Private Insurance: The Facts
Trends and Proposals in the Private Market
From Families USA:
Reinsurance: A Primer aims to help policymakers and advocates better understand what reinsurance is and how it can make coverage easier to obtain and more affordable. It also identifies some of the benefits of reinsurance to aid lawmakers as they design reinsurance programs to meet the needs of their states. (April 2008)
Reward/Penalty Plans for Wellness: Coming Soon to an Office Near You? Encouraging healthy lifestyles is important, but might some wellness plans place your access to health care at risk? This piece explores some of the hidden effects that reward/penalty plans for wellness may have on consumers, as well as the problems that these plans might present in both employer-sponsored coverage and Medicaid. (January 2008)
Maine's Dirigo Health Reform of 2003 is a thorough examination of the state's health care expansion. It discusses program eligibility, how much people pay for the different types of coverage, what benefits they receive, how the expansion is financed, how it reforms the state's insurance regulations, lessons learned so far, and the future of health reform in Maine. (November 2007)
Massachusetts Health Reform of 2006 is a thorough examination of the state's far-reaching expansion in health coverage. The report discusses who is eligible, how much enrollees pay for the different types of coverage available, what benefits they receive, who is providing coverage, the individual mandate, and how the reform is being financed. It also discusses what lessons state advocates have learned from the process of getting the legislation passed. (August 2007)
Retail Medical Clinics: Okay in a Pinch, but No Substitute for Real Health Coverage provides an overview of the growing trend of clinics popping up in stores such as Wal-Mart, Target, and CVS. While their convenience is appealing, the tradeoff may be piecemeal services that lack appropriate oversight. Consumers should use such clinics only to supplement care from their regular primary care physician. (August 2007)
A Pound of Flesh: Hospital Billing, Debt Collection, and Patients' Rights provides an overview of some of the progressive reform measures that state policymakers have implemented to help families struggling with medical debt. (March 2007)
Six Reasons to Be Wary of High-Deductible HSA Plans (December 2006)
Stop Bad Ideas—HSAs: Missing the Target examines the effects that HSAs will have on those without health insurance and on the health care system overall. (November 2006)
Premiums versus Paychecks: A Growing Burden for Workers (October 2006)
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Understanding How Health Insurance Premiums Are Regulated discusses the state and federal regulation of health insurance premiums. (September 2006)
H.R. 2355, The Health Care Choice Act: The Wrong Prescription for America's Health Care Needs discusses how this legislation, sponsored by Rep. Shadegg and favored by the Administration, would undermine state laws designed to protect health care consumers. (August 2006)
Testimony by Ron Pollack, Executive Director, Families USA, before the National Association of Insurance Commissioners, Health Insurance and Managed Care Committee, discusses state insurance reforms that will help consumers and those that won't. (June 12, 2006)
High-Risk Health Insurance Pools provides answers to key questions about high-risk pools, including who they help and how they are financed. The report also includes a list of questions consumers should ask if they are considering joining a high-risk pool, as well as a checklist for advocates. (May 2006)
Summary of S. 1955: The Health Insurance Marketplace Modernization Act outlines the legislation that introduces Small Business Health Plans (SBHPs) and exempts private insurers from many state laws and regulations governing health insurance. 5 pp. (March 23, 2006)
What Consumers Need to Know about Buying Health Coverage from Associations (July 2005)
What Consumers Need to Know about Health Savings Accounts (July 2005)
What Consumers Need to Know about Purchasing Health Insurance as an Individual (July 2005)
Paying a Premium: The Added Cost of Care for the Uninsured quantifies, for the first time, the dollar impact on private health insurance premiums of care provided to the uninsured. Includes data for each state. | Press Release| Map of Family Premiums, 2005| Map of Family Premiums, 2010 (June 2005)
Have health insurance? Think you're well protected? Think Again! This one-page fact sheet provides quick stats on how health care expenses overwhelm even insured working families, forcing many into bankruptcy. (February 2005)
The Administration has put forth several proposals, including Association Health Plans (AHPs), designed to expand health coverage to the uninsured. How Will Association Health Plans Affect Minority Health? Separating Fact from Fiction analyzes the real impact that AHPs will have on the health care access of uninsured racial and ethnic minorities. (February 2005)
HSAs: Why High-Deductible Plans Are Not the Solution This fact sheet examines the effects that health savings accounts (HSAs) will have on those without health insurance and on the health care system overall. (January 2005)
