This report outlines the treatment of noncitizens (aliens) under H.R. 3200, America’s Affordable Health Choices Act of 2009. In particular, the report analyzes specific provisions in H.R. 3200, and whether there are eligibility requirements for noncitizens in the provisions. Within the bill, noncitizens are treated differently in several provisions. In 2008, there were approximately 37.3 million foreign-born persons in the United States. The foreign-born population was comprised of approximately 15.1 million naturalized U.S. citizens and 22.2 million noncitizens.
Congressional Research Service. Unauthorized Aliens’ Access to Federal Benefits: Policy and Issues. RL34500. August 20, 2009. [Full Text (pdf)]
Federal law bars aliens residing without authorization in the United States from most federal benefits; however, there is a widely held perception that many unauthorized aliens obtain such benefits. The degree to which unauthorized resident aliens should be accorded certain rights and privileges as a result of their residence in the United States, along with the duties owed by such aliens given their presence, remains the subject of intense debate in Congress. This report focuses on the policy and legislative debate surrounding unauthorized aliens’ access to federal benefits.
Researchers at the Pew Hispanic Center estimate that there were 11.9 million unauthorized immigrants living in the United States in March 2008. Jeffrey Passel’s calculations based on the 2008 March Current Population Survey (CPS) estimated that the number of persons living in families in which the head of the household or the spouse was an unauthorized alien was 16.6 million. There were 8.8 million unauthorized families, which he defines as a family unit or solo individual in which the head or spouse is unauthorized. A noteworthy portion of the households headed by unauthorized aliens are likely to have U.S. citizen children, as well as spouses who may be legal permanent residents (LPRs), and are referred to as “mixed status” families. The number of U.S. citizen children in “mixed status” families has grown from 2.7 million in 2003 to 4.0 million in 2008.
Passel estimates that one-in-three children who have a parent who is unauthorized is also considered poor according to the federal poverty rate. Policy researcher Steven Camarota concludes (based on his estimates drawn from the 2002 CPS) that the U.S. citizen children of unauthorized aliens account for much of the costs associated with illegal migration.
Jacob Hacker | Public Plan Choice in Congressional Health Plans: The Good, the Not-So-Good and the UglyAugust 29, 2009
J.S. Hacker. Public Plan Choice in Congressional Health Plans: The Good, the Not-So-Good and the Ugly. (Washington, DC: Institute for America’s Future, August 20 2009). [Full Text (pdf)]
This policy brief explores the various versions of public plan choice on the congressional agenda and shows how their best aspects can be combined to produce an effective public plan that will deliver on its promise—and why the cooperative “alternative” embraced by negotiators in the Senate Finance Committee does not merit consideration.
The Robert Wood Johnson Foundation’s Changes in Health Care Financing and Organization (HCFO) initiative has released a special topic solicitation to address the most critical questions related to the Medicare Part D prescription drug benefit. This solicitation features a batched application process. Therefore, all proposals submitted under the solicitation will be reviewed simultaneously and competitively. The deadline to submit to this solicitation is Tuesday September 8, 2009.
Please note, only the special topic solicitation will close on September 8th. The HCFO program will continue to accept proposals on a rolling basis.
The Agency for Healthcare Research and Quality (AHRQ), announces its continued interest in supporting conferences through its Large or Recurring Grant Program for Conference Support. AHRQ seeks to support conferences that help to further its mission to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. The types of conferences eligible for support include: 1) Research development – conferences where issues or challenges in the practice and delivery of health care are defined and a research agenda or strategy for studying them is developed; 2) Research design and methodology – conferences where methodological and technical issues of major importance to the field of health services research are addressed or new designs and methodologies are developed; 3) Dissemination and implementation – conferences where research findings and evidence-based information and tools are summarized, communicated and used by organizations and individuals that have the capability to use the information to improve the outcomes, quality, access to, and cost and utilization of health care services; and/or, 4) Research training, infrastructure and career development -conferences where faculty, trainees and students are brought together with stakeholders to develop, share or disseminate research products, experiences, curricula, syllabi, or training competencies. [Details]
Opening Date: November 12, 2009 (Earliest date an application may be submitted to Grants.gov)
Peer Review Date(s): Generally four months after receipt date
Earliest Anticipated Start Date(s): Generally four months after peer review date.
Mental health is critical to overall health and well-being. Serious mental illness, such as major depression and schizophrenia, is a leading cause of disability worldwide, yet only a small fraction of people in need of treatment have access to care in their communities. Many more are subject to neglect and abuse of their human and civil rights whether living on the streets or locked in an institution. One of the first steps to improving individual and community well-being is to break down the stigmas that have plagued the field for far too long. Success in mental health depends upon the contributions and commitment of the entire community and a willingness to break the mold.
Rethinking Mental Health: Improving Community Wellbeing, an online, open source competition co-sponsored by RWJF’s Vulnerable Populations Portfolio and Changemakers, challenges organizations to explore innovations that allow individuals, families, communities and society to move past narrow perceptions of mental health and expand our understanding and collective involvement in finding solutions.
To learn more about how RWJF and Changemakers have framed this issue, read the Welcome Letter from RWJF Team Director Jane Isaacs Lowe.
