The Policy ThinkShop brings your attention to the latest resources on the ACA reform: Survey of Non-Group Health Insurance Enrollees | The Henry J. Kaiser Family Foundation

The Kaiser Family Foundation has released its first survey of the population finding new health coverage under the recently implemented ACA reform.  The survey delineates two main groups taking advantage of the increased access to health insurance: those who had non-group coverage and those who had no insurance at all.  The experiences of these two groups may prove important, the report goes on to say, with significant implications on how the success of the ACA reform is judged.

Apparently, the success of the ACA reform in brining people into the insured fold may be limited by financial literacy, insurance literacy, and health literacy deficits evident in the Kaiser Family Foundation survey.

A preliminary read of the survey report findings by The Policy ThinkShop points to an emergent need to address health literacy in the newly covered group in order to ensure that coverage recipients understand how to take advantage of their presumed efficacy in the insurance market and in their presumed increased access to healthcare itself and cost saving prevention health services.  According to the survey:

“Health insurance is complicated, and many previous studies have documented gaps in health insurance literacy among consumers. The survey finds evidence of this among those who purchase their own coverage, with many respondents unable to answer some basic questions about their plans. For example, nearly one in five non-group enrollees (18 percent) say they don’t know the amount of their monthly premium and almost four in ten (37 percent) don’t know the amount of their annual deductible. Among those with ACA-compliant plans, three in ten (30 percent) say they don’t know the metal level of their plan (platinum, gold, silver or bronze), and among those who report getting a government subsidy to defray their premium cost, nearly half (47 percent) couldn’t say what the amount of the subsidy is.”

The survey report goes on to highlight the segment of the population surveyed who are more privileged because of their prior experience obtaining insurance:

 

“Some groups are more knowledgeable than others, including college graduates, those with higher incomes, and small business owners. Plan switchers, who likely have more experience buying coverage in the non-group market, are also more likely than those who were previously uninsured to be able to report the metal level of their plan and their premium and deductible amounts.”

Policy ThinkShop Policy Resources for you –

You can read the entire survey report at:

http://kaiserfamilyfoundation.files.wordpress.com/2014/06/survey-of-non-group-health-insurance-enrollees-findings-final1.pdf

Report Executive Summary

“January 1, 2014 marked the beginning of several provisions of the Affordable Care Act ACA making significant changes to the non-group insurance market, including new rules for insurers regarding who they must cover and what they can charge, along with the opening of new Health Insurance Marketplaces also known as “Exchanges” and the availability of premium and cost-sharing subsidies for individuals with low to moderate incomes. Data from the Department of Health and Human Services and others provide some insight into how many people purchased insurance using the new Marketplaces and the types of plans they picked, but much remains unknown about changes to the non-group market as a whole. The Kaiser Family Foundation Survey of Non-Group Health Insurance Enrollees is the first in a series of surveys taking a closer look at the entire non-group market. This first survey was conducted from early April to early May 2014, after the close of the first ACA open enrollment period. It reports the views and experience of all non-group enrollees, including those with coverage obtained both inside and outside the Exchanges, and those who were uninsured prior to the ACA as well as those who had a previous source of coverage non-group or otherwise.”

via Survey of Non-Group Health Insurance Enrollees | The Henry J. Kaiser Family Foundation.

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Filed under: ACA and Medicaid, access to education, Aging, Behavioral Health Outcomes, Blogosphere, Children and Poverty, Civic Engagement, consumers, Health Literacy, Health Policy, Healthcare Reform, Maternal and Child Health, Medicaid, Medicaid Expansion, News, Philanthropy, Policy ThinkShop Comments on other media platforms, Public Health, Public Policy

Addressing health problems in your community takes more than understanding what causes them or who they impact most. | ‘A Starting Point for Change’: Fifth Edition of the County Health Rankings Released Today – Robert Wood Johnson Foundation

Addressing health problems in communities takes more than understanding what causes them or who they impact most.  It takes a motivated network of stakeholders to define policies, bring resources, and build appropriate programs.  What can you do to successfully convene and motivate local thought leaders to help you in your public health cause?

