Access to Care

Understanding the Impact of Medicaid Premiums & Cost-Sharing: Updated Evidence from the Literature and Section 1115 Waivers

Our review of recent literature on premiums and cost-sharing is based on studies and reports published between 2017 and 2021. Our analysis of premiums in post-Affordable Care Act (ACA) Section 1115 waivers (approved under the Obama and Trump administrations) is based on available interim and final waiver evaluations as well as annual and quarterly state …

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Drug Overdose Deaths Rose During the COVID-19 Pandemic, Particularly Among Black and American Indian/Alaska Native People

Drug overdose deaths rose during the early part of the COVID-19 pandemic, with some of the biggest jumps occurring among people of color, a new KFF analysis finds. The analysis breaks out drug overdose deaths by race and ethnicity for the first nine months of 2020, when the pandemic triggered widespread shutdowns and job losses,…More

Substance Use Issues Are Worsening Alongside Access to Care

Drug overdose deaths rose during the early part of the COVID-19 pandemic, with some of the biggest jumps occurring among people of color. This analysis breaks out drug overdose deaths by race and ethnicity for the first nine months of 2020, to the same period in each of the two prior years. It also looks …

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Medicaid Authorities and Options to Address Social Determinants of Health (SDOH)

Extensive research and the pandemic have elevated the importance of addressing social determinants of health (SDOH) to improve health and reduce longstanding disparities in health and health care. Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. This …

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Health and Health Care Experiences of Hispanic Adults

The COVID-19 pandemic has exposed and exacerbated longstanding underlying disparities in health and health care facing Hispanic people. Using data from the COVID-19 Vaccine Monitor, this report provides insights into the health care experiences of Hispanic adults and examines how they vary by key factors, including insurance and immigration status.

Are Health Centers Facilitating Equitable Access to COVID-19 Vaccinations? A June 2021 Update.

This analysis updates earlier work and examines the extent to which vaccination efforts through community health centers are reaching people of color using data from the federal government’s weekly Health Center COVID-19 Survey. We include data from the survey weeks of January 8 through May 21, 2021, finding that people of color made up the …

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The Pandemic’s Impact on Children’s Mental Health

The pandemic has taken a heavy toll on the nation’s mental health, and a new issue brief shows that children are also facing worsening emotional and cognitive health. The brief examines factors contributing to worsening mental health and substance use outcomes among children and adolescents during the pandemic, looking closely at those who are at…More

More Than 1 in 4 Medicare Beneficiaries Had a Telehealth Visit Between the Summer and Fall of 2020

As the coronavirus pandemic kept people home last year, just over 1 in 4 Medicare beneficiaries had a telehealth visit with a doctor or other health professional between the summer and fall of 2020, a new KFF analysis finds. Once limited to beneficiaries living in rural areas, coverage of telehealth services by traditional Medicare has…More

Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future

This brief provides an overview of changes in coverage of telehealth under traditional Medicare before the coronavirus pandemic, and estimates changes in use of telehealth services using survey data from the Medicare Current Beneficiary Survey (MCBS) during the pandemic. The analysis also discusses issues and questions related to extending telehealth coverage under traditional Medicare beyond …

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The Pandemic Has Exacerbated Long-Standing Health Care Challenges Faced By Puerto Rico and Other U.S. Territories as the End of Temporary Federal Medicaid Funding Approaches

A new KFF analysis examines how the coronavirus pandemic is affecting U.S. territories as well as issues related to the upcoming expiration of temporary Medicaid funding for the territories at the end of September. Prior to the pandemic, the U.S territories –– American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico,…More

Challenges in the U.S. Territories: COVID-19 and the Medicaid Financing Cliff

More than a year into the public health emergency, the COVID-19 pandemic continues to impact the lives of Americans including those living in the U.S. territories. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health systems challenges for the territories. While additional federal funds have been …

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Medicare-Covered Older Adults Are Satisfied with Their Coverage, Have Similar Access to Care as Privately-Insured Adults Ages 50 to 64, And Fewer Report Cost-Related Problems

This brief analyzes current experiences of Medicare beneficiaries ages 65 and older with respect to satisfaction and access measures and examines whether privately-insured adults ages 50 to 64 report access or cost problems at higher or lower rates than Medicare beneficiaries 65 and older.

How Employer Actions Could Facilitate Equity in COVID-19 Vaccinations

Providing paid time off to employees to get and recover from any side effects could help boost vaccination rates. Overall, nearly three in ten (28%) employed adults who not yet ready to get the vaccine say that they would be more likely to get the COVID-19 vaccine if their employer gave them paid time off …

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Disparities in Health and Health Care: 5 Key Questions and Answers

Disparities in health and health care for people of color and underserved groups are longstanding challenges. The COVID-19 pandemic has exacerbated these disparities and heightened the importance of addressing them. Health disparities are driven by underlying social and economic inequities that are rooted in racism. Addressing disparities is important not only from a social justice …

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New Analysis Summarizes Recent Research on the Effects of ACA Medicaid Expansion, Providing Context for Renewed Expansion Debates in States

New federal financial incentives for Medicaid expansion and the increased reliance on Medicaid as a coverage safety net during the pandemic have renewed debate in the 12 states that have not adopted the Medicaid expansion under the Affordable Care Act. A new KFF literature review provides context for these expansion debates by summarizing evidence from…More

Women’s Health Care Utilization and Costs: Findings from the 2020 KFF Women’s Health Survey

This brief presents findings from the 2020 KFF Women’s Health Survey on women’s use of health care services, costs, and experiences accessing health care. The 2020 survey is a nationally representative survey of 3,661 women ages 18 to 64, conducted between November 19 and December 17, 2020.

