Detailed Information on the
State Planning Grant Program Assessment

The program sunset in FY 2006.

The program sunset in FY 2006.

Measure: Increase the estimated number of lives covered by health insurance as a result of the Pilot Projects per SPG pilot project dollars spent

Explanation:The program sunset in fiscal year 2006. The program is no longer reporting on targets and actuals.

Measure: Increase the percentage of Pilot Projects implemented by Pilot Project Planning grantees within 36 months of receiving an SPG Pilot Project Planning Grant.

Explanation:The program sunset in fiscal year 2006. The program is no longer reporting on targets and actuals.

Measure: Increase the number of new public and/or private health insurance coverage initiatives implemented directly as a result of the SPG Program.

Explanation:The program sunset in fiscal year 2006. The program is no longer reporting on targets and actuals.

Measure: Increase the number of Federal waivers submitted and State legislative proposals introduced to expand access to affordable health insurance coverage as a result of the SPG Program.

Explanation:The program sunset in fiscal year 2006. The program is no longer reporting on targets and actuals.

Measure: Increase the number of previously uninsured Americans who are insured through affordable public or private health insurance directly as a result of the SPG Program.

Explanation:The program sunset in fiscal year 2006. The program is no longer reporting on targets and actuals.

Is the program purpose clear?

Explanation: The program provides grants to the States to develop strategies for providing all uninsured persons with health coverage. States are also to use the funds to conduct surveys of the uninsured and other activities to determining methods of covering the uninsured. The State Planning Grant Program does not have authorizing legislation.

Evidence: 1) The program provides three types of grants: New Grants, Limited Competition Pilot Project Planning Grants, and Limited Competition Planning Grants. All grants are provided for one-year, with an optional one-year extension. New Grants are awarded for 1-year and average award is $800,000. Only States and Territories that have not previously received a State Planning Grant are eligible for an award. Only a State entity can be the recipient of a grant. The Limited Competition Pilot Project Planning grants are awarded for 1-year and the average award is $400,000. Only current or prior State Planning Grant grantees are eligible for the grant. Demonstrated commitment by the State Legislature is required for funding. The Limited Competition Planning grants are awarded for 1-year and the average award is $175,000. Only recipients of the Limited Competition Pilot Program grants are eligible for the award. 2) The program had report language in FY 2000, FY 2001 and FY 2003. - Conference Report on H.R. 3194, Consolidated Appropriations Act, 2000 - Conference Report on H.R. 4577, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2001 - House Report 108-010 - Making Further Continuing Appropriations for the Fiscal Year 2003, and for Other Purposes

Does the program address a specific and existing problem, interest, or need?

Explanation: In 2003, there were an estimated 36 to 45 million Americans without health insurance. The uninsured are up three times more likely than those with insurance to report problems getting needed medical care and are more likely to be hospitalized for an avoidable health problem. About 20% of the uninsured say that their usual source of care is an emergency room. The program supports States in developing plans increase access to insurance. However, there is no evidence that States lack the resources to develop a legislative proposal or plan to cover the uninsured. There is some evidence that State-level data has been useful to analysts working on State health insurance issues. However, on balance, there is not a demonstrated need to increase State-level data on uninsured. Many other comprehensive data sets on the uninsured exist and several of these data sets have State-level information. These existing datasets provide uniform data elements that can be compared from year to year and benchmarked against national trends.

Evidence: 1. DeNavas-Walt, C., Proctor B., and Mills R., (August 2004) Income, Poverty, and Health Insurance Coverage in the United States: 2003, Current Population Reports U.S. Census Bureau: P60-226 U.S. Government Printing Office, Washington, DC 2. Two recent studies conclude that the CPS overestimated the number of uninsured because it undercounted the number of residents enrolled in Medicaid programs. The Actuarial Research Corporation estimated that nine million, or 20%, of the CPS 45 million uninsured had health insurance coverage in 2003. The Urban Institute, based on data from 2001, estimates that four million of the 45 million uninsured identified by CPS had coverage in 2003. 3. Kaiser Commission on Medicaid and the Uninsured. November 2004. The Uninsured: A Primer. Key Facts About Americans Without Health Insurance. 4. Monitoring the Uninsured: A State Policy Perspective, Lynn A. Blewett, Margaret Brown Good, Kathleen Theide Call, Michael Davern, Journal of Health Politics, Policy and Law, Vol. 29, No. 1, p.107-145, February 2004 5. Question 1.3

Is the program designed so that it is not redundant or duplicative of any other Federal, state, local or private effort?