Motivating others to work with you requires a command of the relevant facts to build a reasonable conversation.  Commanding local data, defining local health problems (in terms of needed policies, plans and programs) will help you form a team of local stakeholders that can support your vision of a healthier community.

This year the RWJF released its fifth edition of its county health ranking report.  The report focuses on the relationship between how you feel and where you live.   The website provides a user friendly set of online tools for understanding demographic variables and performing health analysis that can help you increase your “health literacy” as a community member, stakeholder, policy maker and leader with a focus on addressing community health challenges.

The following resources will help you make progress on the health issues impacting your community.

 

The Policy ThinkShop provides you with the following summary of the findings and user friendly links to the website where you can plugin your state, county, etc., and get your data:

http://www.countyhealthrankings.org

Also, you can search the site for best practice programs and policies:

http://www.countyhealthrankings.org/roadmaps/what-works-for-health

 

“This year’s County Health Rankings report shows some important trends, including:

Teen birth rates have decreased about 25 percent since 2007.

The rate of preventable hospital stays decreased about 20 percent from 2003 to 2011.

Smoking rates dropped from 21 percent in 2005 to 18 percent in 2012.

Completion of at least some college attendance increased slightly from 59 percent in 2005 to 64 percent in 2012.

This year’s report also features several new measures:

Housing:

Almost 1 in 5 households are overcrowded, pose a severe cost burden, or lack adequate facilities to cook, clean, or bathe.

These problems are greatest on the East and West coasts, in Alaska, and in parts of the South.

Transportation:

More than three-quarters of workers drive to work alone and among them 33 percent drive longer than a half hour each way.

Driving contributes to physical inactivity, obesity and air pollution.

Food Environment:

People in many parts of the country face food insecurity or the threat of hunger and limited access to healthy foods, especially in counties in the Southwest, across parts of the South and in the Western United States.

Mental Health:

Amid growing attention to mental health care, the availability of mental health providers in the healthiest counties in each state is 1.3 times higher than in the least healthy counties.

The west and northeast regions of the country have the best access to mental health providers.

Injury-Related Deaths:

The third-leading cause of death in the United States, injury death rates are 1.7 times higher in the least healthy counties than in the healthiest counties.

These rates are particularly high in the Southwest, part of the Northwest including Alaska and in the East South Central and Appalachian regions.

Exercise Opportunities:

Access to parks or recreational facilities in the healthiest counties is 1.4 times higher than in the least healthy counties.”

More via ‘A Starting Point for Change’: Fifth Edition of the County Health Rankings Released Today – Robert Wood Johnson Foundation.

Filed under: ACA and Medicaid, Aging, Behavioral Health Outcomes, Blogosphere, Civic Engagement, Data Trends - American Demographics and Public Opinion, Health Literacy, Health Policy, Healthcare Reform, Medicaid Expansion, News, Policy ThinkShop Comments on other media platforms

Is your doctor happy? With Poll from: Gallup.Com

When you visit your doctor does (s)he look happy?  At the end of the day healthcare is a one on one personal experience.  All the insurance coverage or fancy machines in the world won’t improve medical care if the doctor patient relationship is not optimal.

So what is our healthcare system doing to address physician happiness?  The Gallup organization took a closer look at hospitals, one place where physician practice is defined and sustained–for better or for worse…

“When doctors are frustrated, patient care and hospital revenues suffer. Heres how hospitals can engage their physicians — and make a positive impact on patients and the bottom line.”

via Gallup.Com – Daily News, Polls, Public Opinion on Politics, Economy, Wellbeing, and World.

Filed under: ACA and Medicaid, Behavioral Health Outcomes, Blogosphere, Cancer Treatment & Success, Health Literacy, Health Policy, Healthcare Reform, Maternal and Child Health, Medicaid, Medicaid Expansion, Medical Research, Medicare, New American Electorate, Polls and pollsters, Public Health

Addressing Deep and Persistent Poverty: A Framework for Philanthropic Planning and Investment

Given the last decade of a deep and lingering economic downturn, mortgage failures, Wall Street scandals and scams that brought much misfortune to the otherwise fortunate, poverty is no longer a controversial topic that afflicts the few and shakes the policy corridors of Washington.  The new poverty, according to most experts, affects families and children, the hard to employ and many struggling families who face their at home kids’ college loan bills without the benefit of Jr.’s paycheck.

