Tag: Kaiser Family Foundation

Americans’ Challenges with Health Care Costs

Mary Pat Campbell

Link: https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/

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  • About half of U.S. adults say it is difficult to afford health care costs, and one in four say they or a family member in their household had problems paying for health care in the past 12 months. Younger adults, those with lower incomes, adults in fair or poor health, and the uninsured are particularly likely to report problems affording health care in the past year.
  • The cost of health care can lead some to put off needed care. One in four adults say that in the past 12 months they have skipped or postponed getting health care they needed because of the cost. Notably six in ten uninsured adults (61%) say they went without needed care because of the cost.
  • The cost of prescription drugs prevents some people from filling prescriptions. About one in five adults (21%) say they have not filled a prescription because of the cost while a similar share say they have instead opted for over-the-counter alternatives. About one in ten adults say they have cut pills in half or skipped doses of medicine in the last year because of the cost.
  • Those who are covered by health insurance are not immune to the burden of health care costs. About four in ten insured adults worry about affording their monthly health insurance premium, and 48% worry about affording their deductible before health insurance kicks in. Indeed, large shares of adults with employer-sponsored insurance (ESI) and those with Marketplace coverage rate their insurance as “fair” or “poor” when it comes to their monthly premium and to out-of-pocket costs to see a doctor.
  • Health care debt is a burden for a large share of Americans. About four in ten adults (41%) report having debt due to medical or dental bills including debts owed to credit cards, collections agencies, family and friends, banks, and other lenders to pay for their health care costs, with disproportionate shares of Black and Hispanic adults, women, parents, those with low incomes, and uninsured adults saying they have health care debt.
  • Notable shares of adults still say they are worried about affording medical costs such as unexpected bills, deductibles, and long-term care services for themselves or a family member. Additionally, about half of adults would be unable to pay an unexpected medical bill of $500 in full without going into debt.

Author(s): Lunna Lopes, Marley Presiado, and Liz Hamel

Publication Date: 21 Dec 2023

Publication Site: Kaiser Family Foundation

Who Will Care for Older Adults? We’ve Plenty of Know-How but Too Few Specialists

Mary Pat Campbell

Link: https://kffhealthnews.org/news/article/who-will-care-for-older-adults-weve-plenty-of-know-how-but-too-few-specialists/

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Despite the surging older population, there are fewer geriatricians now (just over 7,400) than in 2000 (10,270), he noted in a recent piece in JAMA. (In those two decades, the population 65 and older expanded by more than 60%.) Research suggests each geriatrician should care for no more than 700 patients; the current ratio of providers to older patients is 1 to 10,000.

What’s more, medical schools aren’t required to teach students about geriatrics, and fewer than half mandate any geriatrics-specific skills training or clinical experience. And the pipeline of doctors who complete a one-year fellowship required for specialization in geriatrics is narrow. Of 411 geriatric fellowship positions available in 2022-23, 30% went unfilled.

The implications are stark: Geriatricians will be unable to meet soaring demand for their services as the aged U.S. population swells for decades to come. There are just too few of them. “Sadly, our health system and its workforce are wholly unprepared to deal with an imminent surge of multimorbidity, functional impairment, dementia and frailty,” Gurwitz warned in his JAMA piece.

This is far from a new concern. Fifteen years ago, a report from the National Academies of Sciences, Engineering, and Medicine concluded: “Unless action is taken immediately, the health care workforce will lack the capacity (in both size and ability) to meet the needs of older patients in the future.” According to the American Geriatrics Society, 30,000 geriatricians will be needed by 2030 to care for frail, medically complex seniors.

Author(s): Judith Graham

Publication Date: 10 Nov 2023

Publication Site: Kaiser Health News

Medicaid Enrollment and Unwinding Tracker – 11 Oct 2023

Mary Pat Campbell

Link: https://www.kff.org/medicaid/issue-brief/medicaid-enrollment-and-unwinding-tracker/

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There is wide variation in disenrollment rates across reporting states, ranging from 66% in Texas to 11% in Illinois. Differences in who states are targeting with early renewals as well as differences in renewal policies and system capacity likely explain some of the variation in disenrollment rates. Some states (such as Texas and South Carolina) are initially targeting people early in the unwinding period that they think are no longer eligible or who did not respond to renewal requests during the pandemic, but other states are conducting renewals based on an individual’s renewal date. Additionally, some states have adopted several policies that promote continued coverage among those who remain eligible and have automated eligibility systems that can more easily and accurately process renewals while other states have adopted fewer of these policies and have more manually-driven systems.