Explanation: States can choose to use their own resources to develop plans to cover the uninsured or to provide access to health care. There are also many private, non-profit organizations that seek to develop solutions to expanding access to health care. These organizations include the Kaiser Family Foundation, Families USA, and the Economic Research Initiative on the Uninsured. One notable example is the Robert Wood Johnson Foundation's State Coverage Initiatives (SCI) program. The program is designed to help States develop and implement policies that expand access to health insurance coverage. Since 1999, SCI has received $10 million in private funding and $785,000 from the State Planning Grant Program for technical assistance. Several these organizations also collect data on the uninsured, another major program activity. In addition, the U.S. Census Bureau's Current Population Survey conducts annual surveys of the uninsured. CDC also collects information on insurance, access to health care, and health behaviors though the National Health Interview Survey. AHRQ collects data on the uninsured through their Medical Expenditure Panel Survey (MEPS). There are a multitude of federal programs that seek to address the problems that uninsured individuals face through providing access to health insurance or affordable health care. Health Centers deliver high-quality, affordable, primary and preventative care to nearly 14 million patients, regardless of ability to pay at 3,740 sites annually. In 2006, Health Centers will serve an estimated 16 percent of the Nation's population at or below the 200 percent of the Federal Poverty Line. Medicare will provide an estimated $396 billion in FY 2006 and Medicaid will provide an estimated $X billion in FY 2006 to enhance access to health insurance. Health Savings Accounts and other tax incentives have also expanded access insurance.

Evidence: 1. www.kff.org/uninsured/index.cfm 2. www.familiesusa.org 3. www.umich.edu/~eriu/ 4. Statecoverage.net. 5. www.census.gov/hhes/www/hlthins/hlthins.html 6. www.cdc.gov/nchs/nhis.htm 7. www.meps.ahrq.gov/

Is the program design free of major flaws that would limit the program's effectiveness or efficiency?

Explanation: Data collections methods vary widely across the program. Therefore, the data collected with program funds cannot be compared across States or benchmarked to national trends. In addition, States are not necessarily collecting the most relevant or analytically rigorous data. One grantee reported that their State-run survey provided no more information than what they had gotten from the AHRQ MEPS and it had taken a significant amount of their resources to conduct the survey. They decided to use the MEPS-IC survey in future years in lieu of conducting their own survey. The program strongly encourages grantees to confer consult the University of Minnesota's State Health Access Data Assistance Center (SHADAC) to ensure they are not re-creating work already developed, tested, and/or fielded. States can use customize pre-existing data collection tools, but HRSA cannot veto a State's chosen data collection method. States are not required to commit their own resources towards the grant project. The program does not require State matching funds as a condition of award. The program requires States to demonstrate support from the Governor and the Legislature through letters of support

Evidence: 1. Agendas from SPG Program TA Meetings 2. Health Care Systems Bureau. Sate Planning Grants New Competition. FY 2005 Guidance. HRSA-05-035. Catalog of Federal Domestic Assistance (CFDA) No. 93.256 3. SHADAC compilation of quantitative and qualitative data collection activities for grantees funded FY 2000-FY 2004 (www.shadac.org)

Is the program design effectively targeted so that resources will address the program's purpose directly and will reach intended beneficiaries?

Explanation: Program funds are not targeted to States highest uninsurance rates or the greatest need for assistance to increase access to health insurance. Per guidance provided in HHS' FY 2000 appropriations report language, preference was given to the States with the lowest uninsurance rates or that can demonstrate a potential for a significant decrease in its uninsured population. Grants in 2000, 2001, and 2002 were given based on this preference. The Report Language provided in FY 2001 and FY 2003 did not specify whether or not the program should continue the preference. However, as less than half of the states and territories were eligible for a new Program grant, the program phased out the preference. However, because only States that have completed a New Grant are eligible for the Limited Competition Pilot Project Planning Grants and Limited Competition Planning Grants, states with the greatest need have been fully targeted. The program has funded many States for multiple years since 2000 under the program's three grants.