Perhaps now is a good “quiet and tranquil” time to study the issue of the less fortunate without the cacophony of stakeholder voices drowning out reason.  Perhaps now that Occupy this and that has all but disappeared, the issue of poverty can occupy the voices of reason …

To be sure, the JPB foundation and the Urban Institute have recently partnered to produce an intelligent overview and analytical tools for looking, not only at poverty, but at what they term “deep poverty.”

The Policy ThinkShop provides you with the following link at an article to peruse the issue or the following downloadable report which will give you a deeper look at the deep poverty issue:

http://www.urban.org/UploadedPDF/412983-addressing-deep-poverty.pdf

“The JPB Foundation engaged the Urban Institute to provide background on the problem of deep and persistent poverty in the United States. This paper summarizes the history of US antipoverty policies, synthesizes existing knowledge about poverty and deep poverty, and presents a framework for understanding the complex and multi-faceted landscape of antipoverty efforts today. It also draws on interviews with over 30 experts, philanthropists, and thought leaders in the field to review and distill the most current thinking about promising strategies for tackling deep and persistent poverty. Drawing on these facts and insights, we present a series of questions and choices that any foundation wishing to invest in this area would be well-advised to consider.”

More via Addressing Deep and Persistent Poverty: A Framework for Philanthropic Planning and Investment.

Filed under: ACA and Medicaid, access to education, Blogosphere, Children and Poverty, Data Trends - American Demographics and Public Opinion, Demographic Change, Feminization of Poverty, Medicaid Expansion, News, Public Policy

A Comparison of Today’s Unauthorized Immigrants and the IRCA Legalized: Implications for Immigration Reform

Like most semantically charged (politicized) issues in our public policy conversations, immigration is usually looked at from the perspective of some aggrieved or troubled constituency.  Too often it is the cannon fodder of political battles resonating in the popular canons of the dominant culture.

The Policy ThinkShop seeks to help shed reason and light on all matters impacting families and children caught in the crossfire of pursuing the American Dream while experiencing all of the vulnerabilities that come from escaping economic adversity while becoming one of the most reviled and manipulated symbols within America’s troubling debate over who belongs here and who does not.  According to The Urban Institute (a bipartisan think tank in DC) the demographics of immigration are changing and, one should consider, that if the players (or pawns) change so will the immigration policy debate.

If we are going to hear the voice of reason and stay true to America’s love for:

 “Give me your tired, your poor,

Your huddled masses yearning to breathe free,

The wretched refuse of your teeming shore.

Send these, the homeless, tempest-tost to me,

I lift my lamp beside the golden door!”

… then we better get busy understanding and participating in the current decision to lock unauthorized immigrants from the benefits of our healthcare system.  Important and “here to stay” segments of this large group (perhaps as many as 11 million) will continue to show up in emergency rooms and make important demands on local public health infrastructures.

What may seem prudent in today’s austere and sluggish economy may prove a pound foolish in the not too distant future…

“Today’s unauthorized immigrants are older, better educated, more geographically dispersed, have more diverse country-of-origin backgrounds, and have spent more time in the United States than unauthorized immigrants who legalized under the Immigration Reform and Control Act of 1986 (IRCA). Nevertheless, the wage gap between unauthorized immigrants and native-born workers is wider today than it was in 1986. Policymakers must keep such differences in mind when using IRCA to anticipate the impacts of legalization programs today and making decisions about how to implement such programs.”

via A Comparison of Today’s Unauthorized Immigrants and the IRCA Legalized: Implications for Immigration Reform.