Health Care: Are you better off today than you were four years ago? Health care has emerged as one of the top concerns of Americans in recent years. To understand what forces are driving this change, Families USA posed a variation of a question raised by Ronald Reagan more than two decades ago: When it comes to health care, are we better off today than we were four years ago? The results of our analysis show that the answer is a clear no. | en español (September 2004)
What's Wrong with Tax-Free Savings Accounts for Health Care? Tax-free personal savings accounts for health care have become the latest cure-all for the problems facing our health care system. This Issue Brief uses a hypothetical company to examine how such accounts undermine the pooling of risk -- the basis for insurance. (November 2003)
Tax-Free Savings Accounts for Medical Expenses: A Tax Cut Masquerading as Help to the Uninsured: This Issue Brief discusses Health Savings Accounts and Health Savings Security Accounts, two kinds of personal savings accounts that were created by a bill attached to the House Republican Medicare prescription drug legislation. (July 2003)
Health Action In Depth: Some Employers Turn to Troubling New Insurance Plans This article from our newsletter Health Action discusses the emergence of Health Reimbursement Arrangement (HRA) plans, which some employers are touting as a way to contain health costs. However, these plans are more likely to simply shift costs to employees They also threaten to further segment the health insurance market; place far greater burdens on those who require more medical care, such as seniors and those with chronic or serious illnesses; and lead to health care rationing. (January 2003)
Health Action in Depth: Worrisome Changes Loom in the Private Health Insurance Market: This article from our newsletter Health Action discusses skyrocketing health care costs, why such costs are increasing, and how employers are passing many of those costs on to their employees. (November 2002)
More than 725,000 Laid-off Workers Have Lost Health Coverage Since the Recession Began in March A Special Report. (December 2001)
Healthy Pay for Health Plan Executives The managed care industry claims that the cost of patients' rights legislation will make families lose health insurance coverage--a charge that is both misleading and self-serving. This report examines the compensation for the highest-paid executives of 10 for-profit, publicly traded companies that own health plans serving multiple states. A Special Report. (June 2001)
Premium Pay: Corporate Compensation in America's HMOs This report examines the 1996 costs of compensation for top level executives of some of the nation's most profitable HMOs (April 1998)
Skyrocketing Health Inflation 1980-1993-2000: The Burden on Families and Businesses (Print only) An analysis of health care spending of American families and businesses, nationally and state-by-state. Also includes data on sources of payment by families and businesses. (November 1993)
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From the Access Project:
2007 Health Insurance Survey of Farm and Ranch Operators provides key findings from a survey of 2,000 farmers from seven states. It discusses their age, racial and ethnic background, income, and health insurance status, as well as whether health care expenses contribute to other financial problems, overall debt, and reduced access to health care. (September 2007)
The Illusion of Coverage: How Health Insurance Fails People when They Get Sick describes how private insurance fails to protect people from financial hardship when they become ill or are injured. The report discusses the aspects of insurance that lead to medical debt and that hamper people's ability to make meaningful choices when purchasing health plans, as well as the consequences of medical debt. It also provides recommendations on how to provide people with access to comprehensive and affordable insurance products. (March 2007)
From the American Diabetes Association and Georgetown University Health Policy Institute:
Falling Through the Cracks: Stories of How Health Insurance Can Fail People with Diabetes l Executive Summary Obtaining and keeping quality, affordable health insurance is a challenge for people with diabetes. The culmination of 14 months of research on how people with diabetes fare in the health insurance market, this report shares the challenges and stories of more than 850 people from all 50 states and the District of Columbia. (February 2005)
From the California HealthCare Foundation:
Snapshot: Health Insurance: Can Californians Afford It? This presentation compares health insurance premiums and out-of-pocket expenses to hourly wages and household spending across California and within six local areas. The results show the significant financial pressure that health care costs are putting on insured Californians. The presentation focuses on the small business and individual insurance markets, where the greatest number of uninsured Californians would get their insurance if they thought they could afford it. (May 2005)
California Employers and Consumers Respond to Changing Health Benefits Employers say they feel that costs are more under control today than they were two years ago, but they increasingly are concerned about the negative consequences of employee cost-sharing measures. Not surprisingly, consumers are less satisfied with their health benefits than they were two years ago and are particularly worried about not being able to pay for the portion of health care services that must come out of their own pocket. Also, a significant percentage of people with chronic illnesses, particularly those with lower incomes and poorer health, report having problems paying their medical bills, and some are skipping recommended care as a way of controlling costs. (January 2005)
