Health insurance - your way, sort of

The rising cost of health care coverage has prompted growing interest and enrollment in consumer-directed health plans (CDHPs), according to a study released by the Government Accountability Office (GAO) yesterday. CDHPs are offered by private health insurance carriers to employers and individuals. A CDHP combines a high-deductible health plan with a health reimbursement arrangement (HRA) or health savings account (HSA), both of which have tax advantages.

HRAs and HSAs allow CDHP enrollees greater discretion in their health care. Because unused funds can be accrued, the report notes the incentive for enrollees to limit their health care expenditures; the counter-argument is that with its high deductibles, CDHPs may only attract healthier individuals and thereby raise premiums in traditional plans where the less healthy remain. Because CDHPs are relatively new, GAO did a broad survey of government and industry officials and employers and financial institutions for this study.

CONSUMER-DIRECTED HEALTH PLANS: Small but Growing Enrollment Fueled by Rising Cost of Health Care Coverage, GAO-06-514, April 28, 2006
     Full report (pdf, 644KB, 38p.)
     Highlights (pdf, 56KB, 1p.)
     Abstract (html)

Related GAO reports on CDHPs for federal employees:

FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM: First-Year Experience with High-Deductible Health Plans and Health Savings Accounts, GAO-06-271 (pdf, 544KB, 28p.), January 31, 2006

FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM: Early Experience with a Consumer-Directed Health Plan, GAO-06-143 (pdf, 480KB, 27p.), November 21, 2005

Internet content driven by speed not class

Pew Internet released a report Sunday describing the surge in home broadband Internet use. Compared to a similar survey last year, "home broadband adoption grew by 40% in the year prior to March 2006, twice the growth rate of the year before."

A few of the report's findings include:

• Growth in broadband adoption has been very strong in middle-income households.
• 48 million internet users have posted content to the internet and the large majority of them are home broadband users.
• Having a fast, always-on internet connection at home is associated with users' posting content to the internet and thereby shaping the environment of cyberspace.
• User-generated content is driven by young home high-speed users. Fully 51% of "under 30" home broadband users have posted content to the internet compared with 36% of home high-speed users older than 30.

Home Broadband Adoption 2006 Home broadband adoption is going mainstream and that means user-generated content is coming from all kinds of internet users.
(available in pdf, 128KB, from PEW Internet)

A closed door (for now) on open standards

Seems Massachusetts' Peter Quinn got the wrong side of a slammed door for his troubles to open state IT wide open - "open standards, open documents, open-source software." Governing magazine's May 2006 issue reports on the tribulations and resignation of Mass. CIO, Peter Quinn. FR reported last year of the excitement in public, state and IT circles to Massachusetts' embrace of open standards. However, that turned out to be more the thrown gauntlet.

Government's responsibility is to keep its information open and unimpeded, not only today but also tomorrow.

Not quite the last words in the ensuing battle to be open, but no longer issuing as state policy. Governing reports of the efforts, soon after Mr. Quinn's public support of open standards, by lobbyists supportive of Microsoft and by legislators concerned with Mr. Quinn's management vision and tactics, as well as of a press attack on his ethics. His decisions denounced by a Senate audit committee, his vision accused as being "unworkable," and questioned by the press of improper use of travel expenses (later retracted), Mr. Quinn resigned.

Microsoft products are used on 90 percent of the desktops in Massachusetts government, all based on proprietary software code.

"They're not the 900-pound gorilla, they're the 1,800-pound gorilla in this marketplace," says John Weathersby, executive director of the Open Source Software Institute, a nonprofit organization that promotes adoption of open technology in government. "They own the desktop space. They're going to fight against it tooth and nail, and I expect nothing less."

Read the Governing article:
Open Sorcerer A crusade for open standards in technology cost one top official his job in Massachusetts. But the issue isn't going away.

also, the online special face-off between Peter Quinn and Microsoft's Alan Yates:
Open Standards: a Face-off

Work and families

The Boston College Sloan Work and Family Research Network's stated mission is

to promote informed decision making about work and family issues and to facilitate dialogue that encourages community building among three stakeholders groups (and their constituents) - academics/researchers; employers and the workplace; and state public policy makers.

