Category Archives: Health Care

Understanding Finances and Changes in Retiree Health Care

Source: Joshua Franzel and Alexander Brown, Government Finance Review, February 2012

From the summary:
This article from Center vice president for research Joshua Franzel and Center researcher Alex Brown advises governments to understand what has been done thus far to address OPEB liabilities so they can assess their own efforts and determine if their retiree health care programs are sustainable.

Turning to Fairness: Insurance Discrimination Against Women Today and the Affordable Care Act

Source: National Women’s Law Center, March 2012

From the abstract:
Through our research we have found that women are continuously charged more for health coverage simply because they are women, and individual market health plans often exclude coverage for services that only women need, like maternity coverage. The report provides an in-depth analysis of these inequalities and explains how the Affordable Care Act explicitly removes these discriminations by 2014.

Have Working-Age People with Disabilities Shared in the Gains of Massachusetts Health Reform?

Source: John Gettens, Monika Mitra, Alexis D. Henry, and Jay Himmelstein, Inquiry,Vol. 48, No. 3, Fall 2011
(subscription required)

From the abstract:
The Massachusetts health reform, implemented in 2006 and 2007, reduced the uninsurance rate for working-age people with disabilities by nearly half. Enrollment in Medicaid and subsidized insurance accounted for most of the gain in insurance coverage. The reduction in uninsurance was greatest among younger adults. The reform also reduced cost-related problems obtaining care; however, cost remains an obstacle, particularly among young adults with disabilities. The Massachusetts outcomes demonstrate that insurance subsidies, Medicaid expansions for low-income adults, individual insurance mandates, and enrollment initiatives can lead to substantial reductions in uninsurance and cost-related problems obtaining care among working-age people with disabilities.

What Can We Expect from the “Cadillac Tax” in 2018 and Beyond?

Source: Bradley Herring and Lisa Korin Lentz, Inquiry, Vol. 48, No. 4, Winter 2011/2012
(subscription required)

From the abstract:
One controversial aspect of the Patient Protection and Affordable Care Act is the provision to impose a 40% excise tax on insurance benefits above a certain threshold, commonly referred to as the “Cadillac tax.” We use the Employer Health Benefits Survey, sponsored by the Kaiser Family Foundation and Health Research and Educational Trust, to examine the number and characteristics of plans that likely will be affected. We estimate that about 16% of plans will incur the tax upon implementation in 2018, while about 75% of plans will incur the tax a decade later due to the indexing of the tax thresholds with the Consumer Price Index. If the Cadillac tax is ultimately implemented as written, we find that it will likely reduce private health care benefits by .7% in 2018 and 3.1% in 2029, and will likely raise about $931 billion in revenue over the ensuing 10-year budget window from 2020 to 2029.

Performance in an Era of Uncertainty: Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care

Source: Towers Watson, 2012

From the abstract:
The 17th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care tracks employers’ strategies and practices, and the results of their efforts to provide and manage health benefits for their workforce. This report identifies the actions of high-performing companies, as well as current trends in the health care benefit programs of U.S. employers with at least 1,000 employees. Respondents were also asked about specific implications for their health care benefit programs attributed to the health care reform Patient Protection and Affordable Care Act (PPACA).

The survey was completed by 512 employers between December 2011 and January 2012, and reflects respondents’ 2011 and 2012 health program decisions and strategies and, in some cases, their 2013 plans. Respondents collectively employ 9.2 million full-time employees have 8.0 million employees enrolled in their health care programs and operate in all major industry sectors. In 2011, respondents spent, on average, $10,982 per employee on health care, which equates to a collective $87 billion in total health care expenditures.

How Would Eliminating the Individual Mandate Affect Health Coverage and Premium Costs?

Source: Christine Eibner, Carter C. Price, RAND Corporation, Research Brief, RB-9646-CMF, 2012

From the abstract:
An analysis of the effects of implementing the Affordable Care Act without an individual mandate found that over 12 million people who would have otherwise signed up for coverage will be uninsured and premium prices will increase by 2.4 percent.

Employer and Worker Contributions to Health Savings Accounts and Health Reimbursement Arrangements, 2006-2011

Source: Paul Fronstin, Employee Benefit Research Institute, EBRI Notes, Vol. 33, No. 2, February 2012

From the summary:
This report presents findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey, as well as earlier surveys, examining the availability of health reimbursement arrangement (HRA) and health savings account (HSA)-eligible plans (consumer-driven health plans, or CDHPs). It also looks at employer and individual contribution behavior.

Health-insurance Coverage for Low-wage Workers, 1979-2010 and Beyond

Source: John Schmitt, Center for Economic and Policy Research, February 2012

From the abstract:
This paper uses data from the Current Population Surveys for 1980 through 2011 to review trends in health-insurance coverage rates for low-wage workers (defined as workers in the bottom fifth of the wage distribution in each survey year). In 2010, over 38 percent of low-wage workers lacked health insurance from any source, up from 16 percent in 1979. The biggest reason for the decline in coverage is the erosion of employer-provided health insurance, either through a worker’s own employer or as a dependent on another family member’s employer-provided policy. Over the last three decades, the role of public insurance in providing coverage for low-wage workers has increased, though not nearly enough to offset the declines in private insurance. In 2010, about 10 percent of low-wage workers had coverage through Medicaid, double the share in 1979. While a great deal of uncertainty still surrounds the Affordable Care Act (ACA) and its likely impact on employers and workers, reasonable estimates based on consensus projections suggest that the ACA will have a substantial positive effect on health-insurance coverage rates for low-wage workers. Even so, the ACA will likely leave an important share of low-wage workers, especially low-wage Latino, African American, and Asian workers, as well as many immigrant workers, without coverage. At the same time, if the ACA is blocked – in the courts or in Congress – there is every indication that coverage rates for low-wage workers will continue their long, steady decline.

Employer and Worker Contributions to Health Savings Accounts and Health Reimbursement Arrangements, 2006-2011

Source: Paul Fronstin, Employee Benefit Research Institute, EBRI Notes, Vol. 33, No. 2, February 2012

Enrollment in health savings accounts (HSAs) and heath reimbursement arrangements (HRAs) continues to grow, but contribution patterns to these account-based health plans are changing, according to a new report from EBRI. Annual contributions from employer have fallen since 2008, while contributions from individuals have gone up.
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