Private Insurance: Availability

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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.

From Families USA

Job-Based Coverage and the Affordable Care Act: Why the Law Won't Cause Employers to Drop Coverage explains why employers will continue to offer coverage under the Affordable Care Act and how the law makes it easier for small employers to offer coverage to their workers. (May 2013)

Worry No More: Americans with Pre-Existing Conditions Are Protected by the Health Care Law provides estimates of how many people will be protected from discrimination based on their health status thanks to the health care law. For the first time, the state reports include county-level data, and they include state-level data that are broken down by age, income, and racial or ethnic group. (July 2012)

Wellness Programs: Evaluating the Promises and Pitfalls presents an overview of current programs, identifies how their role could soon change, explains how certain programs can limit access to coverage and care, and provides recommendations for policies that will help prevent these programs from limiting access. (June 2012)

Good Business Sense: The Small Business Health Care Tax Credit in the Affordable Care Act provides national and state-level estimates of the number of small businesses that will be eligible for this tax credit and of how much the credits will be worth. It also includes data on how many workers could benefit as a result, broken down according to racial and ethnic group. (Done in collaboration with Small Business Majority, May 2012)

When a Health Insurer Leaves the Individual Market: What States Can Do before Certain Affordable Care Act Changes Take Effect in 2014 discusses specific actions states can take to protect consumers who need to buy coverage in the individual market. It examines existing protections and explains how states can supplement them. (May 2012)

Getting Covered: Finding Health Insurance When You Lose Your Job is designed to help consumers who've lost their health coverage sort through possible options for new coverage, including COBRA, Medicaid, CHIP, other federal and state programs, and the individual market. (Updated February 2012)

The Bottom Line: How the Affordable Care Act Helps America's Families shows the net financial effects of the Affordable Care Act on family budgets. We found that lower- and middle-income families, both uninsured and insured, will be financial winners. | State Reports (October 2011)

The Basic Health Option: Will It Work for Low-Income Consumers? provides a framework for advocates to think about whether this option, created by the health care law, will work for their state. It covers program basics, discusses the problems it might address, and raises key issues that can affect the direction such a program might take. (July 2011)

Why We Need a Health Insurance Exchange is a one-page handout that cites several reasons why consumers will benefit from the new exchanges, including competition, affordability, and quality. Advocates can modify this version to fit their needs. (June 2011)

The Affordable Care Act: Patients' Bill of Rights and Other Protections is a compilation of all of our fact sheets to date on consumer rights and protections. (April 2011)

States Are Benefitting from Provisions of the Affordable Care Act lists the number of people in each state who are already benefiting from each of five provisions. The provisions include measures that are helping small businesses provide coverage to their workers, helping seniors get free preventive care, and protecting children with pre-existing conditions. | Table (March 2011)

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From Other Organizations

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. (Kaiser Family Foundation, December 2012)

Jobs without Benefits: The Health Insurance Crisis Faced by Small Businesses and Their Workers explains how the Affordable Care Act will help small business employees, who are more likely to be uninsured than workers in large firms, with new coverage options, tax credits, the medical loss ratio rule, and protection from coverage denials for pre-existing conditions. (Commonwealth Fund, November 2012)

Selling Health Insurance across State Lines: An Assessment of State Laws and Implications for Improving Choice and Affordability of Coverage analyzes the implementation of laws in six states (GA, KY, ME, RI, WA, and WY) that allow the sale of insurance across state lines. Although these laws were designed to enhance consumer choice, to increase competition, and to make insurance more affordable, the complexities of how insurance is sold and regulated have deterred insurance companies from entering new markets, thereby undermining the laws’ goals. (Center on Health Insurance Reforms, October 2012)

Putting Men’s Health Care Disparities on the Map: Examining Racial and Ethnic Disparities at the State Level documents the persistence of health disparities among men by providing extensive state-level data, broken down by racial and ethnic group, on three factors: health status, access to and use of care, and social determinants of health. (Kaiser Family Foundation, September 2012)

Employer Health Benefits: 2012 Summary of Findings provides a detailed look at trends in job-based health coverage, including premiums, employee contributions, and cost-sharing. It includes data that are broken down by firm size and plan type, and it also includes information on participation in wellness programs. (Kaiser Family Foundation and the Health Research and Educational Trust, September 2012)

After the Ruling: A Consumer’s Guide is a user-friendly explanation of how the Supreme Court’s decision will affect people without insurance, consumers who get insurance through their jobs, people who want insurance but cannot afford it, people with health problems, small business owners, and seniors. It also explains parts of the law that are already in place. (Kaiser Family Foundation, June 2012)

Number of Young Adults Gaining Insurance Due to the Affordable Care Act Now Tops 3 Million finds that the gains in coverage for young adults were almost entirely from increases in private insurance. It also notes that coverage gains for young men, who previously had the highest rates of uninsurance of any gender-age group combination, were particularly large. (Department of Health and Human Services, June 2012)

Young, Uninsured, and in Debt: Why Young Adults Lack Health Insurance and How the Affordable Care Act Is Helping finds that, between September 2010 and June 2011, the number of insured young adults increased by 2.5 million as a result of the dependent coverage provision. It also finds that most young adults do enroll in coverage when it is accessible and affordable, and only 6 percent of those surveyed said they do not need coverage. (Commonwealth Fund, June 2012)

Employment-Based Health Benefits: Trends in Access and Coverage, 1997—2010 provides data on the offer, coverage, and take-up rates among workers. It also examines why many workers are not covered, and it includes breakdowns by age, gender, and race/ethnicity. (Employee Benefit Research Institute, April 2012)

Gaps in Health Insurance: Why So Many Americans Experience Breaks in Coverage and How the Affordable Care Act Will Help finds that one-quarter of adults aged 19 to 64 experienced a gap in their health insurance in 2011, with a majority remaining uninsured for one year or more. It also explains how the Affordable Care Act’s Medicaid expansion and exchanges will help people maintain coverage. (Commonwealth Fund, April 2012)

States and the Affordable Care Act is a series of state reports that analyze the effects of the Affordable Care Act on coverage, health expenditures, affordability, access, and premiums. It also assesses state’s progress with implementation of the law. The reports examine the following states: CO, MD, NY, OR, and RI. (Urban Institute, April 2012)

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