Founded in 1997, the Network serves as "a virtual commons" with three main concourses: Research/Teaching; Workplace Practice; and State Policy. Offering downloads by topic (e.g., afterschool care; Family and Medical Leave Act (FMLA); changing definitions of families; and flexible work schedules), and by issue (Policy Leadership Series), the Network is a one stop shopping for work-family resources. The Work-Family Bills and Statutes Database, created primarily for state policy makers, provides easy overview access to relevant proposed state bills and passed laws. Bills and statutes may be downloaded as topic clusters in pdf, browsed by state, and searched by keyword.

Highlighted by the Network is the National Partnership for Women and Families' annual overview of paid family and medical leave initiatives introduced in state legislatures:
Where Families Matter: State Progress Towards Valuing America's Families, February 2006.
(available in pdf, 224KB, from the National Partnership)

Workplace Flexibility 2010, a Network partner, is located at Georgetown University Law Center. Also funded by the Alfred P. Sloan Foundation, Workplace Flexibility 2010 "is designed to support the development of a comprehensive national policy on workplace flexibility." The initiative provides pdf documents discussing laws impacting workplace flexibility, and offers online materials distributed at their May 1, 2006 congressional briefing, Meeting the Needs of Today's Families: The Role of Workplace Flexibility .

Offshoring in human services? (Revised)

The Government Accountability Office (GAO) today issued a revised version of its March 28 report on Offshoring in Six Human Services Programs "to correct errors in data reported...."

OFFSHORING IN SIX HUMAN SERVICES PROGRAMS: Offshoring Occurs in Most States, Primarily in Customer Service and Software Development, GAO-06-342
     Full report (pdf, 632KB, 46p.)
     Highlights (pdf, 80KB, 1p.)
     Abstract (html)

See earlier FR post, Offshoring in human services?

Government snooping - what's legal?

Citing a May 11 USA Today article reporting that the National Security Agency (NSA) "has been secretly collecting the phone call records of tens of millions of Americans, using data provided by AT&T, Verizon and BellSouth," the Congressional Research Service (CRS) issued a paper May 17 summarizing legal authorities for the Government to access telephone calling information "for either foreign intelligence or law enforcement purposes."

In a U.S. Supreme Court case, Smith v. Maryland, and in the U.S. Code, in the Foreign Intelligence Surveillance Act (FISA), 50 U.S.C. §1841 et seq., and for law enforcement purposes in 18 U.S.C. §3121 et seq., CRS discusses the use of pen registers and trap and trace devices. "Pen register" and "trap and trace device" are defined in 18 U.S.C. §3127 (3) and (4) as, basically, devices which record information to identify the source of a wire or electronic communication. The report also covers other Code sections relating to criminal investigations, business records, stored electronic communications, and the Communications Act of 1934 (pdf), as amended, specifically 47 U.S.C. §222 , and §§501-503.

Government Access to Phone Calling Activity and Related Records: Legal Authorities, CRS Report RL33424, May 17, 2006
(pdf, 88KB, 19p., from Open CRS)

Pandemic flu effects - from macro to you

The Congressional Budget Office (CBO) yesterday issued an update to its December 2005 report on the macroeconomic effects of an avian flu pandemic. As stated in the cover letter, this update focuses on "changes in the level of preparedness." The federal government's preparedness policy is evolving in three areas: vaccines and vaccine production capacity, antiviral drugs and other medications to mitigate the effects of a pandemic, and preparing state and local government responses to an outbreak.

Since the December 2005 assessment, CBO notes several developments: additional studies, one of which predicts a milder impact than previous estimates; the Department of Health and Human Services (HHS) contracting with six vaccine manufacturers to be able to inoculate, by 2011, the entire U.S. population within six months of an outbreak; the Administration's publication this month of a National Strategy for Pandemic Influenza Implementation Plan (pdf, 4MB, 233p., from the Homeland Security Council); and the enactment of the Public Readiness and Emergency Preparedness (PREP) Act, P.L. 109-148 (pdf), at 119 Stat. 2818, which protects "countermeasure" manufacturers from liability.

