TANF at 10

“An Examination of the First Ten Years Under TANF in Three States: The Experiences of New Jersey, New York, and Pennsylvania.” Robert G. Wood and Justin Wheeler, October 2006. Ten years ago, Congress reformed welfare by creating Temporary Assistance for Needy Families (TANF), which required most welfare recipients to work and imposed time limits on benefits for the first time. Recent changes to federal TANF rules place additional pressure on states to move more recipients from welfare to work. This specially commissioned report on the implementation of TANF in New Jersey, New York, and Pennsylvania highlights their different approaches to welfare reform and explores how these approaches may have affected caseload declines, as well as the proportion of TANF recipients who are working.

Medicare Advantage

"Analysis of the Characteristics of Medicare Advantage Plan Participation.” Marsha Gold and Stephanie Peterson, July 2006. This report explores the growth of Medicare Advantage (MA) in 2006 concurrent with the introduction of the new drug benefit. Based on analysis of publicly available CMS data, the authors find that the widely heralded expansion in MA masks important differences in the rate of growth by area of the country and market segment. Through interviews with MA sponsoring firms, the authors learned that firms’ responses to the new drug benefit required balancing the demands of starting up new prescription drug plans with expansion in MA. In deciding on MA expansion strategies, firms: (1) built on their base; (2) targeted “low hanging fruit”; (3) favored strategies consistent with their perceived market strength; (4) sought expansions appropriate within the full range of their business; (5) tailored the level of business risk; (6) responded to individual market preferences; and (6) started positioning themselves in 2005 or earlier. Plans were interviewed before making final decisions on 2006 offerings. However, firms seemed positioned to refine their current mix of offerings, with selective expansions particularly with private fee-for-service and special needs plans. The authors conclude that the Medicare market has changed in 2006, but it remains to be seen how stable the changes are and whether they lead to fundamental changes in Medicare.

Children with Special Health Care Needs

"Children with Special Health Care Needs in Commercial Plans." Quality Care for Special Kids: Profiles of Children with Chronic Conditions and Disabilities No. 1. Shanna Shulman, Henry Ireys, and Stephanie Peterson, September 2006. Out of every five persons in a commercial health insurance plan who has a chronic condition, one is a child. This first brief in a new series profiles children with disabilities and chronic conditions in commercial plans, who account for more than 70 percent of every dollar spent on child health. The brief, which examines their health status, severity of conditions, and use of services, notes that they might benefit from care or disease management.

"Prescription Drug Costs for Children with Special Health Care Needs." Quality Care for Special Kids: Profiles of Children with Chronic Conditions and Disabilities No. 2. Henry Ireys, Shanna Shulman, and Stephanie Peterson, October 2006. The rapidly escalating costs of prescription drugs affect children and adults alike and contribute to concerns that traditional employer-based insurance will be unaffordable in the future. However, little information is available on costs for children with chronic conditions and disabilities, who make heavy use of these drugs. This brief, based on the most comprehensive data available for a large sample of commercially insured children, recommends strategies for helping to ensure that children have access to needed medications in the future.

Beyond Test Scores

“Expanding Beyond Academics: Who Benefits and How?” John Deke and Joshua Haimson, September 2006. The growing use of math and reading scores to measure school and student performance, spurred by the No Child Left Behind Act, has heightened an old debate about which competencies public schools should encourage students to develop. A new issue brief looks at how students’ competencies in high school relate to postsecondary educational attainment and earnings later in life. These competencies include academic achievement (as measured by test scores), leadership skills, sports-related skills, work habits, prosocial behavior, and locus of control (a measure of students’ belief that they control their future). The brief concludes that many of these competencies appear to predict students’ later success in higher education and the labor market. It also concludes that not all students would benefit from improving the same competencies, suggesting that an individualized approach to education may be preferable to a "one-size-fits-all" approach. Click here for full report.

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