Publications

Parity in mental health benefits rectifies unfairness in health insurance coverage and reduces financial risk for those with mental illness. However, increased coverage for mental illness has been seen as creating inefficiencies and increasing total spending, based largely on results from the RAND Health Insurance Experiment conducted in the 1970s. Newer evidence suggests that cost control techniques associated with managed care give health plans alternatives to discriminatory coverage for containing costs. We review both eras of research on mental health insurance and conclude that comprehensive parity implemented in the context of managed care would have little impact on total spending.

 

Adult children are crucial sources of care for frail older Americans, but childless adults face limited informal care options. This report examines how the absence of children affects the receipt, amount, and source of care.

Frail older adults are one of the most vulnerable groups in the nation. Disproportionately female, widowed, and in their 80s and 90s, most older people with disabilities living outside of nursing homes have little education and limited financial resources. Given the scarcity of public financing for home-based care, about three-quarters of those receiving assistance rely exclusively on unpaid caregivers. Providing help is often a burden on spouses, children, and friends, leaving some older Americans without the care they need. As the population ages, the demands on government and families will only intensify and put more older people at risk.