A Potential Influenza Pandemic: An Update on Possible Macroeconomic Effects and Policy Issues (pdf, 132KB, 22p.), May 22, 2006

A Potential Influenza Pandemic: Possible Macroeconomic Effects and Policy Issues (pdf, 312KB, 50p.), Dec. 8, 2005

HHS has created a pandemic-avian flu website which includes planning and response information for each state.

For Hawaii - pandemic flu information:

• HHS site
• Hawaii Dept. of Health (DOH) site
• Hawaii Pandemic Flu Summit, April 25, 2006

A loaded deck

Pew Research Center today released survey results of American adults' views on gambling. They report that most Americans (70%) feel legalized gambling encourages people to gamble more than they can afford. However almost the same percentage (71%) approves of lotteries as a means to raise state revenue. Less than a third (23%) say they enjoy betting, during a period which saw a sharp increase in high profile betting, including casino and slot machines. Industry estimates for 2005, for example, report that 890 casinos "took in more than $52 billion in gross revenues," and that 41 states sold $52 billion in lottery ticket sales. $13 billion alone is estimated to have been wagered online in Internet gambling. The most common form of betting is the state lottery with over one-half of the adult population claiming to have purchased a lottery ticket in the past year.

The Pew survey conducted February 2006 found the negatitive attitude "appears to be driven by concerns that people are gambling too much rather than by any revival of the once common view that gambling is immoral." 42% felt casinos had a negative impact on communities while 34% say a positive impact.

Interestingly enough, Pew found:

Just 9% of gamblers say they sometimes gamble more than they should...Similarly, when respondents (whether or not they gamble) were asked whether gambling has ever been a source of problems within their family, just 6% said that it has.

Gambling: As the Take Rises, So Does Public Concern
(available in pdf, 184KB, from Pew)

In a related story also published today, Stateline.org reports, State Governments Now Depend on the Proceeds to Finance their Budgets:

...the lure of easy new money for schools, tax relief and public services has led to an explosion of state-sanctioned casinos, slot machines at racetracks and lottery games.

Report card on NCLB, year 4

As stated on their website, the Center on Education Policy (CEP) "is a national, independent advocate for public education and for more effective public schools." In March CEP released their fourth annual analysis of the state by state implementation of the No Child Left Behind Act (NCLB). (The U.S. Department of Education also has an all states evaluation, How NCLB is making a difference in your state, available on the Ed.gov website.)

According to the CEP's news release, the NCLB has affected the "everyday lives of students and educators; [with] greatest impact in urban districts." Their survey of 50 state education officials, 299 school districts, and 38 geographically diverse case studies and 42 individual schools found that 71 percent " reported having reduced instructional time in at least one other subject to make more time for reading and mathematics, the topics tested for NCLB purposes. "

"The effects of NCLB are complex, and this policy has both strengths and weaknesses," said Jack Jennings, president and CEO of the independent, nonpartisan CEP. "If anyone is looking for a simple judgment on NCLB, such as 'good' or 'bad,' they will not find it in this report."

From the Capital to the Classroom: Year 4 of the No Child Left Behind Act
(available in pdf, 1.5MB, from CEP)

Summary, available in pdf, 428KB.
News release, available in pdf, 32KB.

Art is a hammer (Pound was an axe)

The Urban Institute (UI) was founded in 1968 as an independent nonpartisan center to "analyze policies, evaluate programs, and inform community development to improve social, civic, and economic well-being." They are committed to sharing their "research findings with policymakers, program administrators, business, academics, and the public online and through reports and scholarly books." One such report tackles the less articulated issue of the artist's value in American culture.

How are artists valued in society? What kind of demand is there for their work and social contributions? What kinds of material supports - employment and benefits, grants and awards, and space do artists need? Are artists' training programs preparing them for the environments they will encounter? What kinds of connections and networks enable artists to pursue their careers? And what kinds of information are necessary to assess this more comprehensive notion of support for artists?

