Lack of Comparability Between CHIP and ACA Qualified Health Plans
by Margaret A. McManus and Harriette B. Fox, July 2014.
This fact sheet provide a detailed examination of comparability between separate CHIP programs and child-only qualified health plans in Colorado, Georgia, Oregon, Texas, and West Virginia for children with family incomes between 134% to 300% FPL. It examines cost-sharing requirements, including deductibles, copayments and coinsurance, and out-of-pocket limits, and benefit coverage and treatment limitations in 28 benefit categories. Implications for CHIP reauthorization are also discussed.
Many Low Income Older Adolescents Likely to Remain Uninsured in 2014
by Harriette B. Fox, Margaret A. McManus, and Annalia G. Michelman, October 2013.
This fact sheet identifies the states in which adolescents ages 19 and 20 living at or below the poverty level are likely to remain without health insurance protection in January 2014, despite the passage of the Affordable Care Act. It examines several avenues to state Medicaid coverage: optional Medicaid eligibility for “Ribicoff Children” up to age 21, Section 1115 demonstration waivers covering childless adults, and the ACA’s optional Medicaid expansion for uninsured individuals ages 19 through 64. It also describes the obstacles these older adolescents confront in securing private health insurance coverage through employment and in exchanges.
State EPSDT Policies for Adolescent Preventive Care
by Harriette B. Fox, Katherine K. Rogers, and Margaret A. McManus, September 2011.
This fact sheet presents findings from an analysis of state policy documents that establish guidelines for providers delivering EPSDT preventive services to adolescents. It examines state Medicaid policies including the EPSDT periodicity schedule; comprehensive health history and developmental assessments; physical examinations, laboratory tests, and immunizations; health education; and referrals. Particular emphasis is given to the early identification of problems related to nutritional health, mental health, sexual behavior, substance use, and violence and injury potential and to health education for key topics under Bright Futures. Also examined are state policies regarding adolescents’ private time with providers.
Significant Multiple Risk Behaviors Among U.S. High School Students
by Harriette B. Fox, Margaret A. McManus, and Katherine N. Arnold, March 2010.
Based on an original analysis of the 2007 Youth Risk Behavior Survey, this fact sheet provides national information on multiple health risk behaviors among high school students. It examines 12 types of significant health risk behaviors that include unsafe sexual behaviors, unhealthy eating and exercise patterns, mental health and substance use problems, and behaviors that contribute to violence. It reports on the prevalence and co-occurrence of these health risk behaviors and also differences by gender, race and ethnicity, and grade level. Implications for preventive interventions are also discussed.
Pediatricians' Interest in Expanding Services and Making Practice Changes to Improve the Care of Adolescents
by Harriette Fox, Margaret McManus, Karen O’Connor, Jonathan Klein, Angela Diaz, and Charles Wibbelsman, September 2009.
Based on a 2008 national survey of practicing pediatricians, this fact sheet examines pediatricians’ interest in adding or expanding preventive, mental health, and reproductive health services for adolescents if payment barriers were removed. It also identifies the specific practice and staffing changes they would have an interest in making, as well as the types of support and training they perceive would be most helpful to them in providing comprehensive primary care to adolescent.
Pediatric Perspectives and Practices on Transitioning Adolescents with Special Needs to Adult Health Care
by Margaret McManus, Harriette Fox, Karen O'Connor, Thomas Chapman, Jessie MacKinnon, October 2008.
Based on a 2008 national AAP survey of practicing pediatricians, this fact sheet examines pediatricians' perspectives on the appropriate age to begin planning for transition and their practices regarding the provision of transition support services to adolescents with special needs. It also identifies the economic and non-economic barriers that pediatric practices face in providing transition services and presents options for improving training, financing, adult provider availability, and adolescent and parent education.
State Policies Affecting the Assurance of Confidential Care for Adolescents
by Harriette B. Fox and Stephanie J. Limb, April 2008.
Based on interviews with state Medicaid staff and managed care organization officials and a review of states' minor consent laws, this fact sheet examines the mailing home of explanation of benefit statements for publicly insured adolescents. It looks at how and why Medicaid agencies and their contracting managed care organizations mail EOBs home and also examines whether state policies to exclude particular services from EOB mailings are consistent with state policies allowing minor consent.
The Public Health Insurance Cliff for Older Adolescents
by Harriette B. Fox, Stephanie J. Limb, and Margaret A. McManus, April 2007.
Drawing on data from multiple sources, this fact sheet examines Medicaid and SCHIP eligibility policies affecting older adolescents -- those ages 19 and 20. Included are mandatory coverage pathways, such as parents and pregnant women, and optional pathways, including Ribicoff children, medically needy, adolescents formerly in foster care, and the working disabled. The fact sheet examines states’ use of the available options and income eligibility levels applicable to older adolescents
Making the Case for Addressing Adolescent Health Care
by Margaret A. McManus and Harriette B. Fox, January 2007.
Drawing on data from multiple studies and national surveys, this fact sheet documents that the compelling needs of our nation's adolescents are being poorly addressed through our current system of health care financing and delivery. It argues for more effective teen-friendly health care in which intensive health promotion interventions are available, physical and behavioral health care are integrated, and the unique perspectives and vulnerabilities of adolescents are addressed.
Racial and Ethnic Disparities in Adolescent Health and Access to Care
by Harriette B. Fox, Margaret A. McManus, Matthew Zarit, Gerry Fairbrother, Amy E.Cassedy, Christina D. Bethell, and Debra Read, January 2007.
Based on data from the National Health Interview Survey and the National Survey of Children's Health, this fact sheet examines racial and ethnic differences among Hispanic, Black, and White adolescents ages 12 through 17 for 12 indicators pertaining to health and risk status, access to care, service utilization, and unmet needs. It also examines the influence of income, insurance, mother's or household education, and primary household language on these differences.
Racial and Ethnic Disparities in Health and Access to Care Among Older Adolescents
by Harriette B. Fox, Margaret A. McManus, Matthew Zarit, Amy E. Cassedy, and Gerry Fairbrother, January 2007.
This fact sheet uses data from the National Health Interview Survey to examine disparities in health status, access, and service use among Hispanic, Black, and White adolescents ages 18 through 21 and the influence of income, insurance, and mother's education on these disparities.