Evidence: 1. FY 2000 Conference Report 2. FY 2001 Conference Report 2. FY 2003 Conference Report

Does the program have a limited number of specific long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program?

Explanation: The program has adopted the following long-term measure: Increase the number of previously uninsured Americans who are insured through affordable public or private health insurance directly as a result of the SPG Program.

Evidence: The SPG Program will use the annual reports submitted by active SPG Program states and conduct grantee interviews to track the long-term measure.

Does the program have ambitious targets and timeframes for its long-term measures?

Explanation: The FY 2005 baseline for the program is 482,594 insured individuals. The program has set a target of 579,113 individuals covered by 2012, a 20% increase.

Evidence: The FY 2005 baseline was obtained from a survey of the FY 2000 to FY 2003 grantees. Grantees newly funded FY 2004 and FY 2005 were not surveyed as most coverage initiatives are still in the developmental phase. The program does not have data prior to FY 2005, and as such, it is difficult to determine if the long-term target of +20% is sufficiently ambitious. However, given the challenges that States will face in implementing initiatives to increase access to health insurance, the program believes that a target of +20% over 7 years is an achievable challenge.

Does the program have a limited number of specific annual performance measures that can demonstrate progress toward achieving the program's long-term goals?

Explanation: The program has developed three annual measures. Annual Measure #1: Increase the number of new public and/or private health insurance coverage initiatives implemented directly as a result of the SPG Program. This may include Federal waivers approved and/or State and local legislative proposals passed. Annual Measure #2: Increase the number of Federal waivers submitted and State legislative proposals introduced to expand access to affordable health insurance coverage as a result of the SPG Program. Annual Measure #3: Increase the percentage of Pilot Projects implemented by Pilot Project Planning grantees within 36 months of receiving an SPG Pilot Project Planning Grant.

Evidence: The SPG Program will use the annual reports submitted by active SPG Program states and conduct grantee interviews to track the annual measures. Annual Measure #3 is a developmental measure. The SPG Program Pilot Project Planning grants were first offered in FY 2004. All FY 2004 Pilot Project Planning grants will end on August 31, 2006.

Does the program have baselines and ambitious targets for its annual measures?

Explanation: The program has targets for all its annual measures and baselines for two of its annual measures. The program has not yet developed a baseline for Annual Measure #3. FY 2007 will be the first year for which data becomes available on Annual Measure #3.

Evidence: Annual Measure #1: In 2004, the program had 29 public and/or private health insurance coverage initiatives implemented since 2000. Given the program's historical performance, the target of +6 new initiatives per year is ambitious. Since 2001, the annual number of new initiatives implemented has ranged from +5 to +12. (See measures tab.) Annual Measure #2: In 2004, the program had 86 public and/or private health insurance coverage initiatives implemented since 2000. Given the program's historical performance, the target of +20 to +10 new initiatives per year is ambitious. Since 2001, the annual number of new initiatives implemented has ranged from +10 to +34. The program believes that since many states have already received the New Grant, the number of new initiatives each year will decline. (See measures tab.) Annual Measure #3: The program has adopted a target of 75% of the Pilot Projects implemented by 2007 and 80% implemented by 2008.

Do all partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) commit to and work toward the annual and/or long-term goals of the program?

Explanation: The long-term and annual goals were developed for PART. Program partners have not yet had an opportunity to commit to working towards the long-term and annual goals. The program goals are not contained in grant application guidance.

Evidence: 1. Health Care Systems Bureau. Sate Planning Grants New Competition. FY 2005 Guidance. HRSA-05-035. Catalog of Federal Domestic Assistance (CFDA) No. 93.256

Are independent evaluations of sufficient scope and quality conducted on a regular basis or as needed to support program improvements and evaluate effectiveness and relevance to the problem, interest, or need?

Explanation: No independent evaluations of sufficient scope and quality have been conducted to date. In 2002, the Commonwealth Fund published a report summarizing the activities of 20 State Planning Grant grantees. In 2005, they published another report that summarized the activities of program grantees.

