Rising Premiums, Charity Care, and the Decline in Private Health Insurance. Michael Chernew University of Michigan and NBER

Size: px
Start display at page:

Download "Rising Premiums, Charity Care, and the Decline in Private Health Insurance. Michael Chernew University of Michigan and NBER"

Transcription

1 Rising Premiums, Charity Care, and the Decline in Private Health Insurance Michael Chernew University of Michigan and NBER David Cutler Harvard University and NBER Patricia Seliger Keenan NBER December 2004 This work was funded by the Economic Research Initiative on the Uninsured, the National Institute on Aging, and the Sloan Foundation. Patricia Keenan gratefully acknowledges support from the National Institute on Aging, Grant Number T32-AG00186.

2 Over the past several decades health care costs have increased substantially and the share of the population with insurance coverage has decreased. Relative to GDP, medical care today accounts for 75 percent more of the economy than it did in While health care costs have been rising, the share of the nonelderly population that is uninsured has increased by roughly 4 percentage points since To what extent is the increase in the cost of health insurance responsible for the decline in coverage? Individuals will purchase coverage if the utility of coverage exceeds that of being uninsured. Textbook economic theory suggests that rising medical expenditures ought to increase the utility of coverage because insurance mitigates risk. As medical costs increase, the variability of spending will usually rise as well, and so the insurance product becomes more valuable. 1 This implies that rising costs would be associated with insurance coverage, but in the opposite direction: rising medical costs should lead to more, not less insurance coverage (Phelps, 1997). The rising demand for pharmaceutical coverage following the rise in spending on pharmaceuticals is consistent with this model. In the textbook model, rising costs would be associated with falling coverage only if the cost increases were driven by increased administrative loads. Empirically, though, most medical spending is a result of increased quantities of care received, owing to technological changes in medicine, not greater administrative burden (Cutler and McClellan, 2001). There are two extensions to the textbook model that can help explain a negative relation between health insurance costs and insurance coverage. The first extension focuses on the value of medical care relative to its cost (which determines the utility of coverage). While increased spending buys additional medical services, these services may not be of sufficient value to justify

3 their costs, at least for some consumers, and these people rationally decline coverage as a result. In this theory, rising quantities of care function, in essence, as an increase in administrative loads. Of course, if consumers had the option, they would exclude unvalued care from the insurance policy, but determining which care is valuable and which is not may be difficult, and contracting imperfections may make it difficult for individuals to purchase a plan that limits access to particular services. One type of unvalued care is traditional moral hazard: services are provided because of insurance but are worth less than they cost. Cutler (2004) argues that increased medical spending overall has bought care that is more than worth its value. But that does not imply that the differential growth of service use in some areas of the country relative to other areas is purchasing services of high value. It may be that high cost growth areas are disproportionately buying care with little marginal value. A more subtle story about the relative value of new services concerns the implicit pooling of costs across individuals. Insurance is generally not priced at the individual level. Most insurance is bought in employment groups. Although there may be a group specific wage offset associated with coverage (Pauly and Herring, 1999; Sheiner, 1997), it is likely that relatively healthy groups of individuals would experience a greater increase in premiums, compared to the value they receive, relative to less healthy individuals. Why should a relatively healthy 30 yearold pay 10 percent more each year for insurance, if most of the costs are for services that are very unlikely to be used? Technological advances and rising costs may alter the nature of equilibrium by imposing an implicit tax on the low risk individuals. This could cause markets to unravel and the healthy consumers to turn down coverage. 1 This needn t be true in all contexts; the mean of spending could increase while the spread narrows. However, if technology increases spending proportionately at each point in the distribution, or disproportionately affects 2

4 The second extension to the textbook model focuses on the utility of being uninsured, stressing the availability of care for the uninsured as a mechanism for avoiding the increased costs of coverage (Herring, 2001). People who are uninsured do not pay for all medical care outof-pocket. Rather, much of the care is uncompensated, written off by the provider as bad debt or charity care. Evidence suggests that a lack of coverage is associated with worse health outcomes. Yet the incremental value of the access to care associated with coverage may change over time because the new technology that drives cost increases may also be integrated into charity care, changing the value of access at the margin. Moreover, the impact of new technology on the value of coverage, relative to relying on charity care, may depend on health status. Lack of coverage may have its most pronounced effect on health outcomes for those with chronic illness where access to physician services and maintenance therapies for stable patients may be substantially inhibited. These extensions suggest that trends in coverage associated with new technology (and the associated rising costs) will reflect the value of those services for different subgroups and the availability of charity care to cushion the fiscal and clinical consequences associated with being uninsured. In this work we examine the relationship between coverage declines, premiums and charity care for different subgroups of the population. I. Medical Costs and Insurance Coverage To examine the factors predicting changes in insurance coverage, we use data on coverage in different MSAs at the beginning and end of the 1990s. 2 We create two cohorts of non-elderly individuals from the Current Population Survey: one cohort from and the spending for the very sick, greater spending would be associated with greater variance. 2 See Chernew, Cutler, and Keenan (2004) for discussion of the data and its construction. 3

5 second from Respondents are divided into health insurance units (HIUs), the typical unit in which insurance is purchased. The CPS provides a rich array of HIU and market-level variables that we control for, including basic demographics, income, employment characteristics, and MSA characteristics such as the overall demographic composition. We measure health insurance premiums using premium data from the Health Insurance Association of America and the Kaiser Family Foundation/Health Research and Educational Trust Survey of Employer-Sponsored Health Benefits (KPMG Survey, 1988, 1989, 1998) and (Kaiser Family Foundation, 1999). Surveys are pooled from 1988 and 1989 for the early years and 1998 and 1999 for the later years. To purge the premium data of differences in benefit design, we regress premiums on plan type, whether an employer offers multiple plans, and interactions of these variables with each other and year dummies; cost-sharing parameters such as deductible, coinsurance, and copay amounts; dummy variables for service coverage, including coverage for prescription drugs, outpatient mental health benefits, inpatient mental health benefits, and maternity benefits; firm size and industry dummies; and MSA dummies and their interaction with years. The coefficients on MSA dummies in this regression give adjusted premium estimates at the MSA level. 3 Premiums have increased substantially over time. From the late 1980s to the late 1990s, the cost of a standard insurance policy for an individual increased by $818. Clearly, premium changes may be endogenous to changes in insurance coverage and measurement error in the premium data can bias the estimates. Yet Chernew, Cutler, and Keenan (2004) report that in models for any insurance coverage, IV models using per capita 3 The coefficients from this regression indicate that more generous benefits led to greater premiums; the R 2 from this regression was The resulting premium estimates are quite reasonable: the correlation between adjusted premiums and Medicare part B spending at the MSA level is

