Author: Austin B. BraktPublisher:
ISBN:
Category :
Languages : en
Pages : 23
Book Description
High-risk Pools for Uninsurable Individuals
Author: Austin B. BraktState High-risk Pools
Author: Tanya SchwartzPublisher:
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.
Establishment of State Risk Pools to Provide Health Coverage for Uninsured Americans
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on HealthPublisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 102
Book Description
Health-Care Utilization as a Proxy in Disability Determination
Author: National Academies of Sciences, Engineering, and MedicinePublisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161
Book Description
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Reinsuring Health
Author: Katherine SwartzPublisher: Russell Sage Foundation
ISBN: 1610445201
Category : Medical
Languages : en
Pages : 220
Book Description
America's current system of health insurance, which relies almost exclusively on employer-sponsored coverage, is in danger of collapse, and this problem is not limited to the poor and working class. An increasing number of middle class Americans do not have employer-provided insurance and—due to skyrocketing premiums—cannot afford to purchase coverage for themselves. Reinsuring Health, by economist Katherine Swartz, examines this growing national crisis and outlines a concrete plan to make health insurance accessible and affordable for all Americans. Reinsuring Health documents why the number of uninsured Americans—now 45.5 million people—has grown in the last twenty-five years. Swartz focuses on how labor market changes—such as the decline of domestic manufacturing, decreased unionization, and the growth of non-standard work arrangements—have led U.S. employers to retreat from providing health insurance for their workers. These trends, combined with the increasing costs of medical care, have led to an explosion in health insurance premiums and a decline in coverage, particularly among the middle-class. Since those who seek insurance as individuals are generally most likely to need health care, private insurers charge higher premiums in the individual (non-group) markets than to people who obtain group insurance. This makes individual health insurance less attractive to the young and increasingly unaffordable for middle-class Americans. Similarly, insurers charge higher per person (or per family) premiums to small firms than to large companies, so many small firms do not sponsor coverage for their employees. Reinsuring Health shows how these problems can be overcome if the federal government provides a new reinsurance program which would protect insurance companies that provide small group and individual health insurance against the possibility that their policy-holders will incur very high medical expenses. By assuming some of the risk that people will face extremely costly medical bills, the government will make insurers less hesitant to offer coverage to high-risk individuals, and will help drive down premiums for others. Reinsuring Health demonstrates that this form of government reinsurance has worked in the past, helping to establish smooth running private markets for catastrophe insurance and secondary mortgages. Today, growing numbers of middle class Americans lack health insurance. Protection against the possibility of falling ill or getting hurt and having to pay extraordinary health care bills should not be a luxury available only to the very rich and the very poor. Reinsuring Health proposes a straightforward solution that would bring health insurance back within the reach of the increasing ranks of the uninsured, particularly those who are in the middle class.
Care Without Coverage
Author: Institute of MedicinePublisher: National Academies Press
ISBN: 0309083435
Category : Medical
Languages : en
Pages : 213
Book Description
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Coverage Matters
Author: Institute of MedicinePublisher: National Academies Press
ISBN: 0309076099
Category : Medical
Languages : en
Pages : 204
Book Description
Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.
Health Care Reform
Author: David P. BernsteinPublisher:
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.
Pooling Health Insurance Risks
Author: Mark V. PaulyPublisher: 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?
Employment and Health Benefits
Author: Institute of MedicinePublisher: National Academies Press
ISBN: 0309048273
Category : Medical
Languages : en
Pages : 381
Book Description
The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.