Are Health Centers Facilitating Equitable Access to COVID-19 Vaccinations? An April 2021 Update.

This analysis updates earlier work and examines the extent to which vaccination efforts through community health centers are reaching people of color using data from the federal government’s weekly Health Center COVID-19 Survey. We include data from the survey weeks of January 8 through April 2, 2021, finding that people of color made up the …

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Early COVID-19 Vaccination Efforts Through Community Health Centers Are Reaching People of Color

More than half of those who received their first dose of a COVID-19 vaccine through a community health center were people of color, suggesting that health centers appear to be doing a better job of reaching people of color than are overall vaccination efforts, finds a new KFF analysis. People of color accounted for 54 percent…More

Are Health Centers Facilitating Equitable Access to COVID-19 Vaccinations?

This analysis examines the extent to which early vaccination efforts through community health centers are reaching people of color using data from the federal government’s weekly Health Center COVID-19 Survey. Additionally, this analysis may shed light on the Biden administration’s recent partnership with health centers to advance equitable access to COVID-19 vaccinations by directly supplying …

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How are States Addressing Racial Equity in COVID-19 Vaccine Efforts?

This brief reviews information available through state websites and publicly available vaccine distribution plans to provide greater insight into how states are addressing equity through vaccine allocation and distribution strategies, outreach and communications efforts, and data collection and reporting. It provides a snapshot and examples of state efforts in these areas.

The Hyde Amendment and Coverage for Abortion Services

This brief details the federal programs that are affected by the Hyde Amendment and laws and regulations that have a similar goal, provides estimates on the share of women insured by Medicaid affected by the law, reviews the impact of the law on their access to abortion services, and discusses the potential effect if the …

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Growing Gaps in COVID-19 Vaccinations among Hispanic People

This policy watch piece highlights the potential challenges surrounding COVID-19 vaccinations among Hispanic people, whose health and finances have been extremely hard hit by the pandemic. Low rates of vaccination among Hispanic people would leave them at increased risk for the virus, could further widen existing health disparities, and would leave gaps that hinder our …

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How the COVID-19 Pandemic is Affecting People’s Mental Health and Substance Use

Throughout the COVID-19 pandemic and resulting economic crisis, about 4 in 10 adults nationwide have reported symptoms of anxiety or depressive disorder – a four-fold increase from pre-pandemic levels. Drawing on the latest national survey data, KFF polling and other research, an updated brief explores what’s known about the pandemic’s impact on people’s mental health…More

New Resources Track State Vaccinations by Race/Ethnicity and Examine Demographics of Health Workers

A new Policy Watch, Early State Vaccination Data Raise Warning Flags for Racial Equity, explores the latest state-reported data on vaccination by race/ethnicity available on KFF’s COVID-19 state data and policy tracker. As of January 19, 2021, 17 states were reporting some vaccination data by race/ethnicity, including 16 states reporting the distribution of vaccinations by…More

Community Health Centers’ Role in Delivering Care to the Nation’s Underserved Populations During the Coronavirus Pandemic

In the midst of the coronavirus pandemic, community health centers are serving as public health responders, especially for medically underserved populations. Health centers are a national network of safety net primary care providers who provided care to nearly 30 million patients in 2019, and disproportionately serve patients who are low-income, persons of color, uninsured, or …

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Analysis of Federal Bills to Strengthen Maternal Health Care

The bills in this table address a number of related maternity care issues, including extending Medicaid postpartum coverage from 60 days to one year, funding for clinical training on health equity and implicit bias, developing broader networks of maternity care providers in rural areas, and research on the potential benefits of Medicaid coverage for doula …

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State COVID-19 Data and Policy Actions

Explore state-level data on a variety of COVID-19 metrics, including the latest hotspots, cases and deaths by race and ethnicity and at long-term care facilities. Find up-to-date information on state policy actions on social distancing measures and reducing barriers to COVID-19 testing and treatment.

How Might Internet Connectivity Affect Health Care Access?

A new chart collection looks at how internet access may affect health care in the U.S., as more providers turn to telemedicine during the pandemic. An estimated 25 million Americans – about 8% of the population – lack access to internet at home. Hispanic and Black Americans, seniors, rural residents, and those living in poverty…More

CMS’s 2020 Final Medicaid Managed Care Rule: A Summary of Major Changes

On November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to the Medicaid managed care regulations which were proposed in November 2018. CMS previously finalized a major revision to these regulations in 2016. The November 2020 final rule is not a wholesale revision of the 2016 regulations but adopts changes in …

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CMS’s 2020 Final Medicaid Managed Care Rule: A Summary of Major Changes

On November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to the Medicaid managed care regulations which were proposed in November 2018. CMS previously finalized a major revision to these regulations in 2016. The November 2020 final rule is not a wholesale revision of the 2016 regulations but adopts changes in …

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Election 2020: State Health Care Snapshots

Health care is a top issue for voters in the 2020 election. To understand the health care landscape in which the 2020 election policy debates will unfold, these state health care snapshots provide data across a variety of health policy subjects, including health care costs, health coverage—Medicaid, Medicare, private insurance—and the uninsured, women’s health, health …

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State Data and Policy Actions to Address Coronavirus

Every state and Washington D.C. have eased or lifted at least one social distancing requirement — including 32 states that have eased or lifted stay-at-home orders. From May 21 to May 28, restaurants reopened to dine-in service in 4 more states, and 4 more states eased or lifted their gatherings ban. Between May 28 to …

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