The report found private and public funding for artists at best limited, and that the public view of artists as self-indulgent and frivolous "contributes to a devaluing of the artist as a citizen with the same rights and responsibilities as everyone else." Artists have always struggled to merely survive. They most times lack adequate health care coverage and housing. UI felt the 1990's cutting of federal funding put America's artist support environment in a state of crisis.

Throughout our history, artists in the U.S. have utilized their skills as a vehicle to illuminate the human condition, contribute to the vitality of their communities and to the broader aesthetic landscape, as well as to promote social change and democratic dialogue.

Investing in Creativity - A Study of the Support Structure for U.S. Artists
by Maria-Rosario Jackson, Florence Kabwasa-Green, Daniel Swenson, Joaquin Herranz, Kadija Ferryman, Caron Atlas, Eric Wallner, Carole E. Rosenstein
(available in pdf, 830KB, from The Urban Institute)

Youth lockup costs too much

The Justice Policy Institute (JPI) founded in 1996 is a policy and research non-profit "dedicated to ending society's reliance on incarceration and promoting effective and just solutions to social problems." Their web site offers reports on such issues as juvenile justice; books vs. bars, and drug policy.

Released March 23, 2006, a JPI report discusses the Models for Change states (pdf, 116KB) which "have created incentives to reduce reliance on incarceration and institute sanctions and services in the community." The model states are: Pennsylvania, California, Wisconsin, Ohio, and Illinois.

In answering why it might matter how many youth are sent to state institutions, the report finds:

• Most youth involved in the juvenile justice system can safely be managed without secure confinement.
• State imprisonment is expensive, and it is not cost-effective to send youth to state institutions who do not need to be there.
• Juvenile confinement reduces the chance that troubled youth will successfully transition to adulthood.
• The costs and impact of state secure confinement is not borne equally by all young people, or all communities.

Cost-Effective Youth Corrections-Rationalizing the Fiscal Architecture of Juvenile Justice Systems - By Jasmine Tyler and Jason Ziedenberg
(available in pdf, 2.1MB, from JPI)

National park air tour fees

In a report issued May 11, the Government Accountability Office (GAO) found that the National Park Service has not been able to collect all the air tour fees it is due. Of 86 park units, only three meet the criteria established by the Omnibus Budget Reconciliation Act of 1993, P.L. 103-66, to charge air tour fees: Grand Canyon, Haleakala, and Hawaii Volcanoes National Parks.

While the Park Service is responsible for collecting air tour fees, the Federal Aviation Administration (FAA) has sole jurisdiction of airspace over national park units. The FAA, together with the Park Service, is charged with regulating air tours pursuant to the National Parks Overflights Act of 1987, P.L. 100-91, and the National Parks Air Tour Management Act of 2000 (pdf), P.L. 106-181,title VIII, but the FAA is not required to enforce payment of fees.

GAO found that the Park Service is hindered in collecting fees because it cannot verify air tour activity and thus cannot enforce compliance, and because P.L. 103-66 and P.L. 106-181 set different geographic standards for air tours incurring fees.

NATIONAL PARKS AIR TOUR FEES: Effective Verification and Enforcement Are Needed to Improve Compliance, GAO-06-468
     Full report (pdf, 560KB, 42p.)
     Highlights (pdf, 84KB, 1p.)
     Abstract (html)

See related FR post, National park air tours

Demolition's rental squeeze

Harvard University's Joint Center for Housing Studies (JCHS) reported in their annual report on the state of the nation's rental housing that "The nation is losing approximately 200,000 rental housing units each year due to demolition, significantly compounding the ongoing housing affordability squeeze gripping millions of families." This shrinking rental market affects diverse strata of American society, with "20 percent of all renters have median annual incomes that top $60,000 while 20 percent have incomes below $10,000." The 36 page report went on to find:

Median asking rent rose from $734 in 1994 to $974 in 2004. During the same period, monthly renter income barely grew, rising from $2,272 to $2,348. Seventy percent of the nation's 7 million lowest-incomer renters pay more than half of their income for housing. Lack of adequate funding makes it difficult to preserve, let alone expand, the existing stock of subsidized housing inventory. Despite recent weakness in market rents for better quality rentals, overall rents stand at record levels.