6 MSA level Medicare Part B spending and state level personal spending for the nonelderly as instruments for premiums were even a bit larger than OLS estimates (presumably because of measurement error). We control for several other variables suggested in the literature that might lead to increased levels of uninsurance. Traditional theories of insurance have focused on the tax price of insurance: marginal tax rate reductions over the past two decades have lowered the tax subsidy to health insurance purchases, and thus possibly led to reduced coverage. We measure the tax subsidy for health insurance along the lines of Gruber (2001). Other theories are about the demand for health insurance. A lengthy literature has argued that increased generosity of public insurance, primarily Medicaid, has crowded out private insurance, and thus affected the mix, and perhaps the overall level of coverage. We generate measures of the generosity of Medicaid coverage of children following the approach of Cutler and Gruber (1996). Crowdout may also be generated by the availability of charity care providers. We measure the availability of charity care in each metropolitan area as the number of public and teaching hospital beds per capita. 4 We measure these variables only in 1990 to minimize reverse causality issues that may arise because these measures could be affected by insurance, rather than the reverse. The average area had 1,279 public and teaching hospital beds per 1 million people in Finally, some have hypothesized that a greater share of working women should lead to lower insurance coverage, as employers provide less generous benefits in the hope of 4 We include this variable as an interaction with time period, to examine whether the effect of charity care availability changes over time. 5

7 encouraging employees to take up coverage elsewhere (Farber and Levy, 2000; Dranove, Baker, and Spier, 2000). The first column of Table 1 shows the results of these regressions. 5 The estimates suggest that a $1,000 increase in premiums reduces the propensity to purchase private coverage by 2.67 percentage points. The coefficient is statistically significantly different from zero. Further, it is large. Health costs have increased by $818 per person for a single policy over the past decade, so this estimate suggests that rising health costs can explain about two-thirds of the total 3.3 percentage point reduction in private insurance coverage in our sample over time. The estimates on the other covariates are generally consistent with the existing literature. A higher tax price discourages private coverage. Individuals in markets with a larger share of working women and with greater Medicaid generosity are less likely to have private coverage, consistent with the public health insurance crowdout literature. II. Charity Care and Administrative Loads We examine the reasons why increased premiums might affect insurance coverage in several ways. The second column of Table 1 reports estimates for the models which include the measure of charity care and its interactions with premiums. The results are consistent with the charity care explanation. In particular, insurance coverage is much more responsive to insurance premiums in areas with greater charity care availability. Using marginal effects, we estimate that the responsiveness to private coverage from premiums is nearly twice as great at the mean value of charity care, as compared to if charity care were not available. 5 We use linear probability models in Table 1 and throughout the paper for ease of interpretation, and to avoid issues of different magnitudes of the effect based on the baseline characteristics (Ai and Norton, 2003). Non-linear estimation methods such as probit for column 1 give similar results with a somewhat higher effect of premiums on coverage declines. The standard errors in all cases are adjusted for intra-msa correlation. 6

8 To shed more light on the different theories of the impact of premiums, the remaining columns differentiate the population into younger and older adults (ages 18 through 25 and 50 through 64) as a proxy for healthy and sick, by education level of the family head as a proxy for permanent income (high school or less or greater than high school), and by family income ($30,000 or less or greater than $30,000). The impact of premiums themselves, and of the charity care interaction, is strongest in the young, lower educated and lower income population. The magnitudes of the responsiveness to premiums are depicted in Figure 1 for subgroups by age, education, and income. Younger adults are on average healthier than older adults so that a greater premium response for younger adults relative to older adults is consistent with the pooling hypothesis. It is also consistent with a model in which young adults have greater access to charity care (or are more willing to use it ), a model where the young view new services as less valuable than the old, or a model where the young are less risk averse than the old. It is interesting to note that premiums have no impact on coverage for the older population, regardless of the level of charity care availability. Put another way, for the high risk population, rising costs do not result in a reduction in insurance coverage. Possibly, this suggests that the pure moral hazard explanation for the impact of premiums on costs that additional care is not clinically beneficial is not empirically important. However, note that the impact of the tax price, a measure of pure load, is also not very salient in the older population, suggesting this group is very risk averse and perceives the value of coverage relative to relying on charity care to be substantial. The greater sensitivity of lower educated and income individuals to premiums can be explained by a variety of models. Of particular interest is the result that the availability of charity care increases the premium sensitivity for our lower educated and income groups much 7

9 more than in our higher educated and income samples. This is consistent with the view that education (and income) are inversely related to access to or willingness to rely on charity care. These results also highlight that the crowdout effect of Medicaid is concentrated among lower educated and lower income groups. III. Summary Overall, our results point to several conclusions. First, the evidence is very clear that rising health insurance costs lead to significant reductions in insurance coverage. The link between rising costs and reduced coverage explains the bulk of why health insurance coverage fell in the 1990s. We estimate that up to half of this response to higher costs is related to the availability of charity care. This estimate is rough because our estimates of the availability of charity care are based solely on the availability of beds in public and teaching hospitals. Yet the models consistently demonstrate that the availability of beds in facilities that are relied upon for charity care increases the sensitivity of coverage to rising premiums. By providing access for the uninsured, charity care providers inadvertently create the conditions for crowding out of private health insurance. We suspect that the remaining impact of premiums on coverage is due to diminished utility of coverage associated with rising premiums, particularly for the young and the low income. Of particular importance may be the pooling of high and low risk enrollees, which leads to identifiable transfers from the healthy to the sick. As medical costs increase, the size of these transfers rises, and the willingness of the healthy to make them declines. This finding suggests that the new era of rising medical spending we have recently entered could have a major impact on private insurance coverage. Moreover, the decline in 8

10 coverage caused by rising premiums will place a greater burden on charity care providers. Though important in a time of declining coverage, bolstering the strained charity care system may further exacerbate the decline in coverage, posing a policy dilemma in responding to increases in the uninsured population. 9

11 Table 1: Linear Probability Models Explaining Private Health Insurance Coverage Sample Total Total Ages Ages High sch. or less > High school Income <=$30,000 Income >$30,000 Premiums *** ** * ** *** (000s) (0.0072) (0.0082) (0.0166) (0.0144) (0.0106) (0.0094) (0.0135) (0.0083) Charity ** ** * Care (3.5165) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Charity care* ** ** ** ** premium (5.8094) ( ) ( ) (8.4325) (6.7061) ( ) (4.8264) Tax price *** *** * *** * (0.1846) (0.1844) (0.2349) (0.2512) (0.2681) (0.1896) (0.2428) (0.0737) State Insur * Reforms (0.0060) (0.0060) (0.0097) (0.0099) (0.0092) (0.0051) (0.0114) (0.0038) % Working ** ** ** ** *** Women (0.0615) (0.0627) (0.1634) (0.1058) (0.0956) (0.0702) (0.1068) (0.0739) Medicaid *** *** *** ** *** *** ** Share (0.0181) (0.0182) (0.0439) (0.0694) (0.0311) (0.0216) (0.0370) (0.0196) Obs R-squared Robust standard errors in parentheses * significant at 10%; ** significant at 5%; *** significant at 1% 10