Publication Date: last updated 11 Oct 2023

Publication Site: Kaiser Family Foundation

The End of the COVID-19 Public Health Emergency: Details on Health Coverage and Access

Mary Pat Campbell

Link: https://www.kff.org/policy-watch/the-end-of-the-covid-19-public-health-emergency-details-on-health-coverage-and-access/

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On Jan. 30, 2023, the Biden Administration announced it will end the public health emergency (and national emergency) declarations on May 11, 2023. Here’s what major health policies will and won’t change when the public health emergency ends.

Vaccines

What’s changing: Nothing. The availability, access, and costs of COVID-19 vaccines, including boosters, are determined by the supply of federally purchased vaccines, not the public health emergency.

What’s the same: As long as federally purchased vaccines last, COVID-19 vaccines will remain free to all people, regardless of insurance coverage. Providers of federally purchased vaccines are not allowed to charge patients or deny vaccines based on the recipient’s coverage or network status.

….

At-home COVID tests

What’s changing: At-home (or over-the-counter) tests may become more costly for people with insurance. After May 11, 2023, people with traditional Medicare will no longer receive free, at-home tests. Those with private insurance and Medicare Advantage (private Medicare plans) no longer will be guaranteed free at-home tests, but some insurers may continue to voluntarily cover them.

For those on Medicaid, at-home tests will be covered at no-cost through September 2024. After that date, home test coverage will vary by state.

….

COVID Treatment

What’s changing: People with public coverage may start to face new cost-sharing for pharmaceutical COVID treatments (unless those doses were purchased by the federal government, as discussed below). Medicare beneficiaries may face cost-sharing requirements for certain COVID pharmaceutical treatments after May 11. Medicaid and CHIP programs will continue to cover all pharmaceutical treatments with no-cost sharing through September 2024. After that date, these treatments will continue to be covered; however, states may impose utilization limits and nominal cost-sharing.

….

Author(s): Cynthia Cox Follow @cynthiaccox on Twitter , Jennifer Kates Follow @jenkatesdc on Twitter , Juliette Cubanski Follow @jcubanski on Twitter , and Jennifer Tolbert

Publication Date: 3 Feb 2023

Publication Site: Kaiser Family Foundation

Public Health Agencies Try to Restore Trust as They Fight Misinformation

Mary Pat Campbell

Link: https://khn.org/news/article/public-health-agencies-try-to-restore-trust-as-they-fight-misinformation/

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Across the country, health officials have been trying to combat misinformation and restore trust within their communities these past few years, a period when many people haven’t put full faith in their state and local health departments. Agencies are using Twitter, for example, to appeal to niche audiences, such as NFL fans in Kansas City and Star Wars enthusiasts in Alabama. They’re collaborating with influencers and celebrities such as Stephen Colbert and Akbar Gbajabiamila to extend their reach.

Some of these efforts have paid off. By now, more than 80% of U.S. residents have received at least one shot of a covid vaccine.

But data suggests that the skepticism and misinformation surrounding covid vaccines now threatens other public health priorities. Flu vaccine coverage among children in mid-December was about the same as December 2021, but it was 3.7 percentage points lower compared with late 2020, according to the Centers for Disease Control and Prevention. The decrease in flu vaccination coverage among pregnant women was even more dramatic over the last two years: 18 percentage points lower.

Other common childhood vaccination rates are down, too, compared with pre-pandemic levels. Nationally, 35% of all American parents oppose requiring children to be vaccinated for measles, mumps, and rubella before entering school, up from 23% in 2019, according to a KFF survey released Dec. 16. Suspicion swirling around once-trusted vaccines, as well as fatigue from so many shots, is likely to blame.

Author(s): Laurie Sausser

Publication Date: 3 Jan 2023

Publication Site: Kaiser Health News

Why Do Vaccinated People Represent Most COVID-19 Deaths Right Now?

Mary Pat Campbell

Link: https://www.kff.org/policy-watch/why-do-vaccinated-people-represent-most-covid-19-deaths-right-now/

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The waning protection from vaccines is why CDC recommends recent booster shots, and why it’s especially important for people at higher risk to stay up-to-date on boosters. Per current recommendations, most adults should have received at least 2-3 booster doses by now (including the new bivalent booster), in addition to their primary series. However, only 14% of adults overall and 31% of older adults (65 years and older) have received the latest bivalent boosters. The CDC data show that about 95% of adults who died from COVID-19 in 2022 in these jurisdictions were over age 50, and about 8 in 10 were age 65 or older, underscoring the need for older adults to stay up-to-date on recommended booster shots.

