Medicaid Recipients Most Likely to Suffer from Preventable Illnesses

A survey conducted by The Gallup-Healthways Well-Being Index shows that those who rely primarily on Medicaid are far more likely to have preventable chronic illnesses than those who receive insurance from their employer, union, as part of a military or veteran's benefit package, and those who are uninsured. More than 1 in 3 recipients of Medicaid are obese compared to 27% of those who receive insurance from their employer or union. Those on Medicaid are also three times more likely to suffer from depression than those who receive their primary insurance from their union or employer, with 22% of the former suffering from depression compared to only 7% of the latter. Also concerning is the fact that 16% of Medicaid recipients suffer from asthma, compared to only 6% of those who receive insurance from an employer or union.
       Although these numbers are certainly cause for concern, it should be noted that recipients of Medicaid are usually living in poverty or are disabled, hence why they receive Medicaid. As Gallup notes, there is a strong correlation between poverty and suffering from poor health. Thus, these findings do not necessarily indicate that those on Medicaid are receiving poor quality care, but perhaps they are simply more likely to suffer from these conditions as a result of their poor socioeconomic status.

States of Medicaid Expansion

According to the New York Times, 22 governors have committed to expanding their state's Medicaid program, including seven states with Republican governors.  In the wake of the 2012 Supreme Court decision that made an expansion of government-sponsored health care for lower-income people a state decision, Medicaid expansion has been a polemic issue at the state level.

The federal government has agreed to pay all costs of such an expansion from 2014 to 2016, afterwards paying 90% for an unspecified time, but some governors were not swayed.  Nevada, Arizona, New Mexico, North Dakota, Michigan, Ohio, and Florida are the seven states with Republican governors that now voice support for the bill.  These changes of heart are due to government funding, consumer advocacy, and the health care industry.  Many hospitals are voicing support for the expansion, claiming that the less expensive Medicaid insurance will make up whatever losses the hospitals might incur by the volume of the newly insured.  Were all 22 states to choose to expand Medicaid, the 60 million covered by Medicaid currently would increase to 77 million insured people.

The Number of Uninsured Americans Age 18-25 Continues to Decline

A report on Gallup-Healthways Well-Being Index indicates that the amount of uninsured 18-25 year-old Americans is decreasing.  The number of uninsured 18-25 year-old Americans began to decline (from 28% to 26.3%) in the fourth quarter of 2010, after the passage of the Affordable Care Act.  This act allowed Americans up to age 26 to stay on their parents’ healthcare plan.  Currently, 23.2% of 18-25 year-old Americans are uninsured.  While the passage of the Affordable Care Act had a significant impact on reducing the number of uninsured 18-25 year-olds, the number of uninsured 24-64 year-olds (20%) is increasing and the amount of uninsured Americans over 65 (3%) has not changed significantly.  The increasing amount of 26-64 year-old uninsured Americans can be attributed to high levels of unemployment and the decreasing employee benefits.  For instance, currently only about 44.8% of Americans receive employer-based coverage whereas 49.8% received employer-based coverage in January, 2008. In accordance, since January 2008, more Americans receive their health insurance coverage from a government plan (25.3% compared to. 22.9%) and more Americans are uninsured (16.9% compared 14.6%).  But, it is important to note that that number of uninsured Americans over 26 can be expected to decrease once additional ramifications of the Affordable Care Act go into effect in 2014.   
 

Americans Weigh in on the 2010 Health Care Law

March 29^th marks the completion of the final day of the Supreme Court’s health care hearings.  The Court is expected to make its ruling in late June.  In conjunction with the final day of arguments, The New York Times released its polling data on the public’s support and comprehension of the Affordable Care Act and its implications.  The poll finds that 47% of Americans disapprove of the legislation, while 36% approve.  In addition, while the public can only speculate on the outcome of the health care hearings, the American people have specific opinions on how the Supreme Court should handle the case.  26% believe the law should remain intact, 29% favor overturning the individual mandate, and 38% would prefer the Court to find the entire law unconstitutional.  Americans are much more favorable of the law’s specific provisions.  

Aside from the individual mandate (51% of Americans disapprove of the Affordable Care Act’s requirement that Americans purchase health insurance), the majority of Americans support: (1) the Act’s requirement that health insurance companies cover those possessing existing medical conditions, (2) The provision permitting children to remain on their parents’ policies until age 26, and (3) the Affordable Care Act’s attempt to close the prescription drug coverage gap, commonly known as the “doughnut hole.” 

