Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. General Population

04/01/2000

Multi-year data on trends in drug coverage for the non-Medicare population are not readily available. However, there is evidence that health insurance coverage generally has eroded slightly since 1996. Table 1-16 shows the proportion of noninstitutionalized civilians without Medicare receiving coverage from different sources at any time during 1996 and 1998, as measured by the March supplement to the Census Bureau’s Current Population Survey (CPS). While enrollment in employer plans increased somewhat, the gain was more than offset by a sharp decline in Medicaid participation. Over the two years, the share of the non-Medicare population with no coverage grew by nearly a percentage point.

Source of coverage 1996 1998
Table 1-16. Distribution of Health Insurance Coverage by Type of Insurance, 1996 and 1998
Employer 64.7% 65.5%
Other private 9.9% 9.2%
Medicaid 11.5% 9.8%
Other 3.2% 3.1%
None 18.1% 18.9%

Note: Columns sum to more than 100 percent because some people had multiple sources of coverage during the year. In 1998, use of Indian Health Service facilities is no longer treated as insurance.

Source: Institute for Health Policy Solutions analysis of March 1997 and March 1999 Supplements, Current Population Survey.51

For people with coverage, prescription drug benefits may be less generous now than in 1996. Because rising prescription drug spending has been driving overall growth in employer health plan costs (see Chapter 2), many employers are reportedly focusing on restraining the cost of drug benefits. In the last year, a reported 32 percent of employers with 500 or more workers modified drug benefit design, for example, by increasing financial incentives for participants to use generic or on-formulary drugs. Ten percent have limited coverage for some new drugs or other treatments.

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