Evidence: 1. Commonwealth Fund, Toward Comprehensive Health Coverage for All: Summaries of 20 State Planning Grants from the U.S. Health Resources and Services Administration, November 2002 (www.cmwf.org/publications/publications_show.htm?doc_id=221322) 2. HRSA State Planning Grant Update: A Review of Coverage Strategies and Pilot Planning Activities, Sharon Silow-Carroll, M.B.A., M.S.W., and Tanya Alteras, M.P.P., The Commonwealth Fund, April 2005 (www.cmwf.org/usr_doc/813_Silow-Carroll_HRSA_stateplanninggrant_update.pdf)

Are Budget requests explicitly tied to accomplishment of the annual and long-term performance goals, and are the resource needs presented in a complete and transparent manner in the program's budget?

Explanation: The program did not have a funding request in the FY 2006 President's Budget.

Evidence: HRSA FY 2006 Justification of Estimates for Appropriations Committees

Has the program taken meaningful steps to correct its strategic planning deficiencies?

Explanation: The Program is revising its annual reporting requirements to capture all information relevant to inform the long-term and annual Program performance goals. All grantees will be briefed and informed of these new reporting requirements with specific due dates. The program is also including the long term and annual goals as part of its FY 2005 contracts with the SPG Program's technical assistance contractors, AcademyHealth and SHADAC. The Program is modifying its FY 2005 contract with AcademyHealth to include an independent evaluation of the recently awarded Pilot Projects to inform the development of health insurance expansion plans in other Program states.

Evidence:  

Does the agency regularly collect timely and credible performance information, including information from key program partners, and use it to manage the program and improve performance?

Explanation: HRSA requires funding recipients to submit annual progress reports and a final report at the end of the project period. The program will have to conduct interviews of granttees to gather data for the long-term and annual goals.

Evidence: 1. Example of Final Project report

Are Federal managers and program partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) held accountable for cost, schedule and performance results?

Explanation: Federal manager's performance evaluations do not explicitly evaluate oversight of the program's performance, costs, and schedule. The program's long-term and annual goals are new, and as such, are not currently considered as part of federal managers' performance assessment. Grantees are required to submit annual progress reports and a final report at the end of the project period. These reports, however, do not currently ask the grantees to report on their contributions towards the long-term and annual measures.

Evidence: 1. Sample Performance Evaluation 2. Example of Final Project report

Are funds (Federal and partners') obligated in a timely manner and spent for the intended purpose?

Explanation: All program funds are obligated by the end of the fiscal year. The availability of SPG funds is announced in the HRSA Preview, including funding deadlines set forth in the Application Guidance. All program contracts have been obligated and disbursed in a timely manner and spent on purposes consistent with the contracts' scope of work. The AcademyHealth contract is paid on receipt of monthly vouchers. The purchase orders for SHADAC and AIR are paid quarterly as work is completed. Funds for these contracts are budgeted for in the SPG operational plan, and the Program obligates adequate funding to ensure continuous performance. The program reviews and pays all vouchers within the prescribed time frames; there have been no issues of erroneous vouchers or late payments to any contractor. The vouchers include up to date information on costs incurred to date which facilitates the Project Officer's ability to review and monitor spending with respect to progress of the work being accomplished by the contractors. Vouchers, Project Officer and contractor communications, deliverables, and progress reports document that contractor performance is in accordance with the terms and conditions of the contracts and that funds are spent for the intended purpose.

Evidence: 1. Grant Guidance 2. HRSA FY 2005 Preview 3. Example of AcademyHealth monthly contract voucher - March 2005 4. Sample grantee budget and project management matrix 5. Sample Notice of Grant Award with conditions

Does the program have procedures (e.g. competitive sourcing/cost comparisons, IT improvements, appropriate incentives) to measure and achieve efficiencies and cost effectiveness in program execution?

Explanation: The program developed the following efficiency measure for PART: Increase the estimated number of lives covered by health insurance as a result of the Pilot Projects per SPG pilot project dollars spent. FY 2007 will be the first year for which data becomes available on this annual measure. The SPG Program Pilot Project Planning grants were first offered in FY 2004. All FY 2004 Pilot Project Planning grants will end on August 31, 2006. The program has worked to reduce program execution costs by contracting out technical assistance activities.

Evidence: The program has contracts with the State Coverage Initiatives (SCI) Program, State Health Access Data Assistance Center (SHADAC), and American Institutes for Research (AIR). SCI provides AIR provides site visits for the program. These contracts are not competed, but are awarded via sole source justification. Both the SCI Program and SHADAC were funded by the Robert Wood Johnson Foundation in 1999 to develop and analyze data on the uninsured. Both the SCI Program and SHADAC have become clearinghouses of information on the uninsured.

