Posts Tagged ‘National Center for Health Statistics’

ACA Gives 2.5 Million Young Adults Healthcare Coverage

Tuesday, December 27th, 2011

The number of young adults who have no medical coverage has contracted by 2.5 million since the Patient Protection and Affordable Care Act (ACA) took effect, according to a new analysis by the Obama administration.  That decline is 2½ times larger than earlier government and private estimates, which showed about one million Americans ages 19 – 25 had acquired coverage.

Obama administration officials said they now have more comprehensive data and are slicing the numbers more precisely than the government typically does, in an attempt to identify the impact of a popular provision in the law.  Thanks to the ACA, young adults can remain on their parents’ health insurance plans until their 26th birthdays.  Families have flocked to sign up their offspring, making the transition to work in a challenging economic environment a bit easier.

Thanks to the Affordable Care Act, 2.5 million more young adults don’t have to live with the fear and uncertainty of going without health insurance,” said HHS Secretary Kathleen Sebelius.  “Moms and dads around the country can breathe a little easier knowing their children are covered.”

“This comparison makes it clear that the increase in coverage among 19 to 25 year-olds can be directly attributed to the Affordable Care Act’s new dependent-coverage provision,” according to an Assistant Secretary for Planning and Evaluation (ASPE) brief.  “Furthermore, the coverage gain for young adults was entirely due to an increase in private coverage (from 49 percent to 58 percent), with no change in Medicaid coverage during this period.”

“The increase in coverage among 19- to 25-year-olds can be directly attributed to the Affordable Care Act’s new dependent coverage provision,” according to the Department of Health and Human Services (HHS).  “Initial gains from this policy have continued to grow as…students graduate from high school and college.”

That age group previously recorded the highest uninsured rate. Now, 26- to 35-year-olds have that dubious distinction by a narrow margin, according to the Centers for Disease Control and Prevention.

According to the HHS survey, nearly 36 percent of Americans ages 19 – 25 — more than 10.5 million people — were uninsured in the third quarter of 2010, before the law’s provision took effect.  The majority of employer-based health plans began carrying the provision January 1, 2011.  By the 2nd quarter of 2011, the proportion of uninsured young adults had fallen to slightly more than 27 percent, or about eight million people.

And just who are these young adults?  Some are transitioning from school to work. Others are trying to start their careers by working at low-wage jobs that don’t usually come with healthcare coverage.  Some – known as the “invincibles” – pass up job-based health insurance because they don’t think they’ll need it and prefer some extra money in their paychecks.

Similarly, the National Center for Health Statistics has documented a broadly similar trend, only not nearly as spectacular.  According to administration officials, those statistics do not focus on the change from calendar quarter to calendar quarter, as the new HHS report does.  Instead, they pool data over longer time periods; that tends to dilute the law’s perceived impact.

Why Are More Middle-Aged Women Killing Themselves?

Tuesday, August 9th, 2011

A recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA) found a 49 percent increase in emergency department visits for drug-related suicide attempts for women 50 years and older.  Women in the 40-69 age bracket are at greater risk of killing themselves than other women, according to research on age-specific suicide rates between 1998 and 2007.  In 2007, this age group comprised 60 percent of the 7,328 suicides reported among women.  The question is:  Why is this happening to middle-aged women?

There is a possibility that it is a question of numbers: One in four American adults has a treatable mental health condition; women in the 40-69-year-old age group represent one of the nation’s fastest-growing populations.  Alternatively, it could be a function of baby boomers’ elevated rates of substance abuse, a critical risk factor in suicide, said Julie Phillips, Ph.D., a social demographer and associate professor at Rutgers University.  According to Phillips, the age-specific rates were derived from data from the National Center for Health Statistics and the Census Bureau.

During the nine-year time period studied, suicide rates remained fairly stable for women younger than 40; for women older than 70, suicide rates declined.  Women 50 and older may be in crisis because pain and sleep disorders — widespread problems related to aging — often lead to increased use of prescription drugs, said Albert Woodward, Ph.D., the project director of SAMHSA’s Drug Abuse Warning Network.  According to the SAMHSA report, suicide attempts involving drugs to treat anxiety and insomnia rose 56 percent.  Woodward said that middle-aged women may experience depression because of declining health and other negative life events.   Loneliness and depression also are risk factors for suicide.  “Older women, especially in the U.S., are more isolated and separated from daily human contact outside of work and the internet,” said Ellyn Kaschak, Ph.D., emeritus professor of psychology at San Jose State University and the editor of the journal Women & Therapy.