Filed under: ACA and Medicaid, Behavioral Health Outcomes, Blogosphere, Children and Poverty, Civic Engagement, consumers, Data Trends - American Demographics and Public Opinion, Demographic Change, Health Literacy, Health Policy, Healthcare Reform, Immigration, Maternal and Child Health, Medicaid, Medicaid Expansion, News, Philanthropy

Getting into Gear for 2014: Insights from Three States Leading the Way in Preparing for Outreach and Enrollment in the Affordable Care Act | The Henry J. Kaiser Family Foundation

Policy ThinkShop Resources to help you stay on top of today’s leading policy issues:  Healthcare Reform implementation — The Affordable Care Act

http://kaiserfamilyfoundation.files.wordpress.com/2013/09/8480-getting-into-gear-insights-from-three-states.pdf

 

“Fall 2013 will begin to usher in the key health insurance coverage expansions of the Affordable Care Act (ACA), with open enrollment in new health insurance Marketplaces beginning on October 1, 2013, and Medicaid expanding to adults in states moving forward with the ACA Medicaid expansion as of January 1, 2014. During summer 2013, with open enrollment rapidly approaching, many states were in high gear to finalize preparations for outreach and enrollment efforts to help translate these new coverage options into increased coverage for millions of currently uninsured individuals. This report provides insight into preparations in Maryland, Nevada, and Oregon -three states that have established a State-based Marketplace, are moving forward with the Medicaid expansion, and are among the states leading the way in preparing for outreach and enrollment. The findings provide an overview of where these three states are in establishing their Marketplaces; preparing for the Medicaid expansion; planning for marketing, outreach and enrollment; and establishing enrollment assistance resources. They also highlight the challenges that states have encountered and overcome, the successes they have achieved, and the key lessons that may help inform implementation efforts moving forward.”via Getting into Gear for 2014: Insights from Three States Leading the Way in Preparing for Outreach and Enrollment in the Affordable Care Act | The Henry J. Kaiser Family Foundation.

Filed under: ACA and Medicaid, Blogosphere, Children and Poverty, consumers, Health Literacy, Health Policy, Healthcare Reform, Maternal and Child Health, Medicaid, Medicaid Expansion, News, Public Health, Public Policy

A simple list to keep you on top of the current healthcare battle: A Very Quick Guide To Health Insurance Exchanges – Kaiser Health News

You are a leader…   Whether it is for your family, your organization or your company, you need to have a handle on healthcare reform.

The following is a quick guide you can use and share with others in your efforts to stay “intelligent” on the often confusing and misinformed healthcare debate vs. what the law now being implemented really is…

The Kaiser Foundation has some of the most current and accurate information available on this important subject.

Here is a quick guide to what you need to know about them:

1.

The insurance marketplaces are open to nearly everyone, but If you have insurance through work, Medicare or Medicaid, it’s likely you won’t need to shop for coverage there. They are really for people who are uninsured or folks who buy individual policies now.

2.

Many people will qualify for subsidies to make coverage more affordable there. These subsidies – tax credits to help pay your premiums – will be available to people with incomes up to 400 percent of the federal poverty level. That\’s about $46,000 for one person or $94,000 for a family of four. And there are cost-sharing subsidies to reduce deductibles and copayments, depending on your income.

3.

Immigrants who are in this country illegally are barred from buying on the exchanges.

4.

You can enroll until March 31, 2014, though you\’ll generally need to sign up by Dec. 15 of this year, to be covered as of Jan. 1. You can find your state’s marketplace at healthcare.gov.

5.

Through the marketplace, you can compare health plans in your area. The prices are based on where you live, your family size, the type of plan you select, your age and whether you smoke. All the plans have to comply with the Affordable Care Act’s requirement to have a basic benefits package, but the amount you have to pay in premiums, co-pays and deductibles will vary among plans.

6.

When you apply for coverage on the exchange, you will find out if you’re eligible for subsidies to help pay for premiums. Or, if you have a low income, you can also learn if you are eligible for Medicaid coverage.

7.

Your income — not your assets, such as your house, stocks or retirement accounts – will count toward determining whether you can get tax credits. When you buy your plan, you estimate your income for next year, and your tax credit is based on that estimate. The next year, your tax returns will be checked by the IRS and compared against your estimate.