From the Center for Studying Health System Change:
Behind the Slow Growth of Employer-Based Consumer-Driven Health Plans finds that employees who use a consumer driven health plan (CDHP) are less likely to be given a choice of plans. Also, employers pay approximately the same amount for employees’ CDHPs as they do for traditional plans, but employees in CDHPs are faced with much higher out-of-pocket costs than those in traditional plans. (December 2006)
More Americans Willing to Limit Physician-Hospital Choice for Lower Medical Costs With health care costs on the rise, more Americans are now willing to accept health plans with limited choice of providers and hospitals in exchange for lower out-of-pocket costs. Between 2001 and 2003, the percentage of working-age Americans willing to trade provider choice for lower costs rose from 55 to 59 percent. (March 2005)
Rhetoric vs. Reality: Employer Views on Consumer-Driven Health Care This study, which looks at employer views on consumer-driven health plans in 12 metropolitan areas, finds that employers know more today than in the past about consumer-driven health care plans and that increased knowledge is raising questions about the effectiveness of such plans. In addition, employers are unsure that cost savings will result from consumer-driven care, have concerns about the ability of employees to access the information necessary to make decisions in a consumer-driven system, and are wary of the ability of tiered provider networks to provide sufficient access to quality health care services. (July 2004)
From the Center on Budget and Policy Priorities:
In considering the pending reauthorization of the State Children’s Health Insurance Program (SCHIP), some have recommended that Congress use federal funds to subsidize the purchase of private health insurance rather than to expand public health programs such as Medicaid or SCHIP. Comparing Public and Private Health Insurance for Children provides evidence that public health coverage is less expensive than private insurance and provides comparable, and in some cases better, access to health care for children. (May 2007)
Many health and tax policy analysts suspected that Health Savings Accounts (HSAs) would be used as tax shelters for high-incomes individuals. GAO Study Confirms Health Savings Accounts Primarily Benefit High-Income Individuals indicates that HSAs are disproportionately used by affluent individuals. The report also explains how HSAs and high-deductible plans reduce costs for healthy people while increasing out-of-pocket costs for less healthy people. (September 2006)
According to recent data from the Census Bureau, 46.6 million Americans lack health insurance. The Number of Uninsured Americans Is at an All-Time High discusses the increased number of uninsured, the decline in employer-sponsored coverage, and changes in Medicaid and SCHIP enrollment. (August 2006)
Federal and state officials are discussing possible ways to reduce Medicaid expenditures, and one common proposal is to increase the copayments Medicaid beneficiaries must pay. Out-of-Pocket Medical Expenses for Medicaid Beneficiaries are Substantial and Growing explains that out-of-pocket medical expenses for low-income, adult Medicaid beneficiaries have grown twice as fast as their incomes in recent years. These individuals now spend more than three times as much of their incomes on out-of-pocket medical costs as middle-class adults with private health insurance. (May 31, 2005)
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From the Citizens’ Health Care Working Group:
Health Care that Works for All Americans: Health Report to the American People outlines current health care policy issues and formulates recommendations based on the input of thousands of Americans who participated in community meetings held across the country. The report offers insight into many health care issues, including rising costs, quality shortcomings, and access problems. (September 2006)
From The Commonwealth Fund:
Overburdened and Overwhelmed: The Struggles of Communities with High Medical Cost Burdens: The number of people with potentially high medical cost burdens varies widely across the nation. Some of these people lack insurance, while others are insured but are paying a high portion of their income to get that coverage. Federal support will be critical to addressing this problem. (November 2007)
Whither Employer-Based Health Insurance? The Current and Future Role of U.S. Companies in the Provision and Financing of Health Insurance examines the importance of employer coverage in our current health care system, as well as its limitations. It also calls for employers to join other stakeholders in designing a more rational and equitable health care system. (September 2007)
Squeezed: Why Rising Exposure to Health Care Costs Threatens the Health and Financial Well-Being of American Families examines the implications of rising out-of-pocket costs for all privately insured Americans. The report also analyses the experiences of adults with employer-sponsored coverage compared to those insured through the individual market. (September 2006)