Dr. LeslieBeth Wish, a psychologist and licensed clinical social worker in Sarasota, FL, has found  a surprising increase in suicide attempts by women aged between 45 and 54.  Women are susceptible to depression but older women may also be suffering from pre-menopause hormone fluctuations that can affect mood changes and depression.  According to Dr. Wish, women in their middle years are more aware of their mortality and may be disenchanted that they will never be happy.  Becoming an empty nester also is stressful.

Of greater concern is the 67 percent increase of women taking hydrocodone, and an astonishing 210 percent increase for women taking oxycodone.  According to SAMHSA administrator Pamela S. Hyde, J.D., “The steep rise in the abuse of narcotic pain relievers by women is extremely dangerous and we are now seeing the results of this public health crisis in our emergency rooms.  Emergency rooms should not be the frontline in our efforts to intervene.  Friends, family, and all members of the community must do everything possible to help identify women who may be in crisis and do everything possible to reach out and get them needed help.”

Because they are often members of the so-called “Sandwich Generation,” middle-aged women frequently discount their own needs as they organize commitments to jobs, marriages, kids, and aging parents.  Many say they don’t get enough sleep and eat too much junk-food.  According to medical experts, these habits — combined with soaring cortisol (a steroid hormone, or glucocorticoid, produced by the adrenal gland) levels — from stress — could mean this will be the first generation of women who don’t live five to seven years longer than males.

HHS Issues Guidance for State Healthcare Exchanges

Wednesday, July 27th, 2011

The Department of Health and Human Services (HHS) has proposed a structure for health insurance exchanges that gives states significant flexibility in how and when they set up open marketplaces designed to boost competition.  HHS announced a sliding deadline for states to create the exchanges, allowing them to receive conditional approval if they are in advanced preparation by 2013.

Additionally, states that are not ready by the final 2014 deadline can delay opening the exchanges until 2015 or later.  States that are still deciding whether to establish health insurance exchanges have sought clarity on how these insurance marketplaces will function.  The federal government previously had provided few details on this key part of the Patient Protection and Affordable Care Act (ACA).

The rationale for the exchanges is to create convenient access to an open marketplace of insurance plans that lets uninsured people and small businesses join together to negotiate affordable rates.  States had faced a January 1, 2013, deadline to decide if they would participate in the program.  Those opting to participate are expected to create governance and information technology structures virtually from scratch to have the exchanges in full operation by 2014.

“If we don’t have significant progress made by the end of the year, the IT experts tell us it’s going to be really hard to meet the deadline,” Kansas Insurance Commissioner Sandy Praeger said.  She is working to establish an exchange despite a lack of legislation in her state to move forward with it, not to mention a conservative governor who strongly opposes the health law.  “The health insurance market is often broken, especially for small businesses,” said HHS Secretary Kathleen Sebelius.  Sebelius said the exchanges would share three key features: They will serve as one-stop shops for comprehensive insurance needs; create competition between insurers based on price and quality; and provide basic coverage to all Americans.  “This is how members of Congress get their health insurance today,” she said.  “And once these reforms are fully in place, buying insurance will become much more like buying a home appliance or an airline ticket.”

Meanwhile, HHS announced three new initiatives to help states improve the quality and cut the cost of care for “dual eligible” – the approximately nine million Americans who qualify for both Medicare and Medicaid.  The programs include a demonstration program to try out two new financial models to better coordinate care for people who are eligible for both government programs; a demonstration program to help states upgrade the quality of care for people in nursing homes that focuses on cutting hospitalizations; and setting up a technical resource center to help states improve care for high-need high-cost beneficiaries.  “By improving care to the most vulnerable of our citizens, we can improve the quality of their lives and prevent wasteful spending,” Sebelius said.  “Governors and their staff have been looking for tools to help them accomplish these important goals.  I am pleased that we can continue our strong partnership with the states to do this.”

