Private Insurance
Most Americans receive their health coverage through the private insurance market, usually through their jobs. However, many people buy insurance on their own in the individual market. Since coverage from private companies is the largest source of insurance for Americans, it is likely to be a central part of federal and state health reform efforts.
This section of our Web site keeps you up-to-date on what's happening in the private health insurance arena.
The Latest
From Families USA:
State Advocate To-Do List for 2013 outlines issues that advocates may want to address in 2013 in anticipation of the changing health care environment. (January 2013)
Help Wanted: Preparing Navigators and Other Assisters to Meet New Consumer Needs explains the requirements for navigator programs and answers seven key questions that states will face as they seek to establish effective navigator programs. It is available as an online tool kit and as a PDF. (Updated January 2013)
Filling in Gaps in Consumer Assistance: How Exchanges Can Use Assisters explains the key differences between navigator and assister programs and how in-person assistance can function in the different types of exchanges. It also recommends actions advocates can take. (Updated January 2013)
Consumer-Friendly Standards for Qualified Health Plans in Exchanges: Examples from the States outlines the minimum standards for qualified health plans as set out in the Affordable Care Act. It then provides examples from eight state-based exchanges and one partnership exchange state on how to implement those standards in consumer-friendly ways. (January 2013)
Regulations and Guidance for the Affordable Care Act: The Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Internal Revenue Service (IRS) have issued interim final rules and requests for information on several provisions of the health reform law pertaining to private insurance. Families USA has submitted commments on many of these provisions. Click here for our Regulations and Guidance page.
From the Commonwealth Fund:
Insurers’ Responses to Regulation of Medical Loss Ratios finds that, although insurers reduced administrative costs in response to the medical loss ratio rule in the Affordable Care Act, these reduced costs were offset by increased profits for insurance companies. (December 2012)
State Trends in Premiums and Deductibles, 2003-2011: Eroding Protection and Rising Costs Underscore Need for Action explains that premiums for job-based family coverage increased by 62 percent, employee premium contributions increased by 74 percent, and deductibles more than doubled. It includes state-level data on premiums for family coverage and a map that shows the increase in the cost of premiums as a percentage of household income across the states. (December 2012)
From the Kaiser Family Foundation:
A Comparison of the Availability and Cost of Coverage for Workers in Small Firms and Large Firms: A View from the 2012 Employer Health Benefits Survey compares whether firms offer coverage, how much plans cost, and how much cost-sharing workers are responsible for. It finds that workers in small firms generally pay a higher share of premiums and higher cost-sharing than workers in large firms. (December 2012)
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