12 Figure 1: Charity Care and the Impact of Premiums on Coverage Impact on Prremiums on Coverage Base Age Age <= High Sch > High Sch Inc <30,000 Inc >30, Public and Teaching Hospital Beds per Million Population 11

13 References Ai C. and E.C. Norton Interaction Terms in Logit and Probit Models. Economics Letters 80: Chernew M., D. Cutler, and P. Keenan Increasing Health Insurance Costs and the Decline in Insurance Coverage. Mimeo. Cutler, D.M Your Money or Your Life: Strong Medicine for America s Health Care System. Oxford: Oxford University Press. Cutler, D.M. and M. McClellan Is Technological Change in Medicine Worth It? Health Affairs 20(5): Cutler, D.M. and J. Gruber Does Public Insurance Crowd Out Private Insurance? Quarterly Journal of Economics 111(2): Dranove D., K. Spier, and L. Baker Competition Among Employers Offering Health Insurance. Journal of Health Economics 19(1): Farber, H.S. and H. Levy Recent Trends in Employer-Sponsored Health Insurance Coverage: Are Bad Jobs Getting Worse? Journal of Health Economics 19(1): Gruber, J. July The Impact of the Tax System on Health Insurance Decisions. Mimeo, MIT. Herring B Does Access to Charity Care For the Uninsured Crowd Out Private Health Insurance Coverage. Mimeo. KPMG Survey of Employer-Sponsored Health Benefits, 1988, 1989, Kaiser Family Foundation/Health Research and Educational Trust Survey of Employer- Sponsored Health Benefits, Pauly M.V. and B. Herring Pooling Health Insurance Risks. The AEI Press, Washington, D.C. Phelps C Health Economics. New York: Addison Wesley. Sheiner L Health Care Costs, Wages, and Aging. Mimeo (Federal Reserve Board of Governors, Washington, DC). 12

Charity Care, Risk Pooling, and the Decline in Private Health Insurance

Charity Care, Risk Pooling, and the Decline in Private Health Insurance INSURANCE MARKETS AND HEALTH CARE Charity Care, Risk Pooling, and the Decline in Private Health Insurance By MICHAEL CHERNEW, DAVID CUTLER, AND PATRICIA SELIGER KEENAN* Over the past several decades health-care

More information

Increasing Health Insurance Costs and the Decline in Insurance Coverage. Michael Chernew University of Michigan and NBER

Increasing Health Insurance Costs and the Decline in Insurance Coverage. Michael Chernew University of Michigan and NBER Increasing Health Insurance Costs and the Decline in Insurance Coverage Michael Chernew University of Michigan and NBER David Cutler Harvard University and NBER Patricia Seliger Keenan NBER October 2004

More information

Increasing Health Insurance Costs and the Decline in Health Insurance Coverage

Increasing Health Insurance Costs and the Decline in Health Insurance Coverage Increasing Health Insurance Costs and the Decline in Health Insurance Coverage The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters.

More information

Increasing Health Insurance Costs and the Decline in Health Insurance Coverage

Increasing Health Insurance Costs and the Decline in Health Insurance Coverage Increasing Health Insurance Costs and the Decline in Health Insurance Coverage The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters.

More information

WHY DID EMPLOYEE HEALTH INSURANCE CONTRIBUTIONS RISE?

WHY DID EMPLOYEE HEALTH INSURANCE CONTRIBUTIONS RISE? Economic Research Initiative on the Uninsured Working Paper Series WHY DID EMPLOYEE HEALTH INSURANCE CONTRIBUTIONS RISE? Jonathan Gruber, Ph.D. MIT, NBER Robin McKnight MIT ERIU Working Paper 9 www.umich.edu/~eriu/pdf/wp9.pdf

More information

This PDF is a selection from a published volume from the National Bureau of Economic Research

This PDF is a selection from a published volume from the National Bureau of Economic Research This PDF is a selection from a published volume from the National Bureau of Economic Research Volume Title: Frontiers in Health Policy Research, Volume 6 Volume Author/Editor: David M. Cutler and Alan

More information

THE ECONOMIC EFFECTS OF STATE-MANDATED HEALTH INSURANCE BENEFITS

THE ECONOMIC EFFECTS OF STATE-MANDATED HEALTH INSURANCE BENEFITS THE ECONOMIC EFFECTS OF STATE-MANDATED HEALTH INSURANCE BENEFITS Robert Sobers The College of New Jersey April 2003 I. INTRODUCTION There are currently 41.2 million Americans without health insurance,

More information

How Sensitive are Low Income Families to Health Plan Prices?

How Sensitive are Low Income Families to Health Plan Prices? American Economic Review: Papers & Proceedings 100 (May 2010): 292 296 http://www.aeaweb.org/articles.php?doi=10.1257/aer.100.2.292 The Massachusetts Health Insurance Experiment: Early Experiences How

More information

Generational Aspects of Medicare. David M. Cutler and Louise Sheiner * Abstract

Generational Aspects of Medicare. David M. Cutler and Louise Sheiner * Abstract Generational Aspects of Medicare David M. Cutler and Louise Sheiner * Abstract This paper examines the generational aspect of the current Medicare system and some stylized reforms. We find that the rates

More information

Why did employee health insurance contributions rise?

Why did employee health insurance contributions rise? Journal of Health Economics 22 (2003) 1085 1104 Why did employee health insurance contributions rise? Jonathan Gruber, Robin McKnight Department of Economics, Massachusetts Institute of Technology, MIT

More information

Social Security Eligibility and the Labor Supply of Elderly Immigrants. George J. Borjas Harvard University and National Bureau of Economic Research

Social Security Eligibility and the Labor Supply of Elderly Immigrants. George J. Borjas Harvard University and National Bureau of Economic Research Social Security Eligibility and the Labor Supply of Elderly Immigrants George J. Borjas Harvard University and National Bureau of Economic Research Updated for the 9th Annual Joint Conference of the Retirement

More information

Setting the Record Straight about Medicare

Setting the Record Straight about Medicare Fact Sheet Setting the Record Straight about Medicare Keith D. Lind, JD, MS As the nation considers the future of Medicare, it is important to separate the facts from misconceptions about Medicare coverage,

More information

STATE CONSIDERATIONS ON ADOPTING HEALTH REFORM S BASIC HEALTH OPTION Federal Guidance Needed for States to Fully Assess Option by January Angeles