The fall in the share of deaths that are among unvaccinated people could also be explained by changes in the unvaccinated population. By this far into the pandemic, it is estimated that many unvaccinated people have had COVID-19 at least once and while hundreds of thousands of unvaccinated people have needlessly died from COVID, those who survived may have gained some immune protection against the virus that can help protect them against severe outcomes when they have subsequent infections. However, this protection from a past infection can also diminish over time, which is why it is still recommended that unvaccinated people with prior COVID-19 infections get vaccinated and stay up-to-date on boosters.

Author(s): Cynthia Cox Follow @cynthiaccox on Twitter , Krutika Amin Follow @KrutikaAmin on Twitter , Jennifer Kates Follow @jenkatesdc on Twitter , and Josh Michaud Follow @joshmich on Twitter

Publication Date: 30 Nov 2022

Publication Site: KFF

Deaths Among Older Adults Due to COVID-19 Jumped During the Summer of 2022 Before Falling Somewhat in September

Mary Pat Campbell

Link: https://www.kff.org/coronavirus-covid-19/issue-brief/deaths-among-older-adults-due-to-covid-19-jumped-during-the-summer-of-2022-before-falling-somewhat-in-september/

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As of the week ending October 1, 2022, the United States has lost nearly 1.1 million lives to COVID-19, of which about 790,000 are people ages 65 and older. People 65 and older account for 16% of the total US population but 75% of all COVID deaths to date. Vaccinations, boosters, and treatments have led to a substantial decline in severe disease, hospitalizations, and deaths from COVID-19, but with booster uptake lagging, deaths for older adults rose again during the summer of 2022.

From April to July 2022, the number of deaths due to COVID increased for all ages but rose at a faster rate for older than younger adults and stayed high through August 2022, with deaths due to COVID topping 11,000 in both July and August among people 65 and older. While COVID deaths began to drop again in September, they were still higher for those ages 65 and older than in April or May; for those younger than 65, deaths dropped below their April levels.

The rise in deaths is primarily a function of increasing cases due to the more transmissible Omicron variant. Other factors include relatively low booster uptake, compared to primary vaccination, and waning vaccine immunity, underscoring the importance of staying up to date on vaccination. On September 1st, CDC recommended a new, updated booster for all those ages 12 and older, but particularly for those who are older.

Author(s): Meredith Freed Follow @meredith_freed on Twitter , Tricia Neuman Follow @tricia_neuman on Twitter , Jennifer Kates Follow @jenkatesdc on Twitter , and Juliette Cubanski Follow @jcubanski on Twitter

Publication Date: 6 Oct 2022

Publication Site: Kaiser Family Foundation

What we learned from a massive survey on America’s mental health crisis

Mary Pat Campbell

Link: https://www.cnn.com/2022/10/08/politics/cnn-kff-mental-health-survey-what-matters/index.html

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The vast majority of Americans of all ages, races, generations and backgrounds say the US has a mental health crisis.

Nine in 10 Americans in a new survey from CNN and the Kaiser Family Foundation say the country as a whole is facing a crisis on this front and about half of adults say they’ve experienced a severe mental health crisis in their family.

CNN published a series of stories this week based on the poll in conjunction with KFF. Read the main report here. And read this from CNN’s polling team about how the survey was conducted.

There’s also 988 – the three-digit number anyone in crisis can call, but which the survey found few people know about.

Author(s): Zachary B. Wolf

Publication Date: 8 Oct 2022

Publication Site: CNN

KFF COVID-19 Vaccine Monitor: September 2022

Mary Pat Campbell

Link: https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-september-2022/

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Overall adult vaccination rates have been relatively steady over the past year. The latest COVID-19 Vaccine Monitor finds that nearly eight in ten adults (77%) say they have gotten at least one dose of a COVID-19 vaccine, including about half who say they are fully vaccinated and also received at least one booster dose (47%), about a quarter who have been fully vaccinated but have not gotten a booster (26%), and a small share who are partially vaccinated (3%). Twenty-three percent remain unvaccinated, the vast majority of whom say they will “definitely not” get the COVID-19 vaccine (88% of unvaccinated, or 21% of all adults). For the latest breakdown of self-reported vaccination rates by demographic group, see the Vaccine Monitor Dashboard.

In late August, the Food and Drug Administration authorized the use of new, updated COVID-19 vaccine boosters that target both the new omicron variants and the original strain of the virus. The bivalent boosters (one by Moderna and one by Pfizer) are now authorized for use by those ages 12 and older who have gotten an initial series of a COVID-19 vaccine, including those who have already received one or more boosters.

