Research Roundup: Young Adult Coverage; Medicaid Mentors; Getting Dental Care

Health Affairs: Young Adult Insurance Coverage And Out-Of-Pocket Spending: Long-Term Patterns
The Affordable Care Act appears to have improved health insurance coverage for young adults (ages 18–30). But data from twenty national surveys conducted between 1977 and 2013 paint a more complex picture, showing coverage rates lower in 2013 than they were thirty-six years earlier. Racial and ethnic disparities in coverage have declined recently, while out-of-pocket expenditures remain low for most young adults. (Berk and Fang, 3/23)

Pediatrics: Parent Mentors And Insuring Uninsured Children: A Randomized Controlled Trial
We conducted a randomized trial of the effects of parent mentors (PMs) on insuring uninsured minority children. PMs were experienced parents with ≥1 Medicaid/CHIP-covered child who received 2 days of training, then assisted families for 1 year with insurance applications, retaining coverage, medical homes, and social needs .... PMs were more effective ... than traditional methods in insuring children (95% vs 68%), and achieving faster coverage (median = 62 vs 140 days), high parental satisfaction (84% vs 62%), and coverage renewal (85% vs 60%). PM children were less likely to have no primary care provider (15% vs 39%), problems getting specialty care (11% vs 46%), unmet preventive (4% vs 22%) or dental (18% vs 31%) care needs, dissatisfaction with doctors (6% vs 16%), and needed additional income for medical expenses (6% vs 13%). (Flores et al., 3/17)

Health Affairs: Workplace And Public Accommodations For Nursing Mothers
Although the ACA requires many employers to provide nursing mothers with reasonable break time and private space to express breast milk, a recent study found that only 40 percent of women who gave birth in 2011 or 2012 and returned to work postpartum reported having access to both of these accommodations. A May 2015 report documented that women continued to face challenges in accessing no-cost lactation support and supplies under the new health insurance coverage requirement, and additional anecdotal evidence suggests significant variability in implementation of these provisions. ... statutes supporting breastfeeding vary markedly among states. (Yang, Saunders and Kozhimannil, 3/17)

The Kaiser Family Foundation: Access To Dental Care In Medicaid: Spotlight On Nonelderly Adults
Dental benefits for Medicaid adults are not required by federal law, but are offered at state option, and most states provide only limited coverage .... The progress that states have made in increasing children’s access to and use of dental care, by building stronger provider networks, leveraging accountability through contracts, and investing in care coordination efforts, provides a foundation for similar action for adults in Medicaid. States are also expanding the dental workforce by removing scope-of-practice barriers and through targeted efforts among dental schools to increase diversity among dental students, as under-represented minority students are more likely to provide care to the underserved. Finally, state Medicaid programs are implementing a host of payment and delivery reforms in pursuit of higher-quality care, better patient outcomes, and reduced costs. (Hinton and Paradise, 3/17)

The Kaiser Family Foundation: Trends In Employer-Sponsored Insurance Offer And Coverage Rates, 1999-2014
The majority of nonelderly people get their health coverage through an employer-based plan. This issue brief uses data from the National Health Interview Survey (NHIS) to examine trends in employer-sponsored health insurance (ESI) for different types of people and households. While ESI remains the leading source of coverage for nonelderly people (those under age 65), the percentage covered by an employer plan has declined over the last fifteen years. A similar pattern exists with firm offer rates; fewer workers were offered health insurance from their employer in 2014 than in 1999. The decrease in offer and coverage rates has not been universal; families with low and modest incomes have been most affected by the decline. (Long et al., 3/21)

Urban Institute: Marketplace Plan Choice: How Important Is Price? An Analysis Of Experiences In Five States
Anecdotal evidence has suggested that marketplace consumers are extremely sensitive to premium price when purchasing insurance. We have analyzed available insurer level enrollment data from the five state based marketplaces (California, Rhode Island, New York, Maryland, and Connecticut) which have released the relevant data. We find that consumers are generally quite sensitive to premium price and low cost insurers tend to enroll the largest share; however there are still a significant number of enrollees who have selected higher priced options indicating there are other significant motivations for selecting a particular insurer including brand name recognition, prior satisfaction, or perceived quality differences. (Holahan, Blumberg and Wengle, 3/23)

Here is a selection of news coverage of other recent research:

Medscape: Most US Voters Approve of Paying Kidney Donors, Survey Finds
Most US voters view living kidney donations positively, according to a telephone survey, and most also said they would be motivated toward such a donation if they received $50,000 in compensation. A quantitative survey of 1011 registered US voters likely to vote found that 689 people (68%) would donate a kidney to anyone, and 235 (23%) would donate only to certain people; 87 (9%) would not donate. ... Thomas G. Peters, MD, from the University of Florida College of Medicine in Jacksonville, and colleagues report the survey results in an article published online March 23 in JAMA Surgery. (Frellick, 3/23)

Reuters: U.S. Heart Disease Rates Decline
Over the last 40 years, heart disease rates have dropped in the U.S. overall, but the changes varied widely by region, with the highest rates of the disease shifting from the Northeast to the South, researchers say. “Heart disease” refers to several conditions including coronary artery disease, which can cause heart attack. Despite the decline in deaths over time, heart disease is still the leading cause of death in the U.S., killing more than 600,000 people per year, according to the Centers for Disease Control and Prevention (CDC). (Doyle, 3/21)

CBS News: Many Seniors Using Dangerous Drug Combinations
One in six seniors in the U.S. regularly uses potentially dangerous combinations of prescription and over-the-counter medications and dietary supplements, according to new research. The study, published today in JAMA Internal Medicine, showed a two-fold increase over a five-year period. (Welch, 3/21)

MedPage Today: Mental Health Issues Burden Young Transgender Women
More than one-third of transgender women reported at least one mental health issue, with a fifth reporting two or more, according to a small study of this population in two major U.S. cities. (Walker, 3/21)

NPR: Stand To Work If You Like, But Don't Brag About The Benefits
Too much sitting increases heart failure risk and disability risk, and shortens life expectancy, studies have found. But according to an analysis published Wednesday of 20 of the best studies done so far, there's little evidence that workplace interventions like the sit-stand desk or even the flashier pedaling or treadmill desks will help you burn lots more calories, or prevent or reverse the harm of sitting for hours on end. "What we actually found is that most of it is, very much, just fashionable and not proven good for your health," says Dr. Jos Verbeek, a health researcher at the Finnish Institute of Occupational Health. (Chen, 3/17)

Reuters: Financial Burden Of Cancer Can Harm Quality Of Life
Almost a third of U.S. cancer survivors face financial burdens, and physical and mental health tends to be worse for those who do, according to a new study. There are more than 14 million cancer survivors in the U.S., the authors wrote in a paper released by the journal Cancer. (Doyle, 3/14)

Reuters: For Low-Income Smokers, Calling A Quitline May Cost Too Much
Telephone quitlines offer free and effective treatment for tobacco dependence, but for low-income smokers who only have a cell phone and don’t have unlimited minutes, calls to the quitline may take a substantial portion of their cell minutes for the month, according to a new study. The researchers didn’t ask smokers if this limitation affected whether or not they used the quitlines, but estimated for how many smokers this might potentially be an issue based on phone ownership and service plans. (Doyle, 3/11)

Reuters: Many Parents Unaware Of Newborn Hearing Screenings
Many parents don't remember if their children were tested for hearing loss at birth, a new study found. Diagnosis and treatment of hearing loss at birth is critical to lowering the risk of impaired speech, language and literacy later in life, write the researchers in JAMA Otolaryngology - Head and Neck Surgery. (Seaman, 3/11)