STATE CONSIDERATIONS ON ADOPTING HEALTH REFORM S BASIC HEALTH OPTION Federal Guidance Needed for States to Fully Assess Option by January Angeles 820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org March 13, 2012 STATE CONSIDERATIONS ON ADOPTING HEALTH REFORM S BASIC HEALTH OPTION

More information

Data Concerns in Out-of-Pocket Spending Comparisons between Medicare and Private Insurance. Cristina Boccuti and Marilyn Moon

Data Concerns in Out-of-Pocket Spending Comparisons between Medicare and Private Insurance. Cristina Boccuti and Marilyn Moon Data Concerns in Out-of-Pocket Spending Comparisons between Medicare and Private Insurance Cristina Boccuti and Marilyn Moon As Medicare beneficiaries double over the next 30 years, controlling per enrollee

More information

NBER WORKING PAPER SERIES EMPLOYEE COSTS AND THE DECLINE IN HEALTH INSURANCE COVERAGE. David M. Cutler

NBER WORKING PAPER SERIES EMPLOYEE COSTS AND THE DECLINE IN HEALTH INSURANCE COVERAGE. David M. Cutler NBER WORKING PAPER SERIES EMPLOYEE COSTS AND THE DECLINE IN HEALTH INSURANCE COVERAGE David M. Cutler Working Paper 9036 http://www.nber.org/papers/w9036 NATIONAL BUREAU OF ECONOMIC RESEARCH 1050 Massachusetts

More information

Health Economics Program

Health Economics Program Health Economics Program Issue Brief 2006-05 August 2006 Medicare Supplemental Coverage and Prescription Drug Use, 2004 Medicare is a federal health insurance program that provides coverage for the elderly

More information

Tracking Report. Medical Bill Problems Steady for U.S. Families, 2007-2010 MEDICAL BILL PROBLEMS STABILIZE AS CONSUMERS CUT CARE

Tracking Report. Medical Bill Problems Steady for U.S. Families, 2007-2010 MEDICAL BILL PROBLEMS STABILIZE AS CONSUMERS CUT CARE I N S U R A N C E C O V E R A G E & C O S T S Tracking Report RESULTS FROM THE HEALTH TRACKING HOUSEHOLD SURVEY NO. 28 DECEMBER 2011 Medical Bill Problems Steady for U.S. Families, 2007-2010 By Anna Sommers

More information

Health Coverage among 50- to 64-Year-Olds

Health Coverage among 50- to 64-Year-Olds Health Coverage among 50- to 64-Year-Olds In 2005, more than 51 million Americans were age 50 64. This number is projected to rise to 58 million in 2010, when the first baby boomers turn 64. The aging

More information

kaiser medicaid uninsured commission on Health Insurance Coverage of the Near Elderly Prepared by John Holahan, Ph.D. The Urban Institute and the

kaiser medicaid uninsured commission on Health Insurance Coverage of the Near Elderly Prepared by John Holahan, Ph.D. The Urban Institute and the kaiser commission on medicaid and the uninsured Health Insurance Coverage of the ear Elderly Prepared by John Holahan, Ph.D. The Urban Institute July 2004 kaiser commission medicaid uninsured and the The

More information

Health Policy Brief. what s the issue? what s the background? november 15, 2012

Health Policy Brief. what s the issue? what s the background? november 15, 2012 www.healthaffairs.org 1 Health Policy Brief november 15, 2012 Basic Health Program. The Affordable Care Act offers states another option besides Medicaid and the exchanges for health coverage for low-income

More information

Midterm exam, Health economics, Spring 2007 Answer key

Midterm exam, Health economics, Spring 2007 Answer key Midterm exam, Health economics, Spring 2007 Answer key Instructions: All points on true/false and multiple choice questions will be given for the explanation. Note that you can choose which questions to

More information

Survey of Non-Group Health Insurance Enrollees

Survey of Non-Group Health Insurance Enrollees Survey of Non-Group Health Insurance Enrollees A First Look At People Buying Their Own Health Insurance Following Implementation Of The Affordable Care Act Executive Summary... 1 About The Groups Described

More information

Employee demand for health insurance and employer health plan choices

Employee demand for health insurance and employer health plan choices Journal of Health Economics 21 (2002) 65 88 Employee demand for health insurance and employer health plan choices M. Kate Bundorf Department of Health Medicine, HRP Rewood Building, Stanford University

More information

Committee on Ways and Means Subcommittee on Health U.S. House of Representatives. Hearing on Examining Traditional Medicare s Benefit Design

Committee on Ways and Means Subcommittee on Health U.S. House of Representatives. Hearing on Examining Traditional Medicare s Benefit Design Committee on Ways and Means Subcommittee on Health U.S. House of Representatives Hearing on Examining Traditional Medicare s Benefit Design February 26, 2013 Statement of Cori E. Uccello, MAAA, FSA, MPP

More information

Statement of. Linda J. Blumberg, Ph.D. Senior Fellow The Urban Institute

Statement of. Linda J. Blumberg, Ph.D. Senior Fellow The Urban Institute Statement of Linda J. Blumberg, Ph.D. Senior Fellow The Urban Institute Committee on Energy and Commerce Subcommittee on Oversight and Investigations United States House of Representatives Hearing: The

More information

BACKGROUNDER. Double Coverage: How It Drives Up Medicare Costs for Patients and Taxpayers. Key Points. Robert E. Moffit, PhD, and Drew Gonshorowski

BACKGROUNDER. Double Coverage: How It Drives Up Medicare Costs for Patients and Taxpayers. Key Points. Robert E. Moffit, PhD, and Drew Gonshorowski BACKGROUNDER No. 2805 Double Coverage: How It Drives Up Medicare Costs for Patients and Taxpayers Robert E. Moffit, PhD, and Drew Gonshorowski Abstract Traditional Medicare s cost-sharing structure has

More information

Basic Health Plan Offers a Chance to Provide Comprehensive Health Care Coverage for Low-Income Minnesotans

Basic Health Plan Offers a Chance to Provide Comprehensive Health Care Coverage for Low-Income Minnesotans Basic Health Plan Offers a Chance to Provide Comprehensive Health Care Coverage for Low-Income Minnesotans The number of uninsured in Minnesota has been on the rise over the last decade, with one out of

More information

Issue Brief. Women and Health Coverage: The Affordability Gap. Elizabeth M. Patchias and Judy Waxman National Women s Law Center * * * * *

Issue Brief. Women and Health Coverage: The Affordability Gap. Elizabeth M. Patchias and Judy Waxman National Women s Law Center * * * * * APRIL 2007 Issue Brief Women and Health Coverage: The Affordability Gap Elizabeth M. Patchias and Judy Waxman National Women s Law Center For more information about this study, please contact: Elizabeth

