expired in June 2011, however, states must ramp up their own spending to replace the lost funds, even though states project total spending in the Medicaid program – which is jointly financed by the federal government and the states — to increase on average by 2.2 percent in FY 2012.
The survey finds cost containment actions ranging from restrictions on payments to providers and benefits, to new copayments for beneficiaries and additional efforts to contain the costs of prescription drugs. States also are trying to make their programs more efficient by increasing their reliance on Medicaid managed care, moving long-term care toward community-based care models, and streamlining enrollment procedures.
The state focus on cutting costs occurs as deficit reduction efforts in Washington could reduce federal support for Medicaid and shift costs to states and at a time when states, still coping with a weak economy, also must prepare for the expansion of Medicaid under the health reform.
After several years of relatively modest premium increases, annual premiums for employer-sponsored family health coverage increased to $15,073 this year, up 9 percent from last year, according to the Kaiser Family Foundation/Health Research & Educational Trust 2011 Employer Health Benefits Survey released today. On average, workers pay $4,129 and employers pay $10,944 toward those annual premiums.
Premiums increased significantly faster than workers’ wages (2.1 percent) and general inflation (3.2 percent). Since 2001, family premiums have increased 113 percent, compared with 34 percent for workers’ wages and 27 percent for inflation.
The 13th annual Kaiser/HRET survey of small and large employers provides a detailed picture of trends in private health insurance costs and coverage. This year’s survey also looked at employers’ experiences with several already implemented provisions of the 2010 health reform law affecting employer coverage.
In particular, the survey estimates that employers added 2.3 million young adults to their parents’ family health insurance policies as a result of the health reform provision that allows young adults up to age 26 without employer coverage on their own to be covered as dependents on their parents’ plan. Young adults historically are more likely to be uninsured than any other age group.
The study also finds 31 percent of covered workers are in high-deductible health plans, facing deductibles for single coverage of at least $1,000, including 12 percent facing deductibles of at least $2,000. Covered workers in smaller firms (3-199 workers) are more likely to face such high deductibles, with half of workers in smaller firms facing deductibles of at least $1,000, including 28 percent facing deductibles of $2,000 or more.
These numbers in part reflect the rise of consumer-driven plans, which are high-deductible plans that include a tax-preferred savings options such as a Health Savings Account or Health Reimbursement Arrangement. Over the past two years, more firms have started to offer these plans, and the share of covered workers enrolled in this type of plan has doubled, from 8 percent in 2009 to 17 percent in 2011. Plans that can be used with a Health Savings Account have lower premiums than other plan types, but must have annual deductibles of at least $1,200 for an individual and $2,400 for a family this year.
HIV/AIDS At 30: A Public Opinion Perspective
Source: Kaiser Family Foundation
As the HIV/AIDS epidemic marks its thirtieth year, the Kaiser Family Foundation conducted its eighth large-scale national survey of Americans on HIV/AIDS.
Key findings include:
- Black Americans, and particularly young blacks, express much higher levels of concern about HIV infection than whites.
- Reported HIV testing rates are flat since 1997, including among some key groups at higher risk.
- Thirty years into the epidemic, there is a declining sense of national urgency and visibility of HIV/AIDS.
- At the same time, after nearly a decade of decline, the share of Americans who say they are personally “very concerned” about becoming infected ticked up for the first time in this year’s survey.
- Many Americans still hold attitudes that may stigmatize people with HIV/AIDS, but such reported attitudes have declined in recent years.
- Despite continuing economic problems, more than half of Americans support increased funding for HIV/AIDS, and fewer than one in ten say the federal government spends too much in this area.
- Media, which includes radio, television, newspapers and online sources, is the top information source on HIV across racial/ethnic groups and for younger and older adults alike.
- Three-quarters of Americans could not name an individual who stands out as a national leader in the fight against HIV/AIDS, and no person who was mentioned makes it into double digits.
Kaiser Health Tracking Poll — February 2011
Source: Kaiser Family Foundation
In the wake of the health reform repeal vote in the U.S. House and the ongoing legal challenges over the individual mandate, nearly half the country either believes that the Patient Protection and Affordable Care Act (ACA) has been repealed and is no longer law (22 percent) or doesn’t know enough to say whether it is still law (26 percent). Roughly half of Americans (52 percent) accurately report that the ACA is still the law of the land.
Meanwhile, views on repeal continue to be very mixed: with four in ten backing repeal (but half of those hoping the law will be replaced with a Republican alternative), three in ten backing an expansion of the law, and two in ten hoping to see it implemented as is. And most Americans continue to report they want to keep many of the key provisions of the law. There is more agreement when it comes to the strategy of using the legislative budgeting process to stop implementation of the law: six in ten continue to oppose the idea.
Overall opinion on the law is largely unchanged from January, with the public roughly divided and partisans on opposite sides of the issue, though negative views having risen among senior citizens in recent months. Finally, the survey finds little evidence that the public is suffering from issue fatigue when it comes to health reform.
The February poll is the latest in a series designed and analyzed by the Foundation’s public opinion research team.
+ Findings (PDF)