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.

"Private Insurance General" provides links to several good overview and introductory resources on private insurance.
"Affordability of Coverage" includes studies and other materials that document the rising costs of coverage and ways to address this problem for Americans.
"Adequacy of Coverage" features materials about benefits and cost-sharing, which make or break the quality of an insurance policy.
"Availability of Coverage" looks at the special problems that people with pre-existing conditions or who are otherwise at high risk face in getting and keeping insurance, along with the protections that are necessary to help such people obtain coverage that meets their needs.
"COBRA & TAARA Coverage" has information about how COBRA continuation coverage works, including details about the 65 percent subsidy included in the economic stimulus act, and about the TAARA tax credit to help workers displaced by trade.
"Bad Ideas" discusses Health Savings Accounts (HSAs), Association Health Plans, and other “solutions” to the health crisis that would actually make matters worse, not better.
"Legal Rights" offers resources to help consumers facing an array of complex issues, laws, and regulations in the private health insurance market.
"Improving the Market" provides more technical information for advocates and policymakers about tools used to regulate and improve the private market for consumers.

The Latest

From Families USA:

Health Coverage in the States: How Will Health Reform Help? discusses the major gaps in each state's health coverage system and how health reform will address these gaps and help state residents, including the insured, the uninsured, people in Medicare, and small businesses. (March 2010)

The Dangers of Defeat: The Cost of Failure to Pass Health Reform analyzes the many consequences for America's families and businesses if health reform is—or is not—enacted. It examines what will happen to health insurance premiums, out-of-pocket health care costs, and businesses struggling to provide coverage to workers. (March 2010)

Rate Review: Holding Health Plans Accountable for Your Premium Dollars discusses common problems with the process of reviewing health insurance premium rates, the lessons learned from state rate review procedures, and how health reform will address these problems. (March 2010)

Families USA's Comments on the Genetic Information and Nondiscrimination Act (GINA) Interim Final Rules: We applaud the rules' strong protections against insurance discrimination based on genetic information. Our comments detail the protections against underwriting based on genetic information, which will help make coverage more accessible and affordable for Americans. (December 22, 2009)

Expiration of COBRA Subsidy: Millions of Unemployed Workers and Their Dependents Are at Risk; Many Will Lose Their Subsidy as of December 1, 2009 provides state-specific data on what will happen to family COBRA premiums when the subsidy ends, and it argues for extending the COBRA assistance. (December 2009)

Subsidy extended—see Understanding COBRA Premium Assistance (Updated December 22, 2009)

Your Medical Bills: A Consumer's Guide to Coping with Medical Debt covers steps for paying your medical bills, understanding your rights, and other information you need to know if you are struggling with medical debt. The guide also includes links to many useful online resources. | Fact Sheet | State Protections (November 2009)

From the Commonwealth Fund:

Young, Uninsured, and Seeking Change: Health Coverage of Young Adults and Their Views on Health Reform found that almost half of young adults are uninsured at some time during the year. In the current economic climate, young adults are less likely to find jobs, especially jobs with health benefits, and are often dropped from their parents' insurance upon graduation from college or high school. Provisions in federal health reform legislation could significantly help this group get and keep health coverage. (December 2009)

From the Commonwealth Fund and the California HealthCare Foundation:

COBRA Subsidies for Laid-Off Workers: An Initial Report Card indicates that enrollment in COBRA coverage has increased substantially, and reports show that most eligible people have heard about the subsidy. Unfortunately, many eligible people still can't afford COBRA coverage. In order to further increase enrollment, Congress should consider raising subsidies and further simplifying enrollment procedures. (December 2009)

From the Commonwealth Fund and Washington and Lee University School of Law:

Health Insurance Exchanges in Health Care Reform: Legal and Policy Issues explains the nature and function of an exchange, including six roles that exchanges are intended to play in health reform. The report concludes that, given our past experience, the effectiveness of any new exchange will depend entirely on the institutions that are established to administer it, highlighting the importance of how Congress designs the exchanges in its health reform legislation. (December 2009)

From the Department of Health and Human Services:

Insurance Companies Prosper, Families Suffer: Our Broken Health Insurance System discusses the disturbing trend of insurance companies raising their premiums even while they’re making record profits. States that are seeing the highest premium increases include California (39 percent), Maine (23 percent), and Michigan (56 percent). According to the report, premiums will continue to rise by 20 or even 30 percent. (February 2010)

From the Department of Health and Human Services:

From Health Care for America Now:

Health Insurers Break Profit Records as 2.7 Million Americans Lose Coverage compares the recent rise in profits for the largest insurance companies with the concurrent rise in uninsurance. While the five largest insurers saw a 56 percent increase in profits from 2008 to 2009, they provided coverage to 2.7 million fewer people. These companies also raised rates and cost-sharing and decreased the share of premiums they spent on medical care. (February 2010)

From the Kaiser Family Foundation

Racial/Ethnic Disparities in Access to Care among Children: How Does Medicaid Do in Closing the Gaps? examines how disparities among children in Medicaid compare with those among privately insured and uninsured children. The findings reveal that disparities in Medicaid were similar to those in the private insurance market, and although the majority of children fare well in terms of access, problems still persist for children trying to get access to the health care they need. (December 2009)

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