The Joint Center for Housing Studies is affiliated with the Harvard Design School and the Kennedy School of Government. JCHS aims "to educate business leaders, government officials, policy makers, and the public on critical and emerging factors affecting housing and our communities."

The Joint Center for Housing Studies is Harvard University's center for information and research on housing in the United States. The Joint Center analyzes the dynamic relationships between housing markets and economic, demographic, and social trends, providing leaders in government, business, and the non-profit sector with the knowledge needed to develop effective policies and strategies.

America's Rental Housing: Homes for a Diverse Nation
(available in pdf, 5MB, from JCHS)

2006 Hawaii Session reports

The Bureau Systems Office has published the Bills Passed, 2006 Regular Session and Resolutions Adopted, 2006 Regular Session. Reports contain brief descriptions of all bills and resolutions passed by the Hawaii State Legislature during the Regular Session of 2006. Included are such data as the bill number, title, introducer, description, committee reports, current status, and sections of the Hawaii Revised Statutes affected by the bill; or resolution number, title, introducer, and identification of committee reports on the resolution. These publications reflect data recorded up to and including May 4, 2006, which is the date that the Legislature adjourned sine die.

Bills Passed, 2006 Regular Session
(available in pdf, 475KB)

Resolutions Adopted, 2006 Regular Session
(available in pdf, 172KB)

Legislative blogs on the rise

Legislative blogs are adding their presence to the rapidly growing blogosphere. A Stateline.org article today reports on a blog of Utah's Senate Republicans. Launched in September 2005, the blog calls itself the Unofficial Voice of the Utah Senate Majority. Stateline notes that it "was the first of its kind to strike up a digital dialogue that included entries not just from state Senate Republicans but also from minority Democrats and lawmakers in the opposite chamber."

The article also references a table of legislative blogs and RSS feeds compiled by the National Conference of State Legislatures (NCSL) which links to 53 blogs in 24 states.

See related FR posts:

• Capitol blogs
• Statehouse blogging
  
• Legislative group blog

Social Security individual accounts

The Congressional Research Service (CRS) issued a report May 1 on Social Security individual accounts (IAs). The creation of IAs as part of Social Security - "the fiscal implications of funding accounts and the risks and rewards of investing in equities" - has been debated for years, the report notes, but not the practical issues of managing the accounts. This report addresses the administrative and structural choices facing policymakers in collecting and investing IA funds.

The potential millions of workers and billions of dollars involved would greatly impact the American economy. CRS estimates that if workers contributed 2% of their earnings, IAs could account for as much as 10% of the GDP in 10 years and 25% in 20 years.

Topics covered in the report include: eligibility, participation and enrollment, participation incentives, contribution amounts and collection, education, investment of account assets, fees.

In the area of investments, CRS notes the concern that a government-managed fund may be subject to political interference and presents the centralized investment board as a way to insulate investments from politics while retaining economies of scale. The report cites two centralized investment boards currently in the federal government: the Federal Retirement Thrift Investment Board (FRTIB) which manages the Thrift Savings Program (TSP), and the National Railroad Retirement Investment Trust (NRRIT) which manages the Railroad Retirement program.

The Structure of Social Security Individual Account Contributions and Investments: Choices and Implications, CRS Report RL33398
(pdf, 208KB, 46p., from Open CRS)

Benefit-cost analysis of health-related regulatory interventions

The National Academies Press (NAP) released this month recommendations on measuring "health-related quality of life impacts for diverse public health, safety, and environmental regulations." Authors are Wilhelmine Miller, Lisa A. Robinson, and Robert S. Lawrence, Editors, Committee to Evaluate Measures of Health Benefits for Environmental, Health, and Safety Regulation. The 382 page report should be valuable for public decision makers, regulatory analysts, scholars, and students supporting the work of regulatory programs.

Estimating the magnitude of the expected health and longevity benefits and reductions in mortality, morbidity, and injury risks helps policy makers decide whether particular interventions merit the expected costs associated with achieving these benefits and inform their choices among alternative strategies.