Health savings accounts (HSAs) and high-deductible health plans (HDHPs) have been promoted by the Administration as part of the solution for the problems facing the U.S. health care system. Health Savings Accounts: Why They Won’t Cure What Ails U.S. Health Care presents expert testimony that encouraging Americans to join HSAs will only exacerbate the nation’s health care woes. Current evidence shows that HSAs suffer from low enrollment, low satisfaction, high out-of-pocket costs, and cost-related access problems. (June 2006)
The Effect of Health Savings Accounts on Health Insurance Coverage concludes that HSAs are not likely to be an important contributor to expanding coverage among uninsured people because most of them do not face high enough marginal tax rates to benefit substantially from the tax deductibility of HSA contributions. Meanwhile, HSAs could potentially destabilize the small-group market. To the extent that they encourage well-compensated healthy workers to abandon job-based coverage, HSAs could undermine the entire structure of job-based coverage among small firms. (April 2005)
How High Is Too High? Implications of High-Deductible Health Plans finds that high-deductible health plans (HDHPs) are unlikely to have a substantial effect on either costs or coverage and can undermine the basic purposes of health insurance -- to reduce financial barriers to needed care and protect against financial hardship. The authors suggest legislative modifications to protect lower-wage adults and ensure access to early preventive and primary care. (April 2005)
Early Implementation of the Health Coverage Tax Credit in Maryland, Michigan, and North Carolina: A Case Study Health Coverage Tax Credits (HCTCs), which pay 65 percent of beneficiaries' health insurance premiums, constitute an ambitious experiment in using the federal income tax system to subsidize health coverage for the uninsured. To gather more evidence about HCTCs' effectiveness and assess their prospects as a model for broader reforms, researchers visited Maryland, Michigan, and North Carolina. The authors present key findings and propose reforms to improve HCTC's ability to help its current target population and aid policy makers in designing future health insurance credits. (April 2005)
The market for people who buy their own coverage has long been a troubled segment of the health insurance industry. Many states have attempted to reform their individual health insurance market by requiring carriers to sell coverage to all applicants regardless of age or health; creating high-risk pools for those with preexisting conditions; and placing limits on the extent to which premiums can vary by age, sex, or health status. Insuring the Healthy or Insuring the Sick? The Dilemma of Regulating the Individual Health Insurance Market assesses the effectiveness of such regulatory reforms in seven states. (February 2005)
Wages, Health Benefits, and Workers' Health Although employer-sponsored health insurance coverage provides access to health care for many working Americans, low-wage workers are much less likely than their higher-wage counterparts to receive health insurance benefits, have access to primary and preventive care, and receive paid sick days. This report examines the connection between wages, health insurance, access to care, and the effect that this has on the health and economic stability of workers. (October 2004)
From the Employee Benefit Research Institute:
Findings from the 2007 EBRI/Commonwealth Fund Consumerism in Health Survey presents information about the growth of account-based and high-deductible health plans and their impact on the behavior and attitudes of consumers. It provides statistics on the numbers of adults enrolled in consumer-driven health plans, their incomes, health status, and satisfaction rates, the rates at which they actually use their plans, and whether these plans have had an impact on the numbers of uninsured. (March 2008)
ERISA Pre-emption: Implications for Health Reform and Coverage provides an overview of state and local attempts at comprehensive health insurance reform and finds that ERISA limits states’ ability to carry out these reforms. For example, ERISA prevents states from establishing minimum levels of coverage for employer-based plans and limits their ability to fund health insurance subsidies for low-income adults through a tax. (February 2008)
Employment-Based Retirement Plan Participation: Geographic Differences and Trends, 2006 examines the level of participation by workers in public and private-sector employment-based pension or retirement plans. (November 2007)
2007 Health Confidence Survey: Rising Health Care Costs Are Changing the Ways Americans Use the Health Care System is the 10th annual survey to assess the attitudes of the American public regarding the U.S. health care system. It finds that most people (six out of 10) are getting hit with increasingly high health costs. (November 2007)
Employer Sponsored Health Benefits—General Overview and FAQ This section of the Employee Benefit Research Institute's (EBRI) Web site is designed to answer basic questions about major benefit issues and trends. It provides short, graphical answers with links to the detailed data underlying the figures. It also provides references to the relevant EBRI publication.
