Category Archives: Uncategorized

Employers’ rising health insurance costs leave many families underinsured

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About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

For employer-sponsored health insurance in 2020, premiums and deductibles accounted for 11.6% of the U.S. median household income, an increase from 9.1% in 2010, according to a report published Jan. 12. Source: State Trends in Employer Premiums and Deductibles, 2010–2020, The Commonwealth Fund, New York, January 2022.

In every state, what families pay for employer-sponsored health insurance is consuming a greater share of household income than it did 10 years ago, according to a new report from the Commonwealth Fund. And rising health care costs and drug prices have caused employers to raise monthly insurance premium payments and deductibles to the point where those increases have outpaced median family incomes.

In the report, researchers from the Commonwealth Fund noted that in 37 states, premium contributions and deductibles amounted to 10% or more of median income in 2020, an increase from 32 states in 2015 and from 10 states in 2010. For employers’ plans, health insurance premiums and deductibles accounted for 11.6% of the U.S. median household income in 2020, up from 9.1% in 2010, according to the report, State Trends in Employer Premiums and Deductibles, 2010–2020, published Jan. 12.

Health care journalists could write this story in every state because the report includes extensive data on premiums and deductibles in each state for employer-sponsored health insurance. The report also shows that family income often fails to keep pace with rising health care costs, leading many to be underinsured so that they skip needed care and go into debt to pay for care.

For an excellent example of how to cover this story, see this report from Tom Miller, the morning news anchor at KXAN in Austin, Texas, on Monday (Jan. 17): “Health insurance costs keep rising in Texas—here’s why.” Miller’s report could be a model for journalists in all 50 states, in part because he explained that many employed Texans pay more for health insurance than residents in other states.

In 2020, Texans spent an average of $9,311 for employer-sponsored health insurance premiums and deductibles, an amount that was more than 14.2% of their median income, up from 12.7% in 2010, Miller said.

“Texans are doubly disadvantaged,” Miller wrote, quoting the fund’s vice president Sara Collins. “They’re paying more on average for their premiums and deductibles, and also have lower median incomes on average.”

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Covering rapid testing and resources for journalists

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About Bara Vaida

Bara Vaida (@barav) is AHCJ's core topic leader on infectious diseases. An independent journalist, she has written extensively about health policy and infectious diseases. Her work has appeared in the National Journal, Agence France-Presse, Bloomberg News, McClatchy News Service, MSNBC, NPR, Politico, The Washington Post and other outlets.

Photo by Travis Wise via Flickr.

Rapid COVID-19 testing, how to get rapid tests and how to use them is currently one of the biggest pandemic stories. In the coming weeks, Americans will have more access to rapid tests than ever before now that the Biden administration has rolled out its plan to send one billion tests through the mail in response to the omicron surge.

Yesterday, Americans were able to start visiting  COVIDtests.gov to order up to four free rapid tests per household that will be delivered by mail in seven to 12 days, according to this White House fact sheet. This move comes in conjunction with a plan to send 10 million rapid tests to schools and a new requirement enacted over the weekend requiring private health insurers to reimburse plan holders for buying as many as eight rapid tests a month.

“Public health experts and the Centers for Disease Control and Prevention recommend that Americans use at-home tests if they begin to have symptoms, at least five days after coming in close contact with someone who has COVID-19 or are gathering indoors with a group of people who are at risk of severe disease or unvaccinated,” the White House said in an announcement about the new website on Jan. 14.

Epidemiologist Katelyn Jetelina has a good explainer on how to use rapid tests that you can use in your reporting. 

COVID-19 testing in the U.S. has been challenging for  myriad of reasons including lack of laboratory infrastructure, supply chain gaps, regulatory obstacles, lack of test production capacity and federal leadership attention. Public health experts say that for much of the pandemic, testing in the U.S. has been more about documenting cases than anticipating and altering the course of the pandemic. 

To learn more about the above, read this CNN story and this Washington Post story. They are both balanced, detailed articles explaining why there wasn’t enough supply of COVID-19 tests during this past holiday season. They conclude that the administration has prioritized getting the public fully vaccinated, and the size and capacity of the COVID-19 testing supply wasn’t as high a priority. As of early 2022, there were about a dozen rapid tests approved by the FDA. Manufacturers are pledging to ramp up their supply, and the government has signed contracts to ensure that test makers keep producing tests, even when demand wanes. 

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New tip sheet highlights aging in place trends and challenges

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About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic leader on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Photo by Wade Austin Ellis view Unsplash

The U.S. population of people 65 and older is expected to reach around 71 million by 2030 — nearly double that in 2006. By 2030, older adults will comprise about 20% of the population. By 2034,  the U.S. Census Bureau projects that older adults will edge out children in population size. The number of adults ages 85 and older, the group most often needing help with basic personal care, will nearly quadruple between 2000 and 2040, the Urban Institute predicts.

The majority of older people — 87% — want to remain in their current home and community as they age. Doing so while staying as safe and independent as possible can pose challenges.  So, planning ahead is crucial, according to the National Institute on Aging.

Covering aging in place trends in your community and state is an opportunity for reporters to explore what financial, supportive housing and social services are available and where gaps exist, especially in states where populations are skewing older. Approximately 25% of older Americans live in one of three states: California, Florida, and Texas. Seven other states — Georgia, Illinois, Michigan, New York, North Carolina, Ohio, and Pennsylvania — account for another 25% of Americans age 65 or older, according to the Population Reference Bureau. How can they remain safely at home? Where will they go if unable to live independently?

While retirement, assisted living, or continuing care communities have their appeal, they’re not for everyone. These options can also be expensive. For some, home modifications, in-home assistance or other supportive programs are more viable options.  However, despite the desire to remain in place, doing so can be daunting, according to a report from Fresenius Medical Care. Their survey of 2,000 older people found financial barriers along with other key social determinants of health such as food insecurity, lack of a strong social support network, and trouble completing everyday tasks were significant roadblocks to successful aging in place.

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Investigating lack of aging services in rural Colorado

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About Shannon Najmabadi

Shannon Najmabadi is a rural economy reporter for the Colorado Sun. Previously, she worked at The Texas Tribune, in Austin, Texas, covering higher education, health care, politics and policy.

I was working as a reporter in Texas when the pandemic began, where I spoke to the families of those in long-term care facilities and investigated the disproportionate death toll of coronavirus-infected residents in state veterans’ homes overseen by George B. Bush. 

In reporting on those stories, I heard repeatedly from experts that aspects of the nursing home industry are broken and that it would be better to let people age in smaller settings or at home. 

Those thoughts were rattling around in my head when I moved to a new job in Colorado, one of the fastest aging states in the country. When one of my colleagues saw a press release that suggested a 1,870 square mile rural county had been without a home health or hospice provider for the better part of a year, we thought it would be a good opportunity to write about the availability of these services in the state’s rural areas as baby boomers age.

Unsurprisingly, the picture is bleak. 

It takes providers far longer to commute from home to home in a rural area, especially on roads that become treacherous in snowy and icy conditions. There is a smaller patient volume overall and it fluctuates based on need, making it difficult for a cash-strapped agency to retain the appropriate number of staff at all times. And providers make little more than minimum wage to offer intimate, hands-on care that can be emotionally draining. 

All of this quickly became clear as I began calling various aging agencies across the state. But we [editors at the Colorado Sun] wanted to go beyond the numbers and policy statements to see what this all looked like on the ground. 

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Homelessness may drive extended hospitalizations among people with severe mental illness

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About Katti Gray

Katti Gray (@kattigray) is AHCJ's core topic leader for behavioral and mental health. A former Rosalynn Carter Mental Health Journalism Fellow, Gray is providing resources to help AHCJ members expand their coverage of mental health amid ongoing efforts to de-stigmatize mental illness and to place mental health care on par with all health care.

Photo by Michael Tefft via Flickr.

Recent years have seen an uptick in the nation’s count of homeless people, a population with a greater portion of people with mental illness than in the general population.

The Substance Abuse and Mental Health Services Administration’s still widely referred to 2011 estimate suggests that 26% of unsheltered persons had severe mental illness compared with roughly 5% of people with housing. And when the tally of homeless people with less debilitating mental disorders is added to that equation, the rate jumps as high as 45%.

Published online last fall in Psychiatric Services, a University of California, Los Angeles analysis concluded that homeless people in court-ordered in-patient psychiatric care wound up in psychiatric hospitals for months longer than other involuntarily admitted psychiatric patients.

“Mental Health Conservatorship Among Homeless People With Serious Mental Illness,” an observational study, analyzed hospital administration data for 795 patients, 18 and older, admitted involuntarily to one Los Angeles safety-net hospital between 2016 and 2018. While involuntarily committed patients comprised 6% of the sample population, they accounted for 41% of inpatient days spent hospitalized.

In-patients without housing spent an average of 154.8 days involuntarily in the hospital, while in-patients with homes were hospitalized for an average of 25.6 days.

What’s more, researcher Kristin Choi, Ph.D., M.S., R.N., said, according to a Jan. 2 University of California, Los Angeles (UCLA) press release, “There are very few long-term housing options for people who are disabled by mental illness and in need of supportive housing in Los Angeles. When these individuals are stabilized and ready for a lower level of community-based care, there is no place for them to go.”

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