More information

FACULTY RETIREMENT PLANS: THE ROLE OF RETIREE HEALTH INSURANCE

FACULTY RETIREMENT PLANS: THE ROLE OF RETIREE HEALTH INSURANCE TRENDS AND ISSUES SEPTEMBER 2015 FACULTY RETIREMENT PLANS: THE ROLE OF RETIREE HEALTH INSURANCE Robert L. Clark Zelnak Professor Poole College of Management North Carolina State University Retiree health

More information

IIB. ECONOMIC ISSUES IN THE PRESIDENTIAL CAMPAIGN

IIB. ECONOMIC ISSUES IN THE PRESIDENTIAL CAMPAIGN Econ 1905: Government Fall, 2007 IIB. ECONOMIC ISSUES IN THE PRESIDENTIAL CAMPAIGN Topics I have identified include health care, international trade ( the global economy ), agricultural policy, and taxes,

More information

Indiana s Health Care Sector and Insurance Market: Summary Report

Indiana s Health Care Sector and Insurance Market: Summary Report MPR Reference No.: 6070 Indiana s Health Care Sector and Insurance Market: Summary Report Revised Final Report September 7, 2004 Deborah Chollet Fabrice Smieliauskas Rebecca Nyman Andrea Staiti Submitted

More information

THE EFFECT OF TAX SUBSIDIES TO EMPLOYER-PROVIDED SUPPLEMENTARY HEALTH INSURANCE: EVIDENCE FROM CANADA. Amy Finkelstein 1 MIT.

THE EFFECT OF TAX SUBSIDIES TO EMPLOYER-PROVIDED SUPPLEMENTARY HEALTH INSURANCE: EVIDENCE FROM CANADA. Amy Finkelstein 1 MIT. Forthcoming, Journal of Public Economics THE EFFECT OF TAX SUBSIDIES TO EMPLOYER-PROVIDED SUPPLEMENTARY HEALTH INSURANCE: EVIDENCE FROM CANADA Amy Finkelstein 1 MIT September 2000 Abstract This paper presents

More information

LECTURE: HEALTH INSURANCE AND LABOR MARKETS HILARY HOYNES UC DAVIS EC230 OUTLINE OF LECTURE: 1. Introduction and background

LECTURE: HEALTH INSURANCE AND LABOR MARKETS HILARY HOYNES UC DAVIS EC230 OUTLINE OF LECTURE: 1. Introduction and background LECTURE: HEALTH INSURANCE AND LABOR MARKETS HILARY HOYNES UC DAVIS EC230 OUTLINE OF LECTURE: 1. Introduction and background 2. Theory of health insurance and mobility Madrian Job Lock, QJE 3. Theory of

More information

Government Intervention in Health Insurance Markets

Government Intervention in Health Insurance Markets Florian Scheuer 4/22/2014 Government Intervention in Health Insurance Markets 1 Overview health care - institutional overview rise in health spending impact of health insurance: spending and benefits other

More information

November 30, 2009. Sincerely,

November 30, 2009. Sincerely, CONGRESSIONAL BUDGET OFFICE U.S. Congress Washington, DC 20515 Douglas W. Elmendorf, Director November 30, 2009 Honorable Evan Bayh United States Senate Washington, DC 20510 Dear Senator: The attachment

More information

MEDICAID AND SCHIP PROTECTED INSURANCE COVERAGE FOR MILLIONS OF LOW-INCOME AMERICANS. by Leighton Ku, Matt Broaddus and Victoria Wachino

MEDICAID AND SCHIP PROTECTED INSURANCE COVERAGE FOR MILLIONS OF LOW-INCOME AMERICANS. by Leighton Ku, Matt Broaddus and Victoria Wachino ( 820 First Street, NE, Suite 510, Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org January 31, 2005 MEDICAID AND SCHIP PROTECTED INSURANCE COVERAGE FOR MILLIONS OF

More information

ACTUARIAL VALUE AND EMPLOYER- SPONSORED INSURANCE

ACTUARIAL VALUE AND EMPLOYER- SPONSORED INSURANCE NOVEMBER 2011 ACTUARIAL VALUE AND EMPLOYER- SPONSORED INSURANCE SUMMARY According to preliminary estimates, the overwhelming majority of employer-sponsored insurance (ESI) plans meets and exceeds an actuarial

More information

THE MEDICAID PROGRAM AT A GLANCE. Health Insurance Coverage

THE MEDICAID PROGRAM AT A GLANCE. Health Insurance Coverage on on medicaid and and the the uninsured March 2013 THE MEDICAID PROGRAM AT A GLANCE Medicaid, the nation s main public health insurance program for low-income people, covers over 62 million Americans,

More information

An important challenge in designing policy

An important challenge in designing policy Health Insurance for Children Balancing Efficiency and Equity in the Design of Coverage Expansions for Children Linda J. Blumberg An important challenge in designing policy initiatives to address the problem

More information

75 Washington Ave. Suite 206 Portland, ME 04101. (207) 767-6440 www.marketdecisions.com

75 Washington Ave. Suite 206 Portland, ME 04101. (207) 767-6440 www.marketdecisions.com 75 Washington Ave. Suite 206 Portland, ME 04101 (207) 767-6440 www.marketdecisions.com Comprehensive Report 2014 Vermont Household Health Insurance Survey Vermont Department of Regulation, Insurance Division

More information

Age Rating Under Comprehensive Health Care Reform: Implications for Coverage, Costs, and Household Financial Burdens

Age Rating Under Comprehensive Health Care Reform: Implications for Coverage, Costs, and Household Financial Burdens Age Rating Under Comprehensive Health Care Reform: Implications for Coverage, Costs, and Household Financial Burdens Timely Analysis of Immediate Health Policy Issues October 2009 Linda J. Blumberg, Matthew

More information

Analysis of the Costs and Impact of Universal Health Care Coverage Under a Single Payer Model for the State of Vermont

Analysis of the Costs and Impact of Universal Health Care Coverage Under a Single Payer Model for the State of Vermont Analysis of the Costs and Impact of Universal Health Care Coverage Under a Single Payer Model for the State of Vermont Prepared for: The Vermont HRSA State Planning Grant, Office of Vermont Health Access

More information

How Non-Group Health Coverage Varies with Income

How Non-Group Health Coverage Varies with Income How Non-Group Health Coverage Varies with Income February 2008 Policy makers at the state and federal levels are considering proposals to subsidize the direct purchase of health insurance as a way to reduce

More information

National Findings on Access to Health Care and Service Use for Non-elderly Adults Enrolled in Medicaid

National Findings on Access to Health Care and Service Use for Non-elderly Adults Enrolled in Medicaid National Findings on Access to Health Care and Service Use for Non-elderly Adults Enrolled in Medicaid By Sharon K. Long Karen Stockley Elaine Grimm Christine Coyer Urban Institute MACPAC Contractor Report