Health Savings Accounts and Other Account-Based Health Plans examines accounts that can be used to pay for health care services on a tax-favored basis -- HSAs, FSAs, MSAs, and HRAs. The function of these accounts is described, followed by a discussion of issues related to the accounts, whether expectations for the accounts will be met, and recent evidence on their impact. (September 2004)
From the Employee Benefit Research Institute and The Commonwealth Fund:
The 2nd Annual EBRI-Commonwealth Fund Consumerism in Health Care Survey finds that enrollment in consumer-directed health plans (CDHPs) and high-deductible health plans (HDHPs) is virtually unchanged since 2005. These plans are making little headway in reducing the number of uninsured, and they are still plagued by low levels of satisfaction and high out-of-pocket costs that deter beneficiaries from seeking care. (December 2006)
From Health Affairs:
A Progress Report on State Health Access Reform describes specific state advances in health coverage, including expansions for uninsured children and adults, regulating the individual insurance market, and employer mandates. However, the findings do not predict how long these changes will last. (January 2008)
Financial Burden of Health Care, 2001-2004 presents an analysis of data that shows an increase in out-of-pocket health care cost as incomes remain the same, especially for the privately insured. For a growing number of families, private Insurance no longer provides adequate financial protection. (January 2008)
Employers’ Views on Incremental Measures to Expand Health Coverage examines employers’ views on the importance of health benefits and their perspective on policies aimed at improving employees’ access to coverage and quality care. Employers of all sizes hold a positive view of the value of health benefits in attracting and retaining workers and in improving workers’ health and productivity. (A subscription is necessary to view the full article.) (November 2006)
From the Health Assistance Partnership:
Resources for Programs Serving Consumers with Private Health Insurance -- Learn More About Private Health Insurance This Web page offers a wealth of information on private health insurance, including issue briefs, consumer outreach materials, and links to materials from other organizations. Topics covered include consumer-driven health insurance and HSAs, COBRA, EMTALA and emergency treatments, ERISA (benefit denials and appeals), HIPAA portability of coverage, HIPAA privacy, and TAARA/tax credits.
Health Insurance Portability and Accountability Act (HIPAA) Privacy Regulations: Questions and Answers for Consumer Health Assistance Programs Health privacy regulations that dictate when a person has a right to obtain his or her medical records and other health information and when health plans and other health care entities can share protected information went into effect on April 14, 2003. This report guides consumer health assistance (ombudsman) programs through their rights and responsibilities under these HIPAA privacy regulations. (May 2003)
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From healthinsuranceinfo.net:
Summary of Key Consumer Protections in Individual Insurance Markets This state-by-state chart provides a quick reference for information on key consumer protections, such as guaranteed issue, pre-existing condition exclusions, and rating restrictions. (April 2004)
healthinsuranceinfo.net Consumer guides to getting and keeping health insurance, written by the Georgetown University Health Policy Institute, are available for each state and the District of Columbia. The guides are available online and are updated periodically as changes in federal and state policy warrant.