8.

If you qualify for a tax credit to pay your premiums, you can choose to either have the credit sent directly to the insurer or pay the whole premium up front and claim the credit on your taxes. If you qualify for cost-sharing subsidies, that subsidy will be sent directly to the insurer, and you won’t have to pay as much out of pocket.

9.

If your income increases during the year, notify the exchange promptly so that you can avoid having to pay back the credits. On the other hand, if your income goes down, you could be eligible for a bigger subsidy. Either way it\’s important to notify the exchange if your income changes.

10.

Each plan covers 10 “essential health benefits,” which include prescription drugs, emergency and hospital care, doctor visits, maternity and mental health services, rehabilitation and lab services, among others. In addition, recommended preventive services, such as mammograms, must be covered without any out-of-pocket costs to you.

11.

You won’t have to pay more for insurance if you have a medical condition and that condition will be covered when your policy begins. But older people can be charged more than younger people and smokers could face a surcharge.

12.

The prices for the marketplace plans are likely to be similar to those sold privately. If your broker offers you a plan that is also available on the exchange, you may be eligible for subsidies.

13.

Your insurer generally can\’t drop you, as long as you keep up with your insurance premiums and don\’t lie on your application. Generally, people will be able to enroll in or change plans once a year during the annual open enrollment period. This first year, open enrollment on the exchanges will run for six months, from Oct. 1 through March of next year. But in subsequent years the time period will be shorter, running from October 15 to December 7.

14.

There are certain circumstances when you would be able to change plans or add or drop someone from coverage outside the regular annual enrollment period. This could happen if you lose your job, for example, or get married, divorced or have a child.

15.

The number of plans that you can choose from is likely to vary widely. In some states, only a couple of insurers have announced plans to offer policies though the marketplace, while in others there may be a dozen or more. Even within a state, there will be differences in the number of plans available in different areas. You can expect that insurers will offer a variety of types of plans, including familiar models like PPOs and HMOs.

via A Very Quick Guide To Health Insurance Exchanges – Kaiser Health News.

Filed under: Blogosphere, Health Literacy, Health Policy, Healthcare Reform, Maternal and Child Health, Medicaid, Medicaid Expansion, News, Public Health, Public Policy

The Policy ThinkShop Policy Team Comments on Health insurance: The Obamacare software mess | The Economist

Given today’s liberalization of news information, few bastions remain where one can sift through the cacophony of media bites and babble to form an educated

opinion or assess an educated risk. The Economist is failing in this regard on the American debate on healthcare reform–The Affordable Care Act.

Healthcare reform in America is a struggle for power and wealth at the increasingly small American top and a life and death struggle for most of the people below.

If we loose respected journals like the Economist in these times of mass information as intellectual fodder for the masses, we will be left without an intellectual meeting place where concerned minds can gather to contemplate benchmarks and directions. Regarding The Affordable Care Act debate in America, not only has the current president failed to sell and communicate the important of ACA implementation, he has once again betrayed the needs of the many for the expedient and self serving calculus of preserving power and status by appealing to an imaginary center–not too different here from the pragmatic Bill Clinton on Welfare Reform. But we digress.

The Economist has been a reliable source for decades as it has proven to be an \”objective\” source of information on the complex world stage. It\’s recent coverage of the American scene, however, requires vision and focus if it is going to support the journal\’s reputation as one of the few sources that our college professors respected that were not refereed journals.

The headline of the above story, \”The Obamacare sofware mess,\” is as semantically charged as it is irrelevant to any of the public policy issues raised by a serious American healthcare market debate addressing the important issue of how healthcare is distributed, facilitated or accessed by people in need of healthcare services.

Semantics: The term \”Obamacare\” plays directly into the divisive and charged narrative that portrays the healthcare debate in America as a tug of war between an \”evil and un-American\” president and American freedom. The framing of the current full court press, by conservatives, to obstruct the American president, at all at all costs, and the popular will of a democracy, is akin to saying that Churchill failed to stop Hitler sooner or to foresee the costs of settling with Stalin because of his neonatally determined speech impediment. It is academically irresponsible and intellectually dishonest, at least on the pages of this fine journal, to stain this usually intellectually rigorous space with narratives that are more appropriate in pop news sources that entertain people who are looking to reinforce their own deeply held biases and/or myopic political world views.