Does the program collaborate and coordinate effectively with related programs?

Explanation: The SPG Program collaborates with other HHS programs and private organizations researching the issues of the uninsured. Within HHS, the program has worked closely with the Agency for Healthcare Research and Quality (AHRQ) and has engaged in Inter-Agency Agreements with AHRQ to buy additional sample size for the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC). Initially, some States conducted their own employer surveys, others chose to use the MEPS-IC survey data, and a few decided to purchase additional MEPS-IC sample for their State to improve the quality of the MEPS-IC estimates. The SPG program has made States aware of the MEPS-IC State-level data and has significantly increased the use of MEPS-IC data. The Centers for Medicare and Medicaid Services has presented on various topics on covering the uninsured at SPG TA meetings. Topics include the Health Insurance Flexibility and Accountability (HIFA) Demonstration Initiative, high risk pools, and the Medicare Modernization Act of 2003. Representatives from the Department of Treasury have presented on new tax laws related health savings accounts. The SPG Program also coordinates with private sector organizations researching the uninsured and many organizations have presented at TA meetings.

Evidence: 1. Agendas from SPG Program TA Meetings 2. Interagency agreements with AHRQ for 2001-2003. An interagency agreement for 2005 is in process.

Does the program use strong financial management practices?

Explanation: In FY 2004, HHS OIG conducted an HHS financial statement audit. The audit reported that the Department had serious internal control weaknesses in its financial systems and processes for producing financial statements. OIG considered this weakness to be material. The audit recommended that HHS improve their reconciliations, financial analysis, and other key controls. The September 30, 2002 HRSA independent auditor's report found that the preparation and analysis of financial statements was manually intensive and consumed resources that could be spent on analysis and research of unusual accounting. The audit also found that HRSA's interagency grant funding agreement transactions were recorded manually and were inconsistent with other agencies' procedures. Finally, the audit found that HRSA had not developed a disaster recovery and security plan for its data centers.

Evidence: 1. HHS FY 2004 Performance and Accountability Report 2. HRSA's 2002 audit report measure

Has the program taken meaningful steps to address its management deficiencies?

Explanation: HHS' long-term strategic plan is to resolve the internal control weaknesses is to replace existing accounting systems and other financial systems within HHS with the Unified Financial Management System (UFMS). HHS plans to fully implement the UFMS Department-wide by 2007. HRSA developed a corrective action plan to address the reportable conditions identified in the September 30, 2002 independent auditor's report. For each aspect of the five reportable conditions, HRSA assigned an office responsibility. The plan also outlines milestones and target completion dates. The Department is in the process of developing a new performance plan for all HHS Civilian Managers and Supervisors. This plan is scheduled to be implemented in September 2005. When the new performance measures are in use, results from these measures will be available to public via the HRSA website.

Evidence: 1. HHS FY 2004 Performance and Accountability Report www.hhs.gov/of/reports/account/acct04/pdf/section4.pdf 2. HRSA Corrective Action Plan for FY 2002 Financial Statement Audits

Are grants awarded based on a clear competitive process that includes a qualified assessment of merit?

Explanation: Grants are awarded through HRSA's objective peer review process. A panel evaluates all applications using the review criteria specified in the grant application guidance. Review criteria are published in the application guidance, providing applicants a clear picture of the elements and weights to be used in evaluating their applications. Funding decisions are based solely on the scores provided by the external reviewers of the applications submitted. The Program holds outreach workshops and conference calls to publicize the availability of the grants to the States. During the application period, SPG staff are routinely available to consult with applicants on questions they might have.

Evidence: Each application is reviewed by three non-HRSA individuals. Reviewers base their assessments on the criteria published in the application guidance. Reviewers with conflicts of interest in a particular application recuse themselves from discussion of that application. All reviewers independently score each application. Grant funding decisions are based on the ranked normalized scores of the applications.

Does the program have oversight practices that provide sufficient knowledge of grantee activities?