From Health Services Research
Immigrants and Employer-Sponsored Health Insurance examines why foreign-born workers are less likely to have employer-sponsored health insurance coverage. The authors conclude that immigrants have a higher probability of working in a firm that does not offer insurance. (A subscription is necessary to view the full article.) (February 2007)
From KaiserEDU.org:
A new tutorial entitled Private Health Insurance 101 provides an overview of the private health insurance system. The tutorial outlines basic concepts, including risk spreading, risk selection, and regulation. It also discusses eligibility, coverage, and costs for consumers. (August 2006)
From the Kaiser Family Foundation:
Employer Health Insurance Costs and Worker Compensation analyzes what it costs employers to provide health insurance and the rate at which these costs are growing. Employers’ costs as a percentage of payroll vary across work settings, which makes it challenging for policymakers to establish equitable standards. The report also notes that employees are suffering: Insurance premiums have risen by 78 percent over the last six years while wages have risen by only 19 percent. (March 2008)
How Non-Group Health Coverage Varies with Income examines how often people at different income levels buy individual health coverage when they cannot obtain coverage through their jobs or through public programs. It found that few people at lower incomes buy individual coverage and that, as income increases, coverage rates increase as well. (February 2008)
The Burden of Out-of-Pocket Health Spending among Older Versus Younger Adults: Analysis from the Consumer Expenditure Survey, 1998-2003 compares the ratio of out-of-pocket health care spending to income among people under age 65 to the ratio for people age 65 and older over the period from 1998-2003. It finds that those over 65 spend far more on health care and have substantially lower incomes than do adults under 65. (September 2007)
More than 150 million individuals received health insurance through an employer in 2005, making employer-sponsored coverage the most prevalent form of health coverage for the nonelderly in the U.S. However, recent years have seen erosion in the availability of employer-based health benefits for workers, especially low-income workers. Changes in Percentage of Families Offered Coverage at Work, 1998-2005 shows that from 1998 to 2005, offers of job-based coverage fell across the board. (July 2007)
One of the many reasons an individual may be uninsured is that she or he decides that an employer’s offer of health insurance is too expensive. Insurance Premium Cost-Sharing and Coverage Take-Up looks at how the take-up rate for workers within firms varies with the level of premium contributions in those firms. (February 2007)
Employer-sponsored health insurance is especially important for immigrant families because their eligibility for public coverage, including SCHIP and Medicaid, is restricted. The Role of Employer-Sponsored Health Coverage for Immigrants: A Primer examines the importance of employer-based coverage and the specific hurdles immigrants face in obtaining health insurance. The primer is available in both English and Spanish. (June 2006)
Distribution of Out-of-Pocket Spending for Health Care Services takes a detailed look at out-of-pocket spending for health care, and, in particular, how out-of-pocket costs vary among different groups for different services. Comparisons focus on, for example, what types of drugs and treatments are most often handled out-of-pocket and what share of total health spending occurs out-of-pocket by income bracket. (May 2006)
Retired Steelworkers and Their Health Benefits: Results from a 2004 Survey looks at how the bankruptcies of two steel companies, the LTV Corporation and Bethlehem Steel, affected health coverage for the companies' retirees and dependents. The survey found that although nearly three-quarters of the retirees who responded had obtained replacement coverage or a supplement to their Medicare coverage, many reported that they were less satisfied with their new coverage than they had been with the benefits they lost. Many also had to delay retirement in order to secure replacement coverage. The survey also studied the effects of the Health Coverage Tax Credit (HCTC) enacted in 2002, finding that it played a major role in helping some steel workers renew coverage. (May 2006)
Four in five businesses that now provide retiree health benefits will accept government subsidies for continuing to provide retiree drug coverage that is at least as good as Medicare's coverage when the new drug benefit starts in 2006, according to Prospects for Retiree Health Benefits as Medicare Drug Coverage Begins: Findings from the Kaiser/Hewitt 2005 Survey on Retiree Health Benefits. The survey examined 300 of the nation's largest private-sector employers that provide retiree health benefits. (December 2005)
Changing Health Care Marketplace Project, a Kaiser Family Foundation project, conducts research and analysis on trends in the marketplace, particularly as they affect vulnerable groups like the poor and the elderly, and on policy proposals that involve the private health care system. There have been striking changes in the health care marketplace in the last few years. Some of these changes build on historic trends; others depart, sometimes dramatically, from prior expectations about how the marketplace would evolve. (February 2005)
The Kaiser Health Poll Report provides key tracking information, including historical trends and in-depth analysis of public opinion about timely health care topics.