The Economics has been a leading world source of factual information relevant to the business of serious policy discourse and sober business leadership.

The foregoing comments are submitted on behalf of the Policy ThinkShop blogging team.

https://policyabcs.wordpress.com

As a not for profit, non partisan source of policy analysis and conversation, we rely heavily on sources like the Economist to promote reason and thoughtful

conversation on all things public policy….

Please reconsider your use of the American public policy discourse and reflect on your use of language to add to and further support our current cacophony of obstructionism and self promoting pragmatism in the pursuit of popular power and further public policy noise…

Regards,

The Policy ThinkShop Policy Team

via Comments on Health insurance: The Obamacare software mess | The Economist.

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How to reduce health inequities? | LinkedIn

One of our Policy ThinkShop bloggers posting on other social media regarding poverty policy, or the lack there of, in our country ….

Thanks for the report updating the latest ideas on our ongoing discourse on poverty and for getting us to think about the important connections between education, poverty and health.

The report rehashes, mostly academic, arguments regarding race, statistics, the infamous 1969 poverty measure and the poverty measure’s successive fabrications. I was in graduate school at the University of Chicago in the mid 80s when William J. Wilson led a “one man band” against the Reagan Administration’s and Charles Murray’s assault on “the welfare state, the welfare mother, and so on…”

I sat in Prof. Gary Orfield’s office one day while he fielded a call from the then Ronald Reagan stacked Civil Rights Commission which Prof. Orfield was a member of. It was a turning point for me in how I would henceforth see the role that well-meaning advocates play in our government’s institutions. After nearly four decades experiencing health and human services policy and planning in our nation’s state and local systems, that lesson still holds—facts are not enough, we must do. The problem becomes who is the “we”?

MOre via How to reduce health inequities? | LinkedIn.

Filed under: Blogosphere, Children and Poverty, Culture Think, Education Policy, Family Policy, Feminization of Poverty, Health Policy, Maternal and Child Health, Medicaid, Medicaid Expansion, News, Philanthropy

Spanish is the most spoken non-English language in U.S. homes, even among non-Hispanics | Pew Research Center

Do you speak Spanish?  America, like the rest of the “Americas,” speaks Spanish quite fluently, prevalently and often.  Despite the illusion that North America is monolingual and that being monolingual is somehow more “American,” the truth is that America has been multilingual for hundreds of years prior to the landing of the Niña, the Pinta, and the Santa Maria, followed by May and Flower–the Mayflower, that is, much later.

The original experience of  the inhabitants of the Southwest, for example, included migration patterns by the native peoples of Central America across the Rio Grande and all the way up into the Dakotas and back.  For over a thousand years, the natives of what much later became North America spoke numerous languages and roamed what would become America.  The first settlement at St. Augustine, you could say, established the continent’s first European language–Español.

St. Augustine was founded forty-two years before the English colony at Jamestown, Virginia, and fifty-five years before the Pilgrims landed on Plymouth Rock in Massachusetts – making it the oldest permanent European settlement on the North American continent.

Today, America’s strong and vibrant Spanish heritage is prospering as many of us feel right at home speaking the original colonial language.  According to the Pew Foundation,

“A record 37.6 million persons ages 5 years and older speak Spanish at home, according to an analysis of the 2011 American Community Survey by the Pew Research Center.

Spanish is, by far, the most spoken non-English language in the U.S. The next most spoken non-English languages are Chinese (with 2.8 million speakers), Hindi, Urdu or other Indic languages (2.2 million), French or French Creole (2.1 million), and Tagalog (1.7 million).

The number of Spanish speakers in the U.S. has grown rapidly in recent decades, reflecting the arrival of new immigrants from Latin America and growth in the nation’s Hispanic population. Today 34.8 million Hispanics ages 5 and older speak Spanish at home.

