Author: Jenny Alvarez Publisher: Nova Science Publishers ISBN: 9781624174216 Category : Health insurance Languages : en Pages : 0
Book Description
Since 1975, a growing number of states have implemented high risk pools (HRPs), which offer non-profit health insurance to individuals who are unable to purchase affordable coverage in the private market because of pre-existing conditions. State HRPs often contract with a private health insurance carrier to administer the pool, and plan options can vary significantly both within pools and from state to state. This book examines the temporary federal high risk pool (HRP) program, also known as the Pre-Existing Condition Insurance Plan (PCIP); with a focus on enrolment, benefits and funding.
Author: John E. Dicken Publisher: DIANE Publishing ISBN: 1437921191 Category : Business & Economics Languages : en Pages : 41
Book Description
A growing number of states -- 35 as of June 2009 -- have created high-risk health insurance pools (HRPs) to provide coverage to individuals whose health status limits their access to coverage in the private individual health insurance market. HRPs -- typically state-run nonprofit assoc. -- often contract with a private health insurance carrier to administer the pool and offer a range of health plan options to such individuals, who are commonly referred to as medically uninsurable. This report describes: (1) HRP enrollment and enrollee demographics; (2) HRP plans' cost-sharing provisions, coverage restrictions, and premiums, and comparable information for certain private market health plans; and (3) HRPs' governance, expenditures, and funding. Illus.
Author: Tanya Schwartz Publisher: ISBN: Category : Languages : en Pages : 10
Book Description
State high-risk pools are state programs that offer health insurance to residents who, because of pre-existing medical conditions, are unable to purchase affordable coverage in the individual market. High-risk pools operate in 34 states and provide health insurance to nearly 200,000 U.S. residents. Although high-risk pools have existed since 1976, they have received little national attention until recently. Health reform legislation passed in the House of Representatives and in the Senate creates a temporary national high-risk pool program to provide health coverage to people prior to the implementation of other coverage expansions included in the bills. As the national health reform debate continues, high-risk pools represent one strategy for providing coverage to people with pre-existing medical conditions.
Author: David P. Bernstein Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
Current high-risk pools insure around 190,000 high-risk individuals at a total cost of around $9,400 per enrollee. Expanding high risk pools so they insure a total of one million individuals would necessitate raising an additional $7.6 billion in revenue through premiums, allocations on insurance firms, through government subsidies and other sources. A proposal under consideration by Congress would insure around 60,000 additional individuals. There are around 3.5 million people who are uninsured the entire year and cannot obtain private insurance because of health considerations. Health insurance plans offered by high-risk pools are generally too expensive for lower-income individuals. Efforts to reach lower-income individuals through high-risk pools would require larger subsidies, which would involve either more public funds or a reduction in the number of people insured. Current high-risk pools do not serve individuals who have offers of employer sponsored insurance (ESI) and will therefore not impact the price or availability of ESI from small firms.
Author: Mark V. Pauly Publisher: American Enterprise Institute ISBN: 9780844741192 Category : Business & Economics Languages : en Pages : 120
Book Description
Uncertainty about risks to health virtually requires that people have health insurance. But how is the cost of premiums determined? Should rates vary according to some indicators of risk? How much do premiums vary with risk? Do the young and the healthy actually subsidize the old and the unhealthy?
Author: Mei-Ni Ng Publisher: ISBN: 9781361359501 Category : Languages : en Pages :
Book Description
This dissertation, "High-risk Insurance Pool: a Systematic Review and Assessment on Efficiency and Equity in Healthcare" by Mei-ni, Ng, 吳美妮, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: To enable high-risk individuals to have access to private health insurance, the Hong Kong government has announced the establishment of a high-risk pool reinsurance mechanism. Under the voluntary and government-regulated insurance program, "Health Protection Scheme," the high-risk pool will accept individuals with pre-existing medical conditions or higher health risks. Critics have long expressed their concerns regarding the financial sustainability of Hong Kong''s healthcare system due to its heavy reliance on government subsidies and publicly funded services. Patients with pre-existing conditions are denied coverage by the private insurance sector, and have to rely heavily on the overburdened public healthcare system. Following the United States, the Hong Kong government suggests that a high-risk pool proposal will offer a relatively simpler approach compared to other alternatives. However, little is known about its applicability in Hong Kong or potential problems. Therefore, the objective of this study is to evaluate the effectiveness of high-risk pool in promoting healthcare efficiency, equity, and to make recommendations for the operations in Hong Kong. A systematic literature review was conducted on the MEDLINE database to study the overseas experience of high-risk insurance pools. Of the 52 articles included in the systematic review, the majority of the studies cover the operations in the United States. Results are analysed from the following eight perspectives. For efficiency, the studied areas include (1) fiscal sustainability, (2) adverse selection, (3) risk sharing and (4) cost containment. For equity, (5) insurance premium, (6) out-of-pocket expense, (7) enrolment barrier and (8) program awareness of the high-risk pools are analysed. Results of the systematic review show the inadequacies of the high-risk pool mechanisms in all of the above studied areas. In the United States, while industry assessment and government subsidization intend to facilitate risk sharing for high-risk population, insufficient funding and the industry''s deteriorated risk sharing capabilities undermine system efficiency. In addition, adverse selection and cost containment add to the already lengthy list of problems that high-risk pools have yet to address. Limited subsidies, high out-of-pocket payments, strict eligibility rules, and insufficient program awareness remain the four major barriers to health equity for the uninsurable. While studies on the overseas healthcare system have revealed several inadequacies regarding the high-risk pool mechanism, these uncertainties have to be resolved before Hong Kong can move forward to improve its healthcare efficiency and equity. More thoughts should be given on how the risk sharing capability can be enhanced within the insurance industry. Without a clear definition or a standardized underwriting rule that clearly defines "high-risk," the high-risk pool could become a platform to practice adverse selection and further deteriorate the already limited risk sharing among the population. For addressing the issue of cost containment, the DRG charging system and chronic disease management programs are pivotal components to be incorporated. The government should perform a concrete assessment to justify how the spending on high-risk pool can essentially promote a more equitable system in Hong Kong. By considering the impact on both private in
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health Publisher: ISBN: Category : Health insurance Languages : en Pages : 100
Author: United States Government Accountability Office Publisher: Createspace Independent Publishing Platform ISBN: 9781976429101 Category : Languages : en Pages : 42
Book Description
Health insurance : enrollment, benefits, funding, and other characteristics of state high-risk health insurance pools
Author: Jenny Alvarez
Author: White House Task Force on Health Risk Pooling (U.S.)
Author: John E. Dicken
Author: Cheryl Fish-Parcham
Author: Tanya Schwartz
Author: David P. Bernstein
Author: Mark V. Pauly
Author: Mei-Ni Ng
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Author: United States Government Accountability Office