More information

Health Care Reform without the Individual Mandate

Health Care Reform without the Individual Mandate Health Care Reform without the Individual Mandate Replacing the Individual Mandate would Significantly Erode Coverage Gains and Raise Premiums for Health Care Consumers Jonathan Gruber February 2011 Introduction

More information

PRESIDENT PROPOSES TO MAKE TAX BENEFITS OF HEALTH SAVINGS ACCOUNTS MORE LUCRATIVE FOR HIGHER-INCOME INDIVIDUALS

PRESIDENT PROPOSES TO MAKE TAX BENEFITS OF HEALTH SAVINGS ACCOUNTS MORE LUCRATIVE FOR HIGHER-INCOME INDIVIDUALS 820 First Street, NE, Suite 510, Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org Revised February 9, 2004 PRESIDENT PROPOSES TO MAKE TAX BENEFITS OF HEALTH SAVINGS

More information

Non-Group Health Insurance: Many Insured Americans with High Out-of-Pocket Costs Forgo Needed Health Care

Non-Group Health Insurance: Many Insured Americans with High Out-of-Pocket Costs Forgo Needed Health Care Affordable Care Act Non-Group Health Insurance: Many Insured Americans with High Out-of-Pocket Costs Forgo Needed Health Care SPECIAL REPORT / MAY 2015 WWW.FAMILIESUSA.ORG Executive Summary Since its passage

More information

March 19, 2009. 820 First Street NE, Suite 510 Washington, DC 20002. Tel: 202-408-1080 Fax: 202-408-1056. center@cbpp.org www.cbpp.

March 19, 2009. 820 First Street NE, Suite 510 Washington, DC 20002. Tel: 202-408-1080 Fax: 202-408-1056. center@cbpp.org www.cbpp. 820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org March 19, 2009 HEALTH REFORM PACKAGE REPRESENTS HISTORIC CHANCE TO EXPAND COVERAGE,

More information

Subsidies to employee health insurance premiums and the health insurance market

Subsidies to employee health insurance premiums and the health insurance market Journal of Health Economics 24 (2005) 253 276 Subsidies to employee health insurance premiums and the health insurance market Jonathan Gruber, Ebonya Washington Department of Economics, Massachusetts Institute

More information

AN OVERVIEW OF THE MEDICARE PROGRAM AND MEDICARE BENEFICIARIES COSTS AND SERVICE USE

AN OVERVIEW OF THE MEDICARE PROGRAM AND MEDICARE BENEFICIARIES COSTS AND SERVICE USE AN OVERVIEW OF THE MEDICARE PROGRAM AND MEDICARE BENEFICIARIES COSTS AND SERVICE USE Statement of Juliette Cubanski, Ph.D. Associate Director, Program on Medicare Policy The Henry J. Kaiser Family Foundation

More information

HEALTH RISK INCOME, AND THE PURCHASE OF PRIVATE HEALTH INSURANCE. M. Kate Bundorf Bradley Herring Mark V. Pauly

HEALTH RISK INCOME, AND THE PURCHASE OF PRIVATE HEALTH INSURANCE. M. Kate Bundorf Bradley Herring Mark V. Pauly HEALTH RISK INCOME, AND THE PURCHASE OF PRIVATE HEALTH INSURANCE M. Kate Bundorf Bradley Herring Mark V. Pauly ERIU Working Paper 29 http://www.umich.edu/~eriu/pdf/wp29.pdf Economic Research Initiative

More information

Cost-sharing Charges in Marketplace Health Insurance Plans - Part II

Cost-sharing Charges in Marketplace Health Insurance Plans - Part II September 2013 Cost-sharing Charges in Marketplace Health Insurance Plans - Part II Starting in January 2014, new health insurance marketplaces (also called exchanges) will provide a way for people to

More information

As of January 1, 2014, most individuals must have some form of health coverage, or pay a penalty to the federal government.

As of January 1, 2014, most individuals must have some form of health coverage, or pay a penalty to the federal government. Consumer Alert Health Insurance for 2014: What You Need to Know Before You Enroll (Individuals) As of January 1, 2014, most individuals must have some form of health coverage, or pay a penalty to the federal

More information

Updated November 23, 2009

Updated November 23, 2009 820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org Updated November 23, 2009 HOUSE HEALTH REFORM BILL EXPANDS COVERAGE AND LOWERS HEALTH

More information

The Impact of the Medicare Drug Benefit on Health Care Spending by Older Households

The Impact of the Medicare Drug Benefit on Health Care Spending by Older Households The Impact of the Medicare Drug Benefit on Health Care Spending by Older Households Dean Baker and Ben Zipperer December 2008 Center for Economic and Policy Research 1611 Connecticut Avenue, NW, Suite

More information

Chapter 8: Just in Case Additional Material

Chapter 8: Just in Case Additional Material Chapter 8: Just in Case Additional Material Here I go into detail about Medicare, Medicare Advantage (MA) plans, and Medigap plans. What about Medicare? Medicare is a federal health insurance program for

More information

Medicaid Crowd-Out of Long-Term Care Insurance With Endogenous Medicaid Enrollment

Medicaid Crowd-Out of Long-Term Care Insurance With Endogenous Medicaid Enrollment Medicaid Crowd-Out of Long-Term Care Insurance With Endogenous Medicaid Enrollment Geena Kim University of Pennsylvania 12th Annual Joint Conference of the Retirement Research Consortium August 5-6, 2010

More information

MEDICARE BUY-IN OPTIONS: ESTIMATING COVERAGE AND COSTS. John Sheils and Ying-Jun Chen The Lewin Group, Inc. February 2001

MEDICARE BUY-IN OPTIONS: ESTIMATING COVERAGE AND COSTS. John Sheils and Ying-Jun Chen The Lewin Group, Inc. February 2001 MEDICARE BUY-IN OPTIONS: ESTIMATING COVERAGE AND COSTS John Sheils and Ying-Jun Chen The Lewin Group, Inc. February 2001 Support for this research was provided by The Commonwealth Fund. The views presented

More information

The Consequences of the Growth of Health Insurance Premiums

The Consequences of the Growth of Health Insurance Premiums The Consequences of the Growth of Health Insurance Premiums By KATHERINE BAICKER AND AMITABH CHANDRA* In the United States, two-thirds of the nonelderly population is covered by employerprovided health

More information

Prescription Drugs as a Starting Point for Medicare Reform Testimony before the Senate Budget Committee

Prescription Drugs as a Starting Point for Medicare Reform Testimony before the Senate Budget Committee Prescription Drugs as a Starting Point for Medicare Reform Testimony before the Senate Budget Committee Marilyn Moon The nonpartisan Urban Institute publishes studies, reports, and books on timely topics

More information

This PDF is a selection from a published volume from the National Bureau of Economic Research

This PDF is a selection from a published volume from the National Bureau of Economic Research This PDF is a selection from a published volume from the National Bureau of Economic Research Volume Title: Labor Markets and Firm Benefit Policies in Japan and the United States Volume Author/Editor:

More information

Did Medicare Induce Pharmaceutical Innovation?