However, not all Spanish speakers are Hispanic. According to our analysis, some 2.8 million non-Hispanics speak Spanish at home today. That places Spanish at the top of the list of non-English languages spoken by non-Hispanics along with Chinese and ahead of all other languages.

(The U.S. Census Bureau measure of non-English language use captures how many people say a language other than English is spoken in the home but does not capture how well or how often the language is spoken).

Who are the 2.8 million non-Hispanics who speak Spanish at home? Some 59% trace their ancestry to non-Spanish European countries such as Germany, Ireland, England and Italy. An additional 12% say they are of African American descent. Nonetheless, about one-in-five (18%) non-Hispanic Spanish speakers trace their heritage to a Spanish-speaking country. By comparison, among the non-Hispanic U.S. population ages 5 and older, about two-thirds (64%) trace their ancestry to non-Spanish European countries, 13% say their ancestry is African American and 1% trace their heritage to a Spanish-speaking country.

Nine-in-ten (89%) of non-Hispanic Spanish speakers were born in the U.S., a share similar to that for all non-Hispanics ages 5 and older (91%).

The racial composition of non-Hispanic Spanish speakers mirrors that of the U.S. non-Hispanic population. Overall, three-quarters (77%) of non-Hispanics who speak Spanish at home are white, 14% are black, and 9% say they belong to some other racial group. Among the non-Hispanic U.S. population ages five years and older, 76% are white, 14% are black, and 9% are some other race.

Many non-Hispanic Spanish speakers reside in a household where at least one other member is Hispanic. Overall, 26% of non-Hispanic Spanish speakers live in these types of households. By comparison, just 3% of all non-Hispanics ages 5 and older live in such households.

Three-in-ten (28%) non-Hispanics Spanish speakers who are married live with a Hispanic spouse. By comparison, only 2% of non-Hispanics are living with a Hispanic spouse.

When it comes to English proficiency, eight-in-ten (80%) non-Hispanics who speak Spanish at home say they speak English “very well”, 11% say they speak English “well”, and 9% say they speak English “not well” or do not speak English.  This compares with 96% of all non-Hispanics 5 years and older who speak English only or speak it “very well”, 2% who speak English “well”, and 2% who speak English “not well” or do not speak English.”

via Spanish is the most spoken non-English language in U.S. homes, even among non-Hispanics | Pew Research Center.

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In U.S., Less Than Half Look at Restaurant Nutrition Facts | Gallup Poll

The Policy ThinkShop is expanding its policy analysis and research resources in response to the current  healthcare reform challenges faced by the states and communities.  We will be posting periodic articles and resources addressing the numerous variables that define the nation’s current healthcare challenges which go well beyond putting a health insurance card in a person’s hand.

Visit our health policy and research blog at:

http://healththinkshop.com

for more health specific resources and to share with us which areas of health you want us to address for your daily health administration, policy and planning needs.

The restaurant industry can be seen as fitting into a continuum.  At one extreme are the restaurants that focus on providing easy to make menus, easy to store foods, easy to please customers.  By easy to please we might mean people who are looking for the basic satisfying elements producing the classic “addictive” flavors from sweets, salts and fatty foods.  At the other extreme, difficult to call it “extreme” since it is probably the more reasonable in terms of healthy lifestyle, there is the fresh vegetables, fish and light fowl, moderately portioned cuisine  served in prestigious and select culinary establishments for the educated palate.  Home cooking has historical and culturally embedded positive meaning in our culture but truth be told most home cooking is not very healthy either…  In this case, it probably goes outside our initial restaurant continuum because cooking at home requires skill, time and appropriate ingredients.  Of course, in the available ingredients we find the most difficult challenge.  Keeping fresh vegetables, fish and fowl on hand is to often cumbersome and expensive.  Although budget is often the decisive factor here, time, a more universally unavailable commodity, is often the thing that makes or breaks home cooking.

