Selected Options for Expanding Health Insurance Coverage
DIANE Publishing, 1994 - 79 pages
Analyzes two major approaches for substantially reducing the number of uninsured people. One would expand employment-based coverage, while the other would cover more people under Medicaid. A third approach would be a combination of the two. Covers: advantages and disadvantages of each plan, alternative specifications, and illustrations of each plan. Charts and tables.
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$3 billion 1990 Current Population 200 percent 25 hours actuarial alternative beneﬁciaries billions of 1991 Budget Ofﬁce estimates Census Division Characteristic Millions classiﬁed coinsurance combination Congressional Budget Ofﬁce copayments Current Population Survey currently uninsured dependents East North Central effects elderly employment-based coverage employment-based insurance employment-based plans employment-based policies exemption expanding Medicaid family incomes federal deﬁcit ﬁrms with fewer head or spouse health care health insurance coverage ILLUSTRATIVE EMPLOYER MANDATE ILLUSTRATIVE MEDICAID EXPANSION illustrative option individually purchased insurance policies live in families March 1990 Current Medicaid coverage Medicaid spending Medicare minimum national health expenditures nonelderly North Central number of uninsured offer insurance Ofﬁce estimates based offset out-of-pocket expenses outlays payroll taxes percent of poverty Percentage of Uninsured ployers poverty level poverty threshold premiums primary payer private insurance provide coverage reducing the number secondary coverage small ﬁrms source of insurance speciﬁc spouse is employed surance taxes threshold wages
Page 5 - COMPREHENSIVE MAJOR MEDICAL INSURANCE - a policy designed to give the protection offered by both a basic and a major medical health insurance policy. It is characterized by a low deductible amount, a co-insurance feature, and high maximum benefits, usually $5,000 to $25,000 or higher.
Page 4 - SEC. 1811. The insurance program for which entitlement is established by section 226 provides (basic protection against the costs of hospital and related post-hospital services in accordance with this part for individuals who are age 65 or over and are entitled to retirement benefits under title II of this Act or under the railroad retirement system.
Page 14 - ... virtually all the costs of its beneficiaries, Medicare pays only 45 percent of the total health costs of the aged and disabled eligible for coverage. While many private insurance plans place annual limits on out-of-pocket costs once an enrolled individual has incurred a 1 See S. Long and J. Rodgers, The Effects of Being Uninsured on Health Care Service Use: Estimates from the Survey of Income and Program Participation, Bureau of the Census, SIPP Working Paper #9012, 1990.
Page 12 - D., Uninsured in the United States; The Nonelderly Population without Health Insurance, (Employee Benefit Research Institute, Washington, DC), October, 1988. 2. National insurance statistics for 1980 and 1985 are based on published data from the US Census Bureau, calculations by CDF. 3. These and other 1986 national insurance statistics for children are based on unpublished data from the US Census Bureau, calculations by...
Page 19 - VIII.C. experience rating, a method of establishing health insurance premiums in which the premium is based on the average cost of actual or anticipated health care used by various groups and subgroups of subscribers and thus varies with their experience or with such variables as age.
Page 25 - Drugs (6) (6) SOURCE: Congressional Budget Office estimates based on data from the Health Care Financing Administration, HCFA Form-64. NOTES: Nursing home expenditures include spending for nursing home facilities and intermediate care facilities for the mentally retarded.
Page xv - ... buy in" to Medicaid based on a sliding scale of contributions, thereby avoiding any "notches" where a small increase in income would cause a substantial increase in the cost of participating. Specifically, the contribution or "premium...
Page 5 - Another 3.6 million retired and active-duty military and their dependents receive medical care through military hospitals and an insurance program called the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). (People who receive their primary health insurance coverage through the military hospitals and CHAMPUS are classified as "employment-based...
Page xi - Medicaid program-could substantially reduce the number of uninsured people, while keeping most existing arrangements for insurance intact because four-fifths of the uninsured live in families where at least one adult is employed and three-fifths have family incomes below 200 percent of their poverty thresholds. HEALTH INSURANCE AND THE UNINSURED Most people-about 85 percent of the nonelderly and 99 percent of the elderly-have health insurance.