Did Medicare Induce Pharmaceutical Innovation? January 2006 Did Medicare Induce Pharmaceutical Innovation? Daron Acemoglu David Cutler Amy Finkelstein Joshua Linn Abstract The introduction of Medicare in 1965 was the single largest change in health

More information

Managed Care Penetration and the Earnings of Health Care Workers

Managed Care Penetration and the Earnings of Health Care Workers Managed Care Penetration and the Earnings of Health Care Workers Amy Ehrsam Department of Economics East Carolina University M.S. Research Paper August 2001 Abstract In the last fifteen years one of the

More information

Statement by Gary Claxton Vice President, Henry J. Kaiser Family Foundation Director, Health Care Marketplace Project

Statement by Gary Claxton Vice President, Henry J. Kaiser Family Foundation Director, Health Care Marketplace Project Statement by Gary Claxton Vice President, Henry J. Kaiser Family Foundation Director, Health Care Marketplace Project Before the U.S. Senate Committee on Finance Roundtable on Health Care Coverage May

More information

An Analysis of the Health Insurance Coverage of Young Adults

An Analysis of the Health Insurance Coverage of Young Adults Gius, International Journal of Applied Economics, 7(1), March 2010, 1-17 1 An Analysis of the Health Insurance Coverage of Young Adults Mark P. Gius Quinnipiac University Abstract The purpose of the present

More information

Health Savings Accounts and High-Deductible Health Plans: The Wrong Answer to Women s Health Care Needs

Health Savings Accounts and High-Deductible Health Plans: The Wrong Answer to Women s Health Care Needs Health Savings Accounts and High-Deductible Health Plans: The Wrong Answer to Women s Health Care Needs A combination of Health Savings Accounts (HSAs) and High-Deductible Health Plans (HDHPs) have been

More information

AN INDIVIDUAL HEALTHPLAN EXCHANGE: WHICH EMPLOYEES WOULD BENEFIT AND WHY?

AN INDIVIDUAL HEALTHPLAN EXCHANGE: WHICH EMPLOYEES WOULD BENEFIT AND WHY? AN INDIVIDUAL HEALTHPLAN EXCHANGE: WHICH EMPLOYEES WOULD BENEFIT AND WHY? Leemore Dafny, Katherine Ho and Mauricio Varela * On average, U.S. workers fortunate enough to be offered health insurance through

More information

While Congress is focusing on health insurance for low-income children, this survey highlights the vulnerability of low-income adults as well.

While Congress is focusing on health insurance for low-income children, this survey highlights the vulnerability of low-income adults as well. Insurance Matters For Low-Income Adults: Results From A Five-State Survey While Congress is focusing on health insurance for low-income children, this survey highlights the vulnerability of low-income

More information

Issue Brief. Choosing the Best Plan in a Health Insurance Exchange: Actuarial Value Tells Only Part of the Story OVERVIEW

Issue Brief. Choosing the Best Plan in a Health Insurance Exchange: Actuarial Value Tells Only Part of the Story OVERVIEW August 2012 Issue Brief Choosing the Best Plan in a Health Insurance Exchange: Actuarial Value Tells Only Part of the Story Ryan Lore, Jon R. Gabel, Roland McDevitt, and Michael Slover The mission of The

More information

Bare-Bones Health Plans: Is Something Better than Nothing?

Bare-Bones Health Plans: Is Something Better than Nothing? National Women s Law Center Bare-Bones Health Plans: Is Something Better than Nothing? Some states currently allow private insurance companies to sell bare-bones health insurance plans policies that offer

More information

White Paper. Medicare Part D Improves the Economic Well-Being of Low Income Seniors

White Paper. Medicare Part D Improves the Economic Well-Being of Low Income Seniors White Paper Medicare Part D Improves the Economic Well-Being of Low Income Seniors Kathleen Foley, PhD Barbara H. Johnson, MA February 2012 Table of Contents Executive Summary....................... 1

More information

If I have a psychiatric disability. Will Health Reform Help Me?

If I have a psychiatric disability. Will Health Reform Help Me? If I have a psychiatric disability Will Health Reform Help Me? For consumers of mental health services, a review of the bills passed by Congress in 2009 This paper was written by Chris Koyanagi, policy

More information

TRENDS AND ISSUES TRENDS IN HEALTH CARE SPENDING AND HEALTH INSURANCE DECEMBER 2008

TRENDS AND ISSUES TRENDS IN HEALTH CARE SPENDING AND HEALTH INSURANCE DECEMBER 2008 TRENDS AND ISSUES DECEMBER 2008 TRENDS IN HEALTH CARE SPENDING AND HEALTH INSURANCE David P. Richardson, Ph.D. Principal Research Fellow TIAA-CREF Institute EXECUTIVE SUMMARY Recent trends in health care

More information

PRESCRIPTION DRUG COSTS FOR MEDICARE BENEFICIARIES: COVERAGE AND HEALTH STATUS MATTER

PRESCRIPTION DRUG COSTS FOR MEDICARE BENEFICIARIES: COVERAGE AND HEALTH STATUS MATTER PRESCRIPTION DRUG COSTS FOR MEDICARE BENEFICIARIES: COVERAGE AND HEALTH STATUS MATTER Bruce Stuart, Dennis Shea, and Becky Briesacher January 2000 ISSUE BRIEF How many Medicare beneficiaries lack prescription

More information

President Bush s FY 2008 budget proposed major changes

President Bush s FY 2008 budget proposed major changes The President s Proposed Standard Deduction for Health Insurance The President s Proposed Standard Deduction for Health Insurance: Evaluation and Recommendations Abstract - The President s proposal to

More information

Changes in Family Health Insurance Coverage for Small and Large Firm Workers and Dependents: Evidence from 1995 to 2005

Changes in Family Health Insurance Coverage for Small and Large Firm Workers and Dependents: Evidence from 1995 to 2005 Changes in Family Health Insurance Coverage for Small and Large Firm Workers and Dependents: Evidence from 1995 to 2005 by Eric E. Seiber Curtis S. Florence Columbus, OH 43210 for Under contract no. SBAHQ-06-M-0513

More information

In preparing the February 2014 baseline budget

In preparing the February 2014 baseline budget APPENDIX B Updated Estimates of the Insurance Coverage Provisions of the Affordable Care Act In preparing the February 2014 baseline budget projections, the Congressional Budget Office () and the staff