Aside from the mechanics, logistics and administrative aspects of culinary efficacy there is, perhaps equally decisive as time, health literacy.   That is, knowledge of the relationship between food and health.  That is not the only aspect of health literacy but it just as well aught to be.  According to the Gallop Poll, knowledge about what we eat is woefully missing in the American culinary mind.

The Policy ThinkShop is expanding its policy analysis and research resources in response to the current  healthcare reform challenges faced by the states and communities.  We will be posting periodic articles and resources addressing the numerous variables that define the nation’s current healthcare challenges which go well beyond putting a health insurance card in a person’s hand.

Visit our health policy and research blog at:

http://healththinkshop.com

for more health specific resources and to share with us which areas of health you want us to address for your daily health administration, policy and planning needs.

“Even as more U.S. restaurants list nutritional information on their menus, less than half of Americans, 43%, say they pay a “great deal” or a “fair amount” of attention to it. Americans are much more likely to take note of nutritional labels on food packages, with 68% saying they pay at least a fair amount of attention to this …”

via In U.S., Less Than Half Look at Restaurant Nutrition Facts.

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Key Considerations in Evaluating the ACA Medicaid Expansion for States According to The Henry J. Kaiser Family Foundation… The Policy ThinkShop Cautions …

The Kaiser Family Foundation policy research on medicaid expansion and the implementation of the current healthcare reform is very optimistic and useful.  However, it would be prudent to look at the local healthcare infrastructure’s ability to both create (healthcare outreach) and meet the new demand for the coverage that the healthcare act promises.  Indeed, a decade of the most draconian recession in recent history has not helped the public health sector to recruit and diversify its workforce in order to be ready to take on the potential numbers of Latinos, for example, who would benefit disproportionately from the new access as they are over represented in the labor and business sectors that currently provide jobs without health benefits.  According to the Kaiser Family Foundation, the healthcare reform picture is quite rosy, but for Latinos healthcare reform may not be quite the rose garden envisioned by current mainstream health policy pundits.  The Policy ThinkShop

According to the Kaiser Foundation:

“A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges.  Following the June 2012 Supreme Court decision, states face a decision about whether to adopt the Medicaid expansion. These decisions will have substantial consequences for health coverage for the low-income population. The 3 key questions that states should consider in evaluating the ACA Medicaid expansion are:

1. What are the fiscal implications of the ACA Medicaid expansion for states?

Overall, many states are likely to see net savings from the Medicaid expansion.

The Medicaid expansion also may have positive economic effects for states like increased jobs, revenues or economic activity.

Studies show that the Medicaid expansion could increase revenues to hospitals, offsetting hospital reimbursement reductions that were also included in the ACA.

Some states are concerned about federal deficit reduction efforts and the implications for Medicaid; however, the FMAP formula that determines the federal share of Medicaid spending has remained steady since the start of the program.  Congress has only amended the formula to provide more federal funding, not less.

2. What effect will the Medicaid expansion have on coverage?

The Medicaid expansion would make health care coverage available to millions of low-income adults and significantly reduce the number of uninsured.

A large body of research shows that Medicaid increases access to care and limits out-of-pocket burdens for low-income people.  Despite claims to the contrary, research points to improved outcomes and reduced mortality from Medicaid coverage.

Actions to address workforce challenges and low provider participation in Medicaid will be important to improve access with the Medicaid expansion.

For most states that do not implement the ACA Medicaid expansion, there will be large gaps in coverage for low-income individuals because individuals with incomes below poverty are not able to access subsidies to purchase coverage in in the new health insurance exchanges.

3. What flexibilities do states have in implementing the Medicaid expansion?

States have considerable flexibility to administer traditional Medicaid programs.

Under the ACA Medicaid expansion, states have flexibility around benefits, cost sharing as well as how to deliver and pay for care.

Proposals are emerging that would allow states to purchase exchange coverage for Medicaid expansion enrollees through premium assistance options.

States also continue to have ability to seek approval for demonstration waivers.  Beginning in 2017, 1115 waivers may be combined with State Innovation Waivers.”

MORE via Quick Take: Key Considerations in Evaluating the ACA Medicaid Expansion for States | The Henry J. Kaiser Family Foundation.

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