Awareness of the new boosters is modest, with about half of adults saying they have heard “a lot” (17%) or “some” (33%) about updated booster, 31% saying they have heard “a little,” and one in five saying they have heard “nothing at all” about the new booster doses.

Older adults and Democrats are somewhat more likely than their counterparts to say they have heard at least “some” about the new boosters, but fewer than a quarter across these groups report hearing “a lot” about the new shots.

Author(s): Grace Sparks Follow @gracesparks on Twitter , Lunna Lopes , Liz Hamel Follow @lizhamel on Twitter , Alex Montero , Marley Presiado , and Mollyann Brodie Follow @Mollybrodie on Twitter

Publication Date: 30 Sept 2022

Publication Site: Kaiser Family Foundation

What are the Implications of Long COVID for Employment and Health Coverage?

Mary Pat Campbell

Link: https://www.kff.org/policy-watch/what-are-the-implications-of-long-covid-for-employment-and-health-coverage/

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Preliminary evidence suggests there may be significant implications for employment: Surveys show that among adults with long COVID who worked prior to infection, over half are out of work or working fewer hours (Figure 2). Many conditions associated with long COVID—such as malaise, fatigue, or the inability to concentrate—limit people’s ability to work, even if they have jobs that allow for remote work and other accommodations. Two surveys of people with long COVID who had worked prior to infection showed that between 22% and 27% of those workers were out of work after getting long COVID. In comparison, among all working-age adults in 2019, only 7% were out of work. Given the sheer number of working age adults with long COVID, the employment implications may be profound and are likely to affect more people over time. One study estimates that long COVID already accounts for 15 percent of unfilled jobs.

Author(s): Alice Burns

Publication Date: 1 Aug 2022

Publication Site: KFF

Covid Still Kills, but the Demographics of Its Victims Are Shifting

Mary Pat Campbell

Link: https://khn.org/news/article/covid-still-kills-but-the-demographics-of-its-victims-are-shifting/

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Californians age 75 and older made up 53% of covid deaths through July in 2022, up from 46% in 2020 and 2021. Only about 6% of the state’s residents are 75 and older. And white Californians 75 and older outnumber Latinos in that age group about 3 to 1.

In the initial vaccination rollout, California prioritized seniors, first responders, and other essential workers, and for several months in 2021 older residents were much more likely to be vaccinated than younger Californians.

“Now, the vaccination rates have caught up pretty much with everybody except for kids, people under 18,” Brewer said. “You’re seeing it go back to what we saw before, which is that age remains the most important risk factor for death.”

Author(s): Phillip Reese

Publication Date: SEPTEMBER 21, 2022

Publication Site: KFF

KFF COVID-19 Vaccine Monitor: September 2021

Mary Pat Campbell

Link:https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-september-2021/

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In the midst of a “third wave” of the U.S. COVID-19 pandemic driven largely by the highly contagious Delta variant, more than seven in ten U.S. adults (72%) now report that they have received at least one dose of a COVID-19 vaccine, up from 67% in July. An additional 2% say they plan to get the vaccine as soon as possible. The share who say they want to “wait and see” how the vaccine works for others before getting it themselves dropped to 7% in September. Four percent of adults this month say they will get vaccinated only if required for work, school, or other activities and 12% say they will “definitely not” get the vaccine.

The largest increases in self-reported COVID-19 vaccination rates between July and September were among younger adults (up 11 percentage points among 18-29 year-olds) and Hispanic adults (up 12 percentage points). The largest remaining gap in vaccination rates is by partisanship, with 90% of Democrats saying they have gotten at least one dose compared to 68% of independents and 58% of Republicans. In addition, large differences in self-reported vaccination rates remain between older and younger adults, between those with and without college degrees, and between those with higher and lower incomes, while rural adults continue to lag behind those living in urban and suburban areas. Non-elderly adults without health insurance also continue to report one of the lowest COVID-19 vaccination rates of any group (54%).

Author(s): Liz Hamel Follow @lizhamel on Twitter , Lunna Lopes , Grace Sparks Follow @gracesparks on Twitter , Ashley Kirzinger Follow @AshleyKirzinger on Twitter , Audrey Kearney Follow @audrey__kearney on Twitter , Mellisha Stokes , and Mollyann Brodie Follow @Mollybrodie on Twitter

Publication Date: 28 Sept 2021

Publication Site: Kaiser Family Foundation