Deadline: October 14, 2009
The Robert Wood Johnson Foundation Health & Society Scholars program is designed to build the nation’s capacity for research, leadership and policy change to address the broad range of factors that affect health. The program is based on the principle that progress in the field of population health depends upon collaboration and exchange among the social, behavioral, biological and health sciences. Its goal is to improve health by training scholars to:
1. investigate rigorously the connections among genetic, behavioral, environmental, economic and social determinants of health; and
2. develop, evaluate and disseminate knowledge and interventions based upon integration of these determinants.
The program is intended to produce leaders who will change the questions asked, the methods employed to analyze problems and the range of solutions to reduce population health disparities and improve the health of all Americans..
Deadline: Oct. 2, 2009.
The official announcement and description of this opportunity may be found on the funding agency’s website.
Faced with the prospect of the first major national health reform initiative in 15 years, America’s airwaves are filled with increasingly raucous debates about the pros and cons of ideas being proposed in Washington and on editorial pages across the country.
A common theme is how the U.S. health care system stacks up when compared to the rest of the world and the impact that reform could have on it. Recent surveys show that the majority of Americans believe that despite spotty coverage, high costs and other problems, the U.S. health care system—and the quality of health care delivered—is the best in the world. But is it really?
An analysis from the Urban Institute looks at the evidence on how quality of care in the United States compares to that in other countries and provides implications for health reform. Authors Elizabeth Docteur and Robert Berenson find that international studies of health care quality do not in and of themselves provide a definitive answer to this question.
What they do show is that the evidence for American superiority in quality of care (or lack thereof) is a mixed bag, with the nation doing relatively well in some areas—such as cancer care—and less well in others—such as mortality from treatable and preventable conditions.
And while evidence base is incomplete and suffers from other limitations, it does not provide support for the oft-repeated claim that the “U.S. health care is the best in the world.” In fact, there is no hard evidence that identifies particular areas in which U.S. health care quality is truly exceptional.
Addressing the American public’s widespread concern about the potential negative impact of health reform on the quality of care they currently receive, the authors conclude that reform should in fact be seen as an opportunity to systematically improve quality of care, rather than a threat to the existing system. It provides an opportunity to build on strengths and correct weaknesses in U.S. health care, working towards aims for improvement that the care provided is safe, effective, patient centered, timely, efficient and equitable.
Burman L, Khitatrakun S and Goodell S. Tax Subsidies for Private Health Insurance – Update. Who Benefits and at What Cost? July 2009. [Full Text (pdf)]
Policy-makers are considering modifications to the tax treatment of employer-sponsored insurers (ESI) as a way to raise revenue to help pay for health reform and provide incentives to reduce health care costs. Understanding how current subsidies work is important to assessing health reform proposals. This brief is an update of a previous synthesis report published in 2003, and presents essential information about the structure and distribution of existing tax subsidies for ESI and the implications for policy options.
* Federal tax subsidies for employer sponsored insurance will amount to more than $240 billion in 2010.
* Higher-income workers benefit the most from the current tax subsidies.
* Lower-income families pay the largest percent of income on insurance, but receive the smallest tax subsidy.
Policy-makers may want to think about ways to level the playing field including: Eliminating the tax exclusion for ESI, capping the tax exclusion for ESI; and allowing nongroup coverage to be purchased with pre-tax dollars.
Commonwealth Fund | Comparative Effectiveness Research and Evidence-Based Decision Making Across Four Countries: The U.K., Germany, France, and AustraliaAugust 20, 2009
Comparative Effectiveness Research and Evidence-Based Decision Making Across Four Countries: The U.K., Germany, France, and Australia, July 28, 2009. [Summary]
Australia, France, Germany, and the United Kingdom all have set up agencies to ensure that their investments in health care, including medications, treatments, and new medical technologies, are yielding ‘value for money’ and to assist health care providers in improving their clinical practice. The Commonwealth Fund has just published a new series of issue briefs examining the comparative effectiveness efforts in each country. The issue briefs are:
* Institute for Quality and Efficiency in Health Care: Germany by Mona Nasser, D.D.S., Peter T. Sawicki, M.D., Ph.D.
* Comparative Effectiveness Review Within the U.K.’s National Institute for Health and Clinical Excellence by Kalipso Chalkidou, M.D., Ph.D.
* Evidence-Based Decision-Making Within Australia’s Pharmaceutical Benefits Scheme by Ruth Lopert, B.Sc., B.Med., M.Med.Sci.
* National Authority for Health: France by Lise Rochaix, Ph.D., and Bertrand Xerri, M.D.
Also available is a series of videos featuring comparative-effectiveness experts from these four nations: former Harkness fellow Kalipso Chalkidou, M.D., Ph.D., , Director, Policy Consulting, U.K.’s National Institute for Health and Clinical Excellence (NICE); Sir Michael Rawlins, Chairman of NICE; Professor Emeritus Lloyd Sansom, AO, Chair, the Australian Pharmaceutical Benefits Advisory Committee (PBAC) ; Laurent Degos, M.D., Ph.D., Chair, the French National Authority for Health (Haute Autorité de Santé, or HAS); and Peter Sawicki, M.D., Ph.D., Director, Germany’s Institute for Quality and Efficiency in Health Care.