Valuing Health for Regulatory Cost-Effectiveness Analysis
(available as an Open Book from NAP)

Summary (available as pdf, 344KB)

UI - overpayments; reemployment

The Government Accountability Office (GAO) yesterday released testimony relating to two aspects of unemployment insurance (UI): (1) efforts by the Department of Labor (Labor) to prevent overpayments, and (2) federal and state efforts to get UI claimants back to work. According to the testimony, in FY2004 UI paid $41 billion in benefits to 9 million claimants, and Labor estimated that $3.4 billion was overpaid in calendar year 2004.

UI is a federal-state partnership. GAO reported that one new step Labor has taken to help states detect and prevent overpayments is a pilot program using the National Directory of New Hires (NDNH). NDNH is a database of the Office of Child Support Enforcement (CSE) in the Dept. of Health and Human Services (DHHS) containing information on newly hired employees, quarterly wage reports, and UI claims nationwide.

For reemployment assistance, GAO noted two major changes to UI since its enactment as part of the Social Security Act (SSA) in 1935. In 1993 Congress required states to establish a Worker Profiling and Reemployment Services (WPRS) system to identify claimants needing reemployment services early in their claim. Then the Workforce Investment Act of 1998, PL 105-220 (pdf), in §121, established the one-stop system, requiring states and localities to combine 17 federally-funded employment and training services into one system.

UNEMPLOYMENT INSURANCE: Enhancing Program Performance by Focusing on Improper Payments and Reemployment Services, GAO-06-696T
      Full report (pdf, 272KB, 22p.)
      Highlights (pdf, 88KB, 1p.)
      Abstract (html)

Related GAO reports:

UNEMPLOYMENT INSURANCE: Factors Associated with Benefit Receipt and Linkages with Reemployment Services for Claimants, GAO-06-484T (pdf, 380KB, 27p.), March 15, 2006

UNEMPLOYMENT INSURANCE: Factors Associated with Benefit Receipt, GAO-06-341 (pdf, 2.7MB, 93p.), March 7, 2006

UNEMPLOYMENT INSURANCE: Better Data Needed to Assess Reemployment Services to Claimants, GAO-05-413 (pdf, 868KB, 47p.), June 24, 2005

StateMaster.com: new 50-state database

A new statistical database, StateMaster.com, was launched recently. From its April 11 press release: "Unlike anything before it on the web, StateMaster is a one-stop site for all information related to US states."

StateMaster.com currently claims over 2600 state stats in 17 broad categories, alphabetically from Background to Trade, which are further broken down into such detail as, for example: Education, Assessments, % of Students Above Basic Grade 4 Math, where Hawaii ranks #44 with 73%. (Source: National Center for Education Statistics.) But, no surprise, Hawaii ranks #1 in Energy, Gas Price Average, Regular, at $3.28. (Source: Daily Fuel Gauge Report, AAA, 4/27/06.) Hawaii also ranks a dubious #1 in Economy, Total tax burden (per capita), at $3,050.03. (Source: US Census Bureau, 2004. Hawaii ranks #2 in 2005.) The definition and source for stats are conveniently accessible at the top of each table.

Rhode Island - 1st statewide wireless

Rhode Island aims to become the nation's first wireless state, offering border-to-border broadband connectivity, Reuters reported April 28. The Rhode Island Wireless Innovation Networks (RI-WINs) is the private-public partnership that will operate the $20 million project. A hybrid of WiMAX and Wi-Fi technologies, the network will eventually place 120 base antennas in the 1,045 square-mile state. RI-WINs, launched in 2004 by the Business Innovation Factory, expects to be fully operational by 2007, the article reports. Fees would be $20 per month or a usage fee. Rhode Island has a population of 1.08 million.

According to the RI-WINs web site, project partners include the Rhode Island Economic Development Corporation (RIEDC), the Ocean State Higher Education Economic Development and Administrative Network (OSHEAN), Brown University, and IBM, which became project manager for the pilot test in November 2005.