Problems with private long-term care insurance: nurses can help protect consumers

Nurses are in an excellent position to provide unbiased information to consumers about long-term care insurance. Many policies have serious shortcomings. Support from nurses could help ensure better legislative regulation of the long-term care insurance field.

Including the poor: the fiscal impacts of Medicaid expansion

This article presents the fiscal impacts of the comprehensive reform of the Medicaid program put forth by the Health Policy Agenda for the American People. Proposed reforms include establishment of improved uniform eligibility standards, improvement in the scope and depth of coverage in state Medicaid programs, and increased provider payment rates. We estimate that expanding Medicaid coverage to all currently uninsured nonelderly persons below the federal poverty line would cost approximately $9 billion. A substantial portion of these costs would offset current spending elsewhere in the health care system. Improvement of state packages and increased provider payment could result in sharp increases in costs. We provide a range of estimates considering both the set of benefits provided and the behavior of the private insurance market.

Utilization and coverage of mental health services in health maintenance organizations

Health maintenance organizations (HMOs) generally have very limited coverage of mental health care and have been charged with shortchanging chronic patients in the interests of economy. The authors analyzed 1979-1980 coverage and utilization data from 53 federally qualified HMOs. They found that while coverage is limited and very similar across the spectrum of HMOs, utilization rates vary greatly and do not correlate with extent of coverage. They suggest that management decisions may be critical in determining access to and use of mental health benefits in HMOs.