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.

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.  

Employer-Sponsored Health Insurance On the Decline

Paul Krugman and Reed Abelson, writing with the New York Times, recently highlighted a study displaying the trends within the sources of health insurance for nonelderly Americans.  The study, carried out by the National Institute for Health Care Reform (NIHCR), looked at the form of health insurance coverage for Americans from 2001 to 2010.  The study found that the share of Americans under 65 who receive coverage from Medicaid has risen over 8 percent, up from 9.5 percent in 2001 to 17.6 percent in 2010.  This trend illustrates the paradox of government-sponsored insurance in times of a recession; as people begin to lose their jobs and income, they are more likely to fall under the umbrella of Medicaid.  With the diminishing revenue from income tax, however, the state and federal governments have less funds to support Medicaid.  When a recession hits, more people need Medicaid, but there is less money to fund the program.  The NIHCR data displays this trend, but it also shows the rapidly declining percentage of nonelderly Americans who receive health insurance from their employer.  The share of Americans under 65 who receive employer-sponsored coverage is down from 69.8 percent in 2001 to 53.5 percent in 2010.  This severe drop in employer-sponsored coverage can be attributed to the rise in unemployment over the past decade in conjunction with the decline of employers willing and/or able to provide coverage to employees.  The final notable trend illustrated in the NIHCR study was the growing number of uninsured nonelderly Americans.  The share of Americans under 65 who remain uninsured rose from 14.1 percent in 2001 to 19.5 percent in 2010.  The recession clearly had notable impacts on health insurance coverage, but it will be interesting to see how the recently passed Affordable Care Act, which will not be fully implemented until the beginning of 2015, will affect the NIHCR’s numbers in the future.  In addition, the constitutionality of the Affordable Care Act (specifically, the individual mandate) is currently under review by the Supreme Court, so the outcome of the case will also have significant implications for health insurance coverage.

Number of Uninsured Americans on the Rise

More Americans are now uninsured in 2011 than in 2008, according to a recent Gallup poll. The declining number of Americans who have health insurance has been evident in most population groups, with the exception of younger adults and seniors whose decline rate was within the margin of error. For those who are fortunate enough to have insurance, fewer of them are receiving it from their employer, likely because the employer can not afford to provide insurance or because the employee can not afford to purchase insurance.  Many factors are likely at play in the steady increase of the uninsured. As Gallup reports, while the unemployment rate may be lower in 2011 than in 2008, many more Americans still remain underemployed and thus unable to afford insurance. Health care costs are also continuing to rise with no end in sight, indicating that this trend is likely to continue.

Fewer Americans With Employer-Based Health Insurance

Gallup reports that the percentage of Americans with employer-based health insurance continues to decline. This is likely the result of an increasing number of unemployed and underemployed Americans, but also because there are "fewer employers offering health insurance." When Gallup started tracking Americans' health insurance sources in 2008, nearly 50% of adults 18 and older received health insurance from their employer. This percentage has decreased steadily from 2008 to today, when 44.5% of Americans say they receive employer-based health insurance.These years have also seen an increase in the percentage of uninsured Americans, from 14.6% in 2008 to 17.3% today (though Gallup warns this latter figure may be inflated because in the second half of 2011 surveys were conducted by cell phone, guaranteeing a younger--and more uninsured--respondent population). Gallup has found that 18- to 26- year-olds are less likely to be uninsured than in recent years, perhaps a result of "the provision in the new healthcare law that lets them stay on their parents' health plans until age 26."

But "the other components of the health law that have already been implemented" do not appear to be having the same impact for the larger segment of the population, as "there has been an increase among 25- to- 64-year-olds...without health insurance." These components include "tax credits to help small businesses provide health insurance to their employees and the establishment of a Pre-Existing Condition Insurance Plan among several others." Although the percentage of Americans with government-based health insurance has declined recently, it has still increased since 2008.

Wal-Mart--which "announced in October that new part-time employees who work less than an average of 24 hours a week would no longer be able to get their health insurance from the company--" may present an example that other companies will follow moving forward. Gallup writes: "If Wal-Mart's decision is a precursor of how employers intend to manage their healthcare costs, the downward trend in employer-based healthcare will likely continue."