Urban Institute: Health/Healthcare
Urban Institute reports on: Health/Healthcare - The Urban Institute is a nonprofit nonpartisan policy research and educational organization established to examine the social, economic, and governance problems facing the nation.

• In Pursuit of Assistance, Children with Disabilities Face Complex, Fragmented Service System
  Seldom do the needs of children with disabilities divide neatly along program lines. Instead, children and their families navigate a large, complex, and fragmented array of programs with inconsistent eligibility standards, application procedures, and program goals. "Meeting the Needs of Children with Disabilities" examines these programs, focusing on the three largestspecial education, Medicaid, and Supplemental Security Incomeand suggests ways to unify them into one system that will provide continuous care and support. Efforts at early intervention and prevention and difficulties caused by programs' funding structures are given particular attention.
• Who Has Insurance and Who Does Not in the District of Columbia?
  DC fares better than the nation as a whole in the share of its population that is uninsured. Lower rates of employer-sponsored coverage are more than offset by higher rates of public coverage. The District's relatively generous Medicaid eligibility standards, and the DC HealthCare Alliance, a locally funded coverage program, contribute to the high share of publicly insured residents. Although all low-income individuals are eligible for either Medicaid or the Alliance, some 66,000 residents remain uninsured. These are among the findings of this data brief on insurance status in DC by age, employment, income, family status, and health status.
• The Experiences of SCHIP Enrollees and Disenrollees in 10 States : Findings from the Congressionally Mandated SCHIP Evaluation
  Congress mandated in the Balanced Budget Refinement Act of 1999 (BBRA) that the Secretary of the U.S. Department of Health and Human Services conduct an independent comprehensive study of the State Children's Health Insurance Program (SCHIP). This report presents the findings from the mandated surveys of SCHIP enrollees and disenrollees in 10 states (conducted during 2002). SCHIP programs were found to provide health coverage to the population SCHIP was intended to serve, primarily children who would otherwise have been uninsured. The programs availed enrollees of needed primary and other health care services, and were found to have a positive impact on enrollees' access to health care services, leaving enrollees with fewer unmet needs than they would have had in the absence of SCHIP. Families were satisfied with the ease of enrolling children, many of whom remained enrolled for 12 months, depending on the state.
• Housing in the Nation's Capital 2007
  This is the sixth in a series of annual reports about housing in the Washington metropolitan region. It assembles and analyzes the most current data on housing conditions and trends in the District of Columbia and the surrounding suburbs. Last year's report focused on linkages between housing and schools in the District of Columbia and the metropolitan region. This year's report takes a regional perspective, examining how the region addresses housing for special needs populations. More specifically, the report assesses the housing options and services available to the elderly, disabled, and homeless and explores the consequences and opportunities for housing policy across the region.
• High Prices and Demographic Shifts Will Test Metro D.C.'s Ability to House Residents with Special Needs
  Despite the recent housing market slowdown, home prices and rents remain out of reach for many Washington-area residents, especially those with physical and mental disabilities, elderly people who can no longer live independently, and the homeless, a new study by the Urban Institute concludes.
• Can California's Proposed Coverage Reform Be a Model for the District of Columbia?
  The ongoing debate in California over two competing 2007 proposals for universal health coverage highlights both the strengths and weaknesses of the current insurance system in the District of Columbia as a platform for coverage expansion. The District's advantages include its relatively small uninsured population and existing mechanisms for administering a public coverage program tied to income. But its fiscal base is relatively small compared with California's, its largely unregulated insurance market could lead to severe adverse selection problems for new programs, and it is at much greater risk for border-crossing by both individuals and businesses in response to reform.
• Are Children Accessing and Using Needed Mental Health Care Services?
  This brief presents data on mental health coverage benefits and enrollees' access to and use of mental health services through the Healthy Kids program in San Mateo County, California. The prevalence of mental health conditions among enrollees is similar to national levels, but despite the generous mental health benefits offered under the program, only a small fraction of enrollees with mental health conditions receive care. Reasons why more children do not use mental health services are explored. The brief also shows that enrollees with mental health needs have higher use of other health services compared to all Healthy Kids members.
• Three Independent Evaluations of Healthy Kids Programs Find Dramatic Gains in Well-Being of Children and Families
  This brief presents highlights from rigorous, independent evaluations of the Healthy Kids programs in three California counties, Los Angeles, San Mateo, and Santa Clara. The three Healthy Kids programs provide children with comprehensive health insurance coverage. Children are eligible for Healthy Kids if they are ineligible for California's two major state insurance programs, Medi-Cal and Healthy Families, and live in families with incomes up to 300 percent of the federal poverty level (FPL) in Los Angeles and Santa Clara counties, and 400 percent of the FPL in San Mateo County. This brief describes some of the many positive impacts that Healthy Kids programs have had on children, including improvements in their access to and use of medical services and reductions in their unmet need for care.
• Quality of Early Childhood Health Care in the Los Angeles Healthy Kids Program
  The Los Angeles Healthy Kids program was created in 2003 to provide health insurance to uninsured children ages 05 years in families with household income below 300 percent of the federal poverty level (FPL) who are ineligible for SCHIP or Medicaid. A quality of care survey sampled parents of 538 children ages 1272 months enrolled in the program for at least one year. Results show that quality of preventive care for children in Healthy Kids has similar patterns as care for children in low-income households, both in California and nationally. Content of preventive care is well below American Academy of Pediatrics (AAP) recommendations, although it is consistent with statewide and national levels of care.
• Why Health Insurance Is Important
  Having health insurance is important for several reasons. Uninsured people receive less medical care and less timely care, they have worse health outcomes, and lack of insurance is a fiscal burden for them and their families. Moreover, the benefits of expanding coverage outweigh the costs for added services. Safety-net care from hospitals and clinics improves access to care but does not fully substitute for health insurance. These findings are supported by much research, although some cautions are appropriate in using these results.
• Increasing Health Insurance Coverage of Workers in Small Firms: Challenges and Strategies : Testimony before the Finance Committee United States Senate
  Small employers face substantial disadvantages relative to large employers when providing health insurance to their workers. These problems can largely be summarized as higher administrative costs of insurance, limited ability to spread health care risk, and a workforce with lower wages. But the primary barrier to coverage for workers in small firms is being low-income; workers in small firms are more than twice as likely as those in large firms to have family income below 200 percent of the federal poverty level. Significant inroads into reducing the uninsured in this population will require income-related subsidization of insurance coverage.
• Can a Child Health Insurance Tax Credit Serve as an Effective Substitute for SCHIP Expansion?
  As the State Children's Health Insurance Program (SCHIP) has come up for reauthorization, the coverage of children with incomes above 200 percent of the federal poverty level (FPL) has become a contentious issue. Proposals have surfaced that would subsidizing the purchase of health insurance for childre