In terms of the personal effects of the 2010 health care law, most Americans believe the legislation will not have much effect on their overall health care benefits or the quality of care they receive, but they do expect their health care costs to increase as a result of the legislation.

Lastly, it appears that many Americans are confused with how the Affordable Care Act will affect them and their families.  48% of the public does not understand the 2,700-page act and the effects it will have on their families, while 47% say they do understand the law.  

Obesity a Continuing Problem for Metropolitan Areas

Despite the public campaigns meant to encourage healthy living styles, obesity rates remain high. Gallup reports that 187 out of 190 metropolitan areas had obesity rates higher than 15% for adults. 38.8% of adults sampled in McAllen-Edinburg-Mission, TX were reported as being obese, which is about 12 points higher than the national average of 26.1%. Boulder, CO reported the lowest adult obesity rate with 12.1%. In less surprising data, those living in areas with the highest obesity rates were more likely to suffer from various illnesses, such as diabetes and depression. Additionally, those living in the top 10 metro areas with the highest obesity rates also collectively paid roughly $1 billion more in healthcare costs than their counterparts living in cities where obesity rates were 15%.

Dealing With the Costs of Health Care in America

MSNBC recently covered the National Center for Health Statistic's (NCHS) report on the financial burden of health care.  The NCHS questioned Americans on how easily they were able to pay medical bills from January to June of 2011.  The estimates show that one in five Americans live in a family that is having problems paying medical bills in the past 12 months.  One in ten Americans are in a family that has medical bills that they are not able to pay.  Also, just over a quarter of Americans live in a family that has medical bills that are being paid over time.  Lastly, one in three Americans lives in a family that is experiencing some kind of financial burden due to medical costs. The full report investigates how various demographics are dealing with medical bills.  The most notable stat within these demographics is the fact that those in the 0-17 age group have the highest probability of experiencing some sort of financial burden stemming from health care bills.  With Barack Obama’s Affordable Care Act still in the process of being integrated into the health care system, it will be interesting to see how these numbers may or may not be affected. 

Massachusetts, Northeast Lead Health Coverage Rates; Southern States Trail

According to recent Gallup polling, Massachusetts continues to lead the nation in health coverage, with only 5.3% of its residents uninsured in the first half of 2011. At the other end of the spectrum is Texas, where 27.2% of residents reported being uninsured. Massachusetts has led the nation's states and Texas has trailed them since Gallup began measuring coverage rates in 2008. In Massachusetts, health insurance is required for all residents.

States in the South and West have had lower rates of health coverage in recent years, while states in the Northeast have had higher rates. Of the 10 states with the highest percentage of uninsured adults, eight were Southern and the remaining two--California and Alaska--are in the West. According to Gallup, Hispanics are the most likely demographic group to be uninsured; Texas, California and Florida, all of which have large Hispanic populations, have uninsured rates exceeding 20%. Seven of the 10 states with the lowest uninsured rates are located in the Northeast.

16.8% of adults were uninsured in the first half of 2011, similar to the 16.4% in 2010, but higher than the rate in 2008, when it stood at 14.8%. Only three states have uninsured rates under 10%, and the rate of uninsured adults exceeds 15% in 29 states.

What happens with the Affordable Care Act--and the challenges against it--is something to watch with regard to coverage rates moving forward. Gallup writes: "The fate of uninsured rates in America remains precarious as numerous states are challenging the legality of the new healthcare law in court."

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Low Gains in Nonfarm Payroll Employment in May, Following 3 Months of Solid Improvement

The U.S. Bureau of Labor Statistics (BLS) released its report last Friday on the employment situation in May, 2011, and the news was not as encouraging as in previous months. Only 54,000 jobs were added in May, following an average gain per month of 220,000 over the previous three months. Improvement continued in professional and business services, health care, and mining; were relatively unchanged in major private-sector industries; and employment figures in local government continued their downward slide. Also relatively unchanged were the number of unemployed persons, at 13.9 million, and the unemployment rate, which sat at 9.1 percent. The number of long-term unemployed--those who have been jobless for 27 weeks or more--increased by 361,000 to 6.2 million. The BLS Editor's Desk summarized some of the report's findings here.

As mentioned in an earlier blog post, stocks dropped following negative economic reports for the month of May, and economists were disappointed by figures much lower than they had anticipated.

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