PDF
Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace
This issue brief presents analysis of Qualified Health Plan (QHP) data in the individual market Marketplace for states that use the HealthCare.gov Marketplace platform and State-Based Marketplaces where data is available. It examines plan affordability in 2017 after taking into account premium tax credits and also examines the plan choices that
2017MarketplaceLandscapeBrief.pdf
People Who Currently Buy Individual Market Coverage Could Be Eligible for ACA Subsidies
OffMarketplaceSubsidyeligible.pdf
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. References
Baicker, K. & Levy, H. (2007). Employer health mandates and the risk of unemployment. National Bureau of Economic Research , Working Paper 13528. Retrieved July 14, 2008, from http://www.nber.org/papers/w13528.pdf
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Conclusion
This analysis included a range of health care reform options with widely varying cost and coverage impacts. Figure 13 summarizes some of the key data from each, including the net reduction in the uninsured, as well as the cost to the Federal and state governments. As expected, the most comprehensive reforms, particularly when combined, often r
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Cost Impact
A national combined health care reform initiative of this magnitude would have a net federal cost of $155.8 billion dollars and a net state savings of $2.4 billion, for a total program cost of $153.4 billion (Figure 12). States would achieve a savings of $15.6 billion as a result of reduced spending on other state and local programs, but would i
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Coverage Impact
A national combined health care reform initiative modeled after the Massachusetts plan would reduce the number of uninsured by 39.4 million (Figure 11). Over twenty million previously uninsured individuals would be newly covered with the premium subsidy, 7.4 million would gain coverage from Medicaid and SCHIP, and 11.7 million would gain private
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Features
The features included in the combined model include: an individual mandate, insurance market reforms, premium subsidies for low-income populations, mandatory Section 125 plans, an employer mandate, and a creditable coverage requirement.
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. A Model Combining Certain Features of the Massachusetts Plan
The Commonwealth of Massachusetts is being watched closely after the recent implementation of their health care reform initiative. In April 2006 the Commonwealth enacted legislation that is aimed at providing nearly universal coverage for their residents. There are many different components to the plan, many of which we have discussed and mode
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Cost and Coverage Impacts
As indicated, the cost and coverage estimates vary based on the type of enforcement mechanism modeled. The results are presented below for each variation.
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. A National Individual Mandate
ASPE worked with The Lewin Group to design and model a national individual mandate for the purchase of health insurance. The key design elements of the model include:
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. The Role of a Mandate
An individual mandate is meant to address the phenomenon of “free-riders,” or individuals without coverage who nonetheless access care but do not have the financial resources to pay for it. The cost of this “uncompensated care” is paid for through increased provider rates, higher insurance premiums, and Federal and state subsidy programs
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Individual Mandate
Under an individual mandate to purchase health insurance, individuals would be required by law to obtain health insurance coverage. A mandate of this kind would be precedent setting (Tanner, 2006). As noted by CBO in 1994, “the government has never required people to buy any good or service as a condition of lawful residence in the United St
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Payroll Tax with Automatic Public Program Coverage
In order to have a significant impact on the uninsured, the penalty needs to be high enough to generate a significant amount of revenue that can be used to subsidize alternative coverage for employees of firms paying the tax. These employees could be enrolled in alternative programs such as a publicly administered insurance program or a state be
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Modest Fair Share Assessments
With assessments this small, workers of firms who pay the assessment are not automatically enrolled in an alternative plan. Assessments of this level do not generate enough revenue to cover enrollment into alternative insurance programs. Therefore, the reduction in the uninsured is fairly low, and the cost of the program is really born by empl
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. A National Employer Mandate
ASPE worked with The Lewin Group to model the coverage and cost impact of a national employer mandate. The first analysis is modeled after the Massachusetts “fair share contribution” requirement, with a $295 assessment per employee for firms with 11 or more employees. In order to avoid the assessment, firms must offer coverage to all emplo
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Existing Employer Mandates
Two states and one locality have successfully legislated and implemented employer mandates.
Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. ERISA Preemption
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal statute that regulates employer benefit plans, including health insurance benefits. It does not require that employers provide a health insurance benefit, but for those that do it standardizes the treatment and administration of the benefit. ERISA preempts all state laws