The Public, Managed Care, and Consumer Protections, a Kaiser Health Poll Report, examines the public's attitudes towards, and experiences with, their health plans, with a specific focus on managed care. The report uses current and historical public opinion data from the Kaiser Family Foundation and other polling organizations. It also looks at current and historical support for legislative action with regards to patients' rights. (July/August 2004)
Assessing State External Review Programs and the Effects of Pending Federal Patients' Rights Legislation examines key features of state external review programs and how they very across states. It also compares features of those state programs with the external review provisions in the patients' rights bills passed by the House and Senate. (March 2002)
From the Kaiser Family Foundation and Health Research and Educational Trust (HRET):
Employer Health Benefits: A Summary of Findings reports on the rate of growth of health insurance costs, as well as the percentage of employers that offer high-deductible health plans. The findings indicate that, though the growth rate for health insurance costs is at its lowest since 1999, it is still growing faster than both wages and inflation. (September 2007)
Employer Health Benefits 2006 Annual Survey investigates trends in employer-sponsored health coverage, including changes in premiums, cost-sharing, employee contributions, and the prevalence of high-deductible health plans. The study found that insurance premiums are increasing more than twice as fast as workers’ wages and overall inflation. (September 2006)
Employer Health Benefits 2004 Annual Survey is part of an annual series of studies documenting changes in employer-sponsored health insurance, including trends in premium rates and cost-sharing mechanisms. Among its findings, the survey reports that 61 percent of all workers receive health coverage from their employer, down significantly from its peak in 2001, meaning there were at least 5 million fewer jobs that provide health insurance in 2004 than there were in 2001. (September 2004)
From the Kaiser Family Foundation and eHealthInsurance:
Many people are unfamiliar with the individual health insurance market because most Americans get their health coverage through their jobs or from a public program. Update on Individual Health Insurance provides information about the individual health insurance market, including information on insurance purchasers, premiums, retention rates, and cost-sharing. Future reports will provide trend information in such areas as premiums and cost-sharing and data on other topics such as Health Savings Accounts and small business health insurance trends. (August 2004)
From the Kaiser Family Foundation and Hewitt Associates:
Retiree Health Benefits Now and in the Future provides detailed information on retiree health programs offered by large, private-sector employers, including data on eligibility, benefits, premiums, and total costs in 2003. The report also offers insights as to what changes employers say they are likely to make in the near future. (January 2004)
From the Kaiser Family Foundation and the National Women's Law Center:
Access to Care: A State-Level Analysis of Key Health Policies State policies play a critical role in shaping women's access to health care. This report details state activity on a range of polices that affect women's access to care, with an emphasis on private coverage, Medicaid, and reproductive health. Specific policies covered in the report include Medicaid eligibility expansions, managed care protections, and assistance with the costs of prescription drugs. (July 2003)
From the National Conference of State Legislatures (NCSL):
Changing Definition of "Dependent": Who Is Insured and for How Long includes a table showing state legislation that extends the age under which young adults can be covered under their parents' health insurance policies. (September 28, 2006)
From the National Council of La Raza:
Employer-Sponsored Health Insurance: Already Poor Access Dwindles Further for Working Latino Families examines the rates at which the Latino community receives employer-sponsored health insurance, which is lower than that of any other major racial or ethnic group in the U.S. Employers are less likely to offer Latino workers health coverage, so Latinos have to seek out other avenues of insurance coverage, which are often unaffordable. (January 2008)
From State Coverage Initiatives:
Health Insurance Connectors & Exchanges: A Primer for State Officials examines a crucial component of the 2006 Massachusetts health care reform law known as “the Commonwealth Health Insurance Connector Authority,” or simply, “The Connector.” The Connector is presented as a prototype that other states can adapt when seeking to expand health coverage, depending on the specific characteristics in those states. (September 2007)
Reinsurance is when a state opts to cover a portion of private insurer's claims. This "stop-loss" mechanism may cover catastrophic claims above a certain dollar amount, or it may cover claims within a designated corridor. It is an indirect way of reducing premium prices, thereby providing a more affordable option for uninsured workers, and it remains a popular strategy for states that wish to maintain or increase health coverage. More Answers on Reinsurance is designed to serve as a technical guide for states that are interested in building a reinsurance program. (June 2004)
From the Urban Institute:
Increasing Health Insurance Coverage of Workers in Small Firms: Challenges and Strategies: Testimony before the Finance Committee United States Senate calls for a reduction of small business owners that are uninsured. It suggests income-related subsidization of insurance coverage. (October 2007)
Concerns about Parents Dropping Employer Coverage to Enroll in SCHIP Overlook Issues of Affordability addresses the issue of crowd-out—the substitution of public coverage for private coverage. The report compares family medical spending of those who have employer-sponsored health insurance, those who are covered by Medicaid or CHIP, and those who are uninsured. It aims to dispel common misperceptions about CHIP and the people it was meant to serve. (September 2007)
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