New on the Web 58 (July 2009)
From the Campaign for America’s Future: “How to Structure a ‘Play-or-Pay’ Requirement on Employers”
From the Commonwealth Fund: “Fork in the Road: Alternative Paths to a High Performance U.S. Health System,” “Setting a National Minimum Standard for Health Benefits: How Do State Benefit Mandates Compare with Benefits in Large-Group Plans?”
From Health Affairs: “Families with Mixed Eligibility for Public Coverage: Navigating Medicaid, CHIP, and Uninsurance”
From the Kaiser Commission on Medicaid and the Uninsured: “CHIP Tips: New Federal Funding Available to Cover Immigrant Children and Pregnant Women”
From the Kaiser Family Foundation: “Side-by-Side Comparison of Major Health Care Reform Proposals,” “Medicare Prescription Drug Plans in 2009 and Key Changes since 2006: Summary of Findings,” “Medicare’s Role for Women”
From Mathematica: “Making Progress on Health Care Disparities”
From the Robert Wood Johnson Foundation: “Considering a Health Insurance Exchange: Lessons from the Rhode Island Experience”
From the Urban Institute: “Changes to the Tax Exclusion of Employer-Sponsored Health Insurance Premiums: A Potential Source of Financing for Health Reform”
From the Campaign for America’s Future:
How to Structure a “Play-or-Pay” Requirement on Employers examines not only how to structure an employer coverage mandate, but also the economic and political impacts of such a mandate, as part of health reform. In addition, it offers recommendations for navigating the political issues raised by such a requirement. The authors conclude that the potential negative effects of instituting a mandate are modest and would be outweighed by the benefits. (June 2009)
From the Commonwealth Fund:
Fork in the Road: Alternative Paths to a High Performance U.S. Health System compares three different health reform scenarios: 1) one that includes a public plan option in which health care providers would be paid at rates midway between Medicare rates and private plan rates, 2) one that includes a public plan option that links payments more closely to Medicare rates, and 3) one that includes no public plan (instead relying exclusively on private plans). Cumulative health system savings would range from $3 trillion under option 1 to $2 trillion for option 2 to $1.2 trillion for a purely private plan approach under option 3. (June 2009)
Setting a National Minimum Standard for Health Benefits: How Do State Benefit Mandates Compare with Benefits in Large-Group Plans? compares state-mandated benefits with the services and providers covered under the Federal Employees Health Benefits Program (FEHBP) Blue Cross and Blue Shield standard benefit package. With few exceptions, the FEHBP plan either meets or exceeds the benefits that state mandates require. Under a national standard, states would still have the option of providing other benefits above the national standard. (June 2009)
From Health Affairs:
Families with Mixed Eligibility for Public Coverage: Navigating Medicaid, CHIP, and Uninsurance finds that, in families with multiple children who have different eligibility statuses, there is a 26 percent chance that one or more children will be uninsured. Mixed eligibility occurs most often in families with children of different immigration statuses, where older, foreign-born children may not be eligible for the public coverage their younger, U.S.-born siblings can receive. Medicaid income eligibility thresholds that are linked to age also play a role: In some families, older children are eligible for CHIP, while younger children are eligible for Medicaid. (June 2009) Subscription required
From the Kaiser Commission on Medicaid and the Uninsured:
Side-by-Side Comparison of Major Health Care Reform Proposals compares the leading reform proposals across a number of key characteristics, including expansion of public programs, benefit design, and changes to private insurance. The side-by-side includes details from H.R. 3200, the America’s Affordable Health Choices Act of 2009, along with proposals from the Senate Finance Committee (based on press releases from the committee) and the Senate HELP Committee. (July 2009)
CHIP Tips: New Federal Funding Available to Cover Immigrant Children and Pregnant Women highlights new opportunities for covering children under the Children’s Health Insurance Program Reauthorization Act (CHIPRA). The brief examines how the new option works and provides information about eligibility requirements. In addition, it explains the choices states face when deciding whether to pursue this option. (July 2009)
From the Kaiser Family Foundation:
Medicare Prescription Drug Plans in 2009 and Key Changes since 2006: Summary of Findings includes data on the number of drug plans available, premium increases, and the coverage gap (the “doughnut hole”). The brief also addresses cost-sharing as a part of benefit design, as well as the specialty tier most Part D plans use to cover high-cost medications. (June 2009)
Medicare’s Role for Women examines the demographics of women who rely on Medicare, including their health status and income levels. It also looks at the benefits and cost-sharing requirements of Medicare and the prevalence of other types of coverage, such as job-based insurance or Medigap. For women, who are disproportionately low-income and who have more chronic conditions than men, Medicare is a particularly critical source of retirement security. (June 2009)
From Mathematica:
Making Progress on Health Care Disparities assesses the progress made by the National Health Plan Collaborative (NHPC), a collection of health insurance companies and private and public organizations that works to improve the quality of health care for racial and ethnic minorities. The report looks at the NHPC’s activities that were designed to encourage and support health plans’ leadership in their work on disparities. It also assesses plans’ ability to collect data to better identify disparities. (June 2009)
From the Robert Wood Johnson Foundation:
Considering a Health Insurance Exchange: Lessons from the Rhode Island Experience highlights the importance of clearly defining the goals of an exchange, and getting major stakeholders to participate, during the health reform process. Rhode Island’s public reform process gave participants a greater understanding of which policy goals could be achieved by the various components of the exchange. States looking to Rhode Island as an example should note the basic steps to be followed when analyzing any exchange model. (June 2009)
From the Urban Institute:
Changes to the Tax Exclusion of Employer-Sponsored Health Insurance Premiums: A Potential Source of Financing for Health Reform focuses on a two-part design for reducing or eliminating this tax exclusion: 1) a cap or dollar limit on the amount of job-based health insurance premiums that are excluded from taxable income, and 2) an index that determines how this cap might grow over time. The analysis shows that limiting the tax exclusion would provide substantial funding for health reform and mitigate the inequalities in the current treatment of employer premiums. (June 2009)
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