These moves couldn’t come at a better time.  It is estimated that the growth in the uninsured adult population continued in 2010 — particularly among the number of long-term uninsured and poorer uninsured.  Americans of all ages who were uninsured during the last year reached 60.3 million in 2010, an increase of nearly two million when compared with 2009, according to a report by the National Center for Health Statistics, a division of the Centers for Disease Control and Prevention.

Private health coverage continued to decline while public coverage increased, especially for children.  Among non-elderly adults, 61.1 percent had private coverage in 2010, a 1.7 percent decline.  The rate of privately insured children fell 1.9 percent to 53.8 percent.  While greater numbers of adults became uninsured, fewer children on the whole lost coverage.  That’s largely because the percentage of kids with public coverage — Medicaid and the Children’s Health Insurance Program (CHIP) — increased to 39.8 percent, up nearly two percent.  “Medicaid and CHIP have been a real success story,” said Tom Buchmueller, PhD, a University of Michigan health economist.  State expansion of children’s health programs began increasing the percentage of publicly covered children beginning in 2008.

Sebelius was joined by Washington State Governor Christine Gregoire,  who said the 135,000 dual eligible residents of her state cost $1 billion annually in healthcare costs.  Though they represent only 12 percent of the Medicaid caseload, they total more than one-third of the spending, she said.  “If we could just reduce the cost of two percent a year by investing in community-based solutions rather than nursing homes, which is what our patients want anyway, by helping them avoid psychiatric hospitalizations, we believe we could save at least $10 million a year just with that small segment – that high-risk segment of our dual eligible population.  This is our costliest population, with the greatest need, yet we’re not able to focus on what’s right for them,” Gregoire said.  “The opportunities you’ve provided us will make this possible now.”

ER Usage Study Shows Interesting Results

Tuesday, August 24th, 2010

Twenty percent of Americans visited a hospital emergency room in 2007, the most recent year for which the National Center for Health Statistics has data.  That includes approximately 7.4 percent of the uninsured who visited the ER multiple times, as did 5.1 percent of people with private insurance.  The most frequent ER visitors were Medicaid patients, with 15.3 percent reporting two or more visits in 2007.  A total of 116.8 million ER visits were made that year.

One third of adults in fair or poor health visited the ER at least once during the year and are the patients most likely to use that facility.  Patients over 65 reported more ER visits and described it as their customary source of healthcare.  Approximately 25 percent of individuals aged 75 and older visited the ER at least once in 2007.

The big surprise?  Contrary to conventional wisdom, the uninsured were not more likely to make non-emergency visits to the ER than other groups.  Approximately 10 percent fall into the non-emergency category whether the patient had private insurance, Medicaid coverage or no insurance.  Determining who visits the ER, the frequency and for what reasons requires examining complicated interactions among multiple factors – socioeconomic level, overall health, age, health insurance, access to healthcare and others.

“Our job is to provide the best numbers to inform policy and practice,” said Amy B. Bernstein of the National Center for Health Statistics.  “If people are concerned about the use of emergency rooms and how to make their use more efficient or effective, they should have accurate information about who is actually using them – and not who they think is using them.”

A Mixed Report on Americans’ Health

Tuesday, February 9th, 2010

One-third of Americans say they don’t feel very healthy.  A recent study by the National Center for Health Statistics reveals good news and bad news about the general health of the American public. The bad news is that approximately one-third of respondents say they don’t feel particularly well.  The percentage of Americans reporting they are in excellent health fell to 66.6 percent for the first half of 2009, compared with 69.1 percent in 1998.

Although more Americans report they exercise regularly, upwards of 25 percent are considered obese with a body mass index of 30 or more.  That’s a significant increase over the 19.5 percent reported in 1997.  Type 2 diabetes is also on the rise, with 8.8 percent of Americans diagnosed with the disease in 2009, compared with just 5.3 percent in 1997.  The rate of asthma rose to 8.3 percent in 2009, compared with 7.6 percent in 2001.  Ten percent of children under 15 are asthmatic.

Jeannine S. Schiller, a statistician with the health statistics center, noted that some significant changes exist between the 2008 and 2009 reports.  “Flu vaccines were up for people 18 to 49 years old, leisure-time activity was up, and the failure to attain needed medical care due to cost went up significantly in one year,” according to Schiller.  “Diabetes is also up over the short term.”

The report stressed that 15 percent of Americans do not have healthcare insurance, and lack resources they can access for basic medical care.