Explanation: All grantees must submit an annual report. Grantees complete an annual financial status report and submit requests for carryover balances, if needed. Grantees are required to attend TA grantee meetings. The TA meetings are held 3-4 times per year. The purpose of the TA meetings is for grantee States and Program staff to keep abreast of grantee progress and problems and to assist each other with challenges being similarly faced in other States. All contractors provide individual reports on the progress of their activities. In addition, AcademyHealth conducts site visits to newly funded grantees and newly funded FY 2004 Pilot Project Planning grantees. The newly funded FY 2004 Pilot Project Planning grantees are required to submit quarterly progress reports to HRSA.

Evidence: 1. Annual report outline: www.Statecoverage.net/pdf/hrsareportformat.pdf 2. Sample of grantee reports 3. Agendas from SPG Program TA Meetings 4. SCI Program reports 5. SHADAC reports 6. AIR reports

Does the program collect grantee performance data on an annual basis and make it available to the public in a transparent and meaningful manner?

Explanation: The program does not make available to the public information on granttees performance on the long-term and annual measures. The program does include all annual grantee reports online at the contractor's website, statecoverage.net/hrsa.htm as well as all project applications for which an electronic copy was submitted. The Program has incorporated a direct link to the above website on the front page of the Program website at www.hrsa.gov/osp/stateplanning. In 2001, HRSA published a report of the projects undertaken by the States.

Evidence: 1. statecoverage.net/hrsa.htm 2. SPG Program Synthesis of State Experiences, December, 2001 (www.hrsa.gov/stateplanning/interimreport.htm)

Has the program demonstrated adequate progress in achieving its long-term performance goals?

Explanation: The program developed a long-term measure for PART. However, the program does not have historical data demonstrating progress towards achieving the long-term goal.

Evidence: 1. Questions 2.1 and 2.2 2. Measures Tab

Does the program (including program partners) achieve its annual performance goals?

Explanation: The program has five years of data for Annual Measures #1 and #2. For Annual Measure #1, the number of new public and/or private insurance initiatives has increased by 9 to 12 per year. This is comparable to their annual target established for the PART of 9 new initiatives per year. For Annual Measure #2, the number of Federal waivers submitted and State legislative proposals introduced to expand access to health insurance coverage increased by 10 to 34 per year. This is comparable to their annual target established for the PART of 30 new proposals or waivers per year. The program does not yet have performance information for Annual Measure #3. Data is expected in FY 2007.

Evidence: 1. Questions 2.3 and 2.4 2. Measures Tab

Does the program demonstrate improved efficiencies or cost effectiveness in achieving program goals each year?

Explanation: The program developed an efficiency measure for PART. However, the program does not have historical data demonstrating progress improved cost-effectiveness each year. FY 2007 will be the first year for which data becomes available on this annual measure. The SPG Program Pilot Project Planning grants were first offered in FY 2004. All FY 2004 Pilot Project Planning grants will end on August 31, 2006. The program has worked to reduce program execution costs by contracting out technical assistance activities.

Evidence: Question 3.4

Does the performance of this program compare favorably to other programs, including government, private, etc., with similar purpose and goals?

Explanation: As of 2005, the government has invested $87 million in the program without knowing what return has been received. There are other federal programs that increase access to health insurance or health care that have demonstrated results. Health Centers deliver high-quality, affordable, primary and preventative care to nearly 14 million patients, regardless of ability to pay at 3,740 sites annually. In 2006, Health Centers will serve an estimated 16 percent of the Nation's population at or below the 200 percent of the Federal Poverty Line. Medicare serves an estimated X million elderly and disabled individuals and Medicaid serves an estimated 58 million low-income individuals. In 2006, Medicare and Medicaid will provide an estimated X billion in Disproportionate Share Hospital (DSH) payments to hospitals that serve a high percentage of Medicaid patients. In addition, the government offers a number of tax breaks to incentivize the purchase of health insurance. For example, low-income individuals' under age 65 who are not enrolled in public or employer-sponsored health plans are eligible for a refundable tax credit that can be paid in advance directly to the health plan. The credit can be used for traditional health insurance plan or a Health Savings Account (HSA) and it is estimated that it will provide access to health insurance for 15 million individuals. Small employers receive a tax credit of up to $500 per employee with family coverage and $200 per employee with individual coverage to encourage them to contribute to their employees HSAs.

Evidence:  

Do independent evaluations of sufficient scope and quality indicate that the program is effective and achieving results?

Explanation: No independent evaluations of sufficient scope and quality have been conducted to date.

Evidence: