The contentious debate over health insurance isn’t unique to Congress, it’s occurring on a daily basis all across the nation and in Arizona:
To the worker with no health-care benefits: “Should I pay the light bill or go the doctor’s to check on this nagging cough?”
To the unemployed worker: “Should I continue to pay COBRA or apply that dollar amount to my late house payment?”
To the union worker: “Should I consider striking or just be happy to have a job with benefits and accept the fact I have to pay more for my health insurance?”
Too many Americans are living without health insurance.
How many? Estimates vary, but the Census Bureau’s annual report released in September puts the figure at 46.3 million Americans in 2008. The actual number is likely higher since it does not include the hundreds of thousands of layoffs this year that resulted in loss of employer-provided insurance.
Arizona has one of the highest levels of residents without health insurance – almost 20%, or one in five residents, as noted in the 2009 report, Truth and Consequences: Gambling, Shifting and Hoping in Arizona Health Care.
By and large it’s not the very poor doing without insurance, since many are eligible for Arizona Health Care Cost Containment System (AHCCCS) coverage, Arizona’s version of Medicaid. No, it’s your working-class neighbor – if not yourself – who’s living without coverage. Eight out of 10 Arizonans without insurance are in households where one or more members works at least part time, according to the Truth and Consequences report, prepared by Morrison Institute for Public Policy. And as more full-time employees get laid off, along with the disappearance of dependable paychecks so go their employer-provided health care coverage.
The high cost of COBRA (Consolidated Omnibus Budget Reconciliation Act) prevents many unemployed Arizonans from purchasing the federal government’s stop-gap insurance program, which was never intended to provide long-term coverage.
In Arizona, where average unemployment insurance benefits are $937 a month, the average family COBRA premium is $1,084 – or 116% of UI income, according to a 2009 study by Families USA, a national organization for health care consumers.
In response to the worst recession of our time, the federal stimulus package reduces the COBRA premium for recently unemployed workers so they pay just 35 percent of the usual amount – but only for up to 9 months, at which time COBRA can again charge 102 percent of the premium the employee and employer collectively were playing for insurance.
With their inherent and colossal complexities, health care reform and cost containment are two issues we’ve ignored for too long, and understandably may be a bitter pill for some to swallow all at once. But a fiery debate in the Senate to find the right prescription for the ailing nation is preferred to the daily debate too many Americans face: Groceries or health care.
Tuesday, November 17, 2009
Tuesday, November 3, 2009
The 'new face' of homelessness
MORRISON INSTITUTE BLOG
By Kristin Borns, Senior Policy Analyst
On my way back from lunch one afternoon recently, a kind, clearly homeless man; torn, dirty clothes, skin the deepest shade of brown from having been in the sun constantly, asked if I wouldn’t mind sharing my leftovers. Just one of the everyday encounters with the struggling homeless population that happens in any downtown. This is who Arizonans think about when they think about “helping the homeless”, and they’d be right – but only in part.
The face of homelessness is changing nationwide and in Arizona. Now, more than ever before, homelessness is affecting professionals out of work, single parents, and families - the fastest growing group of homeless, according to the Department of Economic Security (DES).
DES provides an annual point-in-time count of individuals experiencing homelessness in Arizona, and in January of this year, approximately 50% of those individuals who were sheltered were in families. This is a jump from 2007, where only 37% were in families. Additionally, school districts statewide are reporting increases in homeless students as well as students accessing the free and reduced lunch program. In October, Mesa Public Schools reported an increase of 400 homeless students over the last three years. As the recession continues, and more Arizonans lose their jobs, the realities of poverty, hunger, and homelessness become more acute.
Service providers also are seeing clients they’ve never seen before. In fact, in a recent news interview, the spokesman for St. Mary’s food bank noted they are now seeing people coming in for services who last year were providing donations.
Yet, even with this tacit recognition of the increase in need, lawmakers are looking to make even more cuts to adjust a current-year budget that is $2 billion short. Some suggested impact scenarios put forth by state agencies include the Department of Housing’s complete elimination of the Homeless Prevention Program, which could result in 2,000 households now facing eviction or foreclosure; the Department of Economic Security’s reduction of TANF (Temporary Assistance for Needy Families) cash benefits for families in poverty; and perhaps most frightening, the elimination of the KidsCare insurance program, resulting in 47,000 low-income children losing coverage. Nothing can spiral a family into financial ruin like an uncovered health emergency.
Policymakers may not even know or understand the size and need of this new community. Without this understanding, it is impossible to know what long-term impact cuts alone are going to have. Serving those who are experiencing homelessness has always been complex. Even the notions of who those experiencing homelessness in downtown are likely to miss the nuances and needs of the individual I encountered during that lunchtime.
HUD releases an annual report on homelessness nationally, and in the report for 2008, released last July, it was noted that families were more likely than other groups to have been housed the night prior to experiencing homelessness, often staying with family or friends. As families experience lost jobs and incomes, they are exploring other options, with homelessness being the last stop. Even more so now than before, policymakers defining the need and possible consequences of choices is complicated, since preconceptions of those experiencing homelessness do not apply in this new normal.
Our neighbors and friends are the new face of the recession.
By Kristin Borns, Senior Policy Analyst
On my way back from lunch one afternoon recently, a kind, clearly homeless man; torn, dirty clothes, skin the deepest shade of brown from having been in the sun constantly, asked if I wouldn’t mind sharing my leftovers. Just one of the everyday encounters with the struggling homeless population that happens in any downtown. This is who Arizonans think about when they think about “helping the homeless”, and they’d be right – but only in part.
The face of homelessness is changing nationwide and in Arizona. Now, more than ever before, homelessness is affecting professionals out of work, single parents, and families - the fastest growing group of homeless, according to the Department of Economic Security (DES).
DES provides an annual point-in-time count of individuals experiencing homelessness in Arizona, and in January of this year, approximately 50% of those individuals who were sheltered were in families. This is a jump from 2007, where only 37% were in families. Additionally, school districts statewide are reporting increases in homeless students as well as students accessing the free and reduced lunch program. In October, Mesa Public Schools reported an increase of 400 homeless students over the last three years. As the recession continues, and more Arizonans lose their jobs, the realities of poverty, hunger, and homelessness become more acute.
Service providers also are seeing clients they’ve never seen before. In fact, in a recent news interview, the spokesman for St. Mary’s food bank noted they are now seeing people coming in for services who last year were providing donations.
Yet, even with this tacit recognition of the increase in need, lawmakers are looking to make even more cuts to adjust a current-year budget that is $2 billion short. Some suggested impact scenarios put forth by state agencies include the Department of Housing’s complete elimination of the Homeless Prevention Program, which could result in 2,000 households now facing eviction or foreclosure; the Department of Economic Security’s reduction of TANF (Temporary Assistance for Needy Families) cash benefits for families in poverty; and perhaps most frightening, the elimination of the KidsCare insurance program, resulting in 47,000 low-income children losing coverage. Nothing can spiral a family into financial ruin like an uncovered health emergency.
Policymakers may not even know or understand the size and need of this new community. Without this understanding, it is impossible to know what long-term impact cuts alone are going to have. Serving those who are experiencing homelessness has always been complex. Even the notions of who those experiencing homelessness in downtown are likely to miss the nuances and needs of the individual I encountered during that lunchtime.
HUD releases an annual report on homelessness nationally, and in the report for 2008, released last July, it was noted that families were more likely than other groups to have been housed the night prior to experiencing homelessness, often staying with family or friends. As families experience lost jobs and incomes, they are exploring other options, with homelessness being the last stop. Even more so now than before, policymakers defining the need and possible consequences of choices is complicated, since preconceptions of those experiencing homelessness do not apply in this new normal.
Our neighbors and friends are the new face of the recession.
Monday, November 2, 2009
Arizona's Public Behavioral Health System: Critical Issues for Critical Times
Arizona's Public Behavioral Health System: Critical Issues for Critical Times prepared jointly by ASU’s Center for Applied Behavior Health Policy and Morrison Institute for Public Policy, notes that Arizona’s billion-dollar public behavioral health system, which serves 150,000 ill residents and their families, is inadequately staffed and struggling under budget cuts and the demands of a 28-year-old class-action law suit.
Among the findings of the report:
35% of Arizona adults with serious mental illness do not qualify for AHCCCS/Medicaid, primarily because they are working poor and uninsured, and thus are at risk for inadequate treatment
Funds for housing and food to support patients’ recovery are essential, yet are not provided to even patients covered by AHCCCS/Medicaid because they are not considered "medically necessary"
Budget pressures put Arizonans at risk through cuts to crisis services, which not only avert suicides and drug overdoses, but provide vital assistance to local hospitals and local law enforcement officials.
The report’s release comes just weeks after Governor Jan Brewer’s October 9th call for a major reorganization of the statewide system.
Among the findings of the report:
35% of Arizona adults with serious mental illness do not qualify for AHCCCS/Medicaid, primarily because they are working poor and uninsured, and thus are at risk for inadequate treatment
Funds for housing and food to support patients’ recovery are essential, yet are not provided to even patients covered by AHCCCS/Medicaid because they are not considered "medically necessary"
Budget pressures put Arizonans at risk through cuts to crisis services, which not only avert suicides and drug overdoses, but provide vital assistance to local hospitals and local law enforcement officials.
The report’s release comes just weeks after Governor Jan Brewer’s October 9th call for a major reorganization of the statewide system.
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