More information

The Future of U.S. Health Care Spending Conference, April 11, 2014

The Future of U.S. Health Care Spending Conference, April 11, 2014 The Future of U.S. Health Care Spending Conference, April 11, 2014 The Potential Impact of Alternative Health Care Spending Scenarios on Future State and Local Government Budgets Author: Donald Boyd, Rockefeller

More information

Improved Medicare for All

Improved Medicare for All Improved Medicare for All Quality, Guaranteed National Health Insurance by HEALTHCARE-NOW! Single-Payer Healthcare or Improved Medicare for All! The United States is the only country in the developed world

More information

Advanced Health Economics Econ555/HPA543. Week 4: Health Insurance

Advanced Health Economics Econ555/HPA543. Week 4: Health Insurance Advanced Health Economics Econ555/HPA543 Week 4: Health Insurance Types of Insurance Coverage Fee-for-Service: Coinsurance Deductibles Catastrophic Maximum Indemnity Capitation Mixed Coinsurance - Patient

More information

Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange

Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange The Affordable Care Act (ACA) makes health insurance available to nearly all Americans and the law requires

More information

Demand for and Supply of Supplementary Health Insurance in Shanghai Wen Chen 1, Xiaohua Ying 1, Shanlian Hu 1, Guozhen Sun 2, Li Luo 1, Wenwei Tang 2

Demand for and Supply of Supplementary Health Insurance in Shanghai Wen Chen 1, Xiaohua Ying 1, Shanlian Hu 1, Guozhen Sun 2, Li Luo 1, Wenwei Tang 2 Demand for and Supply of Supplementary Health Insurance in Shanghai Wen Chen 1, Xiaohua Ying 1, Shanlian Hu 1, Guozhen Sun 2, Li Luo 1, Wenwei Tang 2 1 School of Public Health, Fudan University, Shanghai

More information

SNHPI Safety Net Hospitals for Pharmaceutical Access

SNHPI Safety Net Hospitals for Pharmaceutical Access SNHPI Safety Net Hospitals for Pharmaceutical Access Why the 340B Program Will Continue to be Important and Necessary after Health Care Reform is Fully Implemented Since 1992, the 340B drug discount program

More information

Controlling Health Care Costs Through Limited Network Insurance Plans: Evidence from Massachusetts State Employees

Controlling Health Care Costs Through Limited Network Insurance Plans: Evidence from Massachusetts State Employees Controlling Health Care Costs Through Limited Network Insurance Plans: Evidence from Massachusetts State Employees Jonathan Gruber, MIT and NBER Robin McKnight, Wellesley and NBER Our Setting Massachusetts

More information

Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance?

Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance? Available online at www.sciencedirect.com Journal of Health Economics 27 (2008) 201 217 Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance? Jonathan

More information

The Affordable Care Act in New Hampshire

The Affordable Care Act in New Hampshire The State of New Hampshire Insurance Department 21 South Fruit Street, Suite 14 Concord, NH 03301 (603) 271-2261 Fax (603) 271-1406 TDD Access: Relay NH 1-800-735-2964 The Affordable Care Act in New Hampshire

More information

NBER WORKING PAPER SERIES THE TAX EXCLUSION FOR EMPLOYER-SPONSORED HEALTH INSURANCE. Jonathan Gruber

NBER WORKING PAPER SERIES THE TAX EXCLUSION FOR EMPLOYER-SPONSORED HEALTH INSURANCE. Jonathan Gruber NBER WORKING PAPER SERIES THE TAX EXCLUSION FOR EMPLOYER-SPONSORED HEALTH INSURANCE Jonathan Gruber Working Paper 15766 http://www.nber.org/papers/w15766 NATIONAL BUREAU OF ECONOMIC RESEARCH 1050 Massachusetts

More information

Arizona Health Care Cost Containment System Issue Paper on High-Risk Pools

Arizona Health Care Cost Containment System Issue Paper on High-Risk Pools Arizona Health Care Cost Containment System Issue Paper on High-Risk Pools Prepared by: T. Scott Bentley, A.S.A. Associate Actuary David F. Ogden, F.S.A. Consulting Actuary August 27, 2001 Arizona Health

More information

Improved Medicare for All

Improved Medicare for All Take Action: Get Involved! The most important action you can take is to sign up for Healthcare-NOW! s email list, so you can stay connected with the movement and get updates on organizing efforts near

More information

How much would it cost to cover the uninsured in Minnesota? Preliminary Estimates Minnesota Department of Health, Health Economics Program July 2006

How much would it cost to cover the uninsured in Minnesota? Preliminary Estimates Minnesota Department of Health, Health Economics Program July 2006 How much would it cost to cover the uninsured in Minnesota? Preliminary Estimates Minnesota Department of Health, Health Economics Program July 2006 Executive Summary This background paper, prepared by

More information

TESTIMONY OF JUDITH SOLOMON HOUSE BILL 700, THE PENNSYLVANIA HEALTH CARE REFORM ACT HOUSE INSURANCE COMMITTEE MAY 3, 2007

TESTIMONY OF JUDITH SOLOMON HOUSE BILL 700, THE PENNSYLVANIA HEALTH CARE REFORM ACT HOUSE INSURANCE COMMITTEE MAY 3, 2007 820 First Street NE Suite 510 Washington DC 20002 (202)408-1080 fax (202)408-1056 center@cbpp.org www.cbpp.org TESTIMONY OF JUDITH SOLOMON HOUSE BILL 700, THE PENNSYLVANIA HEALTH CARE REFORM ACT HOUSE

More information

NBER WORKING PAPER SERIES WHAT DO PEOPLE BUY WHEN THEY DON T BUY HEALTH INSURANCE AND WHAT DOES THAT SAY ABOUT WHY THEY ARE UNINSURED?

NBER WORKING PAPER SERIES WHAT DO PEOPLE BUY WHEN THEY DON T BUY HEALTH INSURANCE AND WHAT DOES THAT SAY ABOUT WHY THEY ARE UNINSURED? NBER WORKING PAPER SERIES WHAT DO PEOPLE BUY WHEN THEY DON T BUY HEALTH INSURANCE AND WHAT DOES THAT SAY ABOUT WHY THEY ARE UNINSURED? Helen Levy Thomas DeLeire Working Paper 9826 http://www.nber.org/papers/w9826

More information

HEALTH CARE REFORM FREQUENTLY ASKED QUESTIONS

HEALTH CARE REFORM FREQUENTLY ASKED QUESTIONS HEALTH CARE REFORM FREQUENTLY ASKED QUESTIONS Consumers When will the health care reform law take effect? The health insurance reforms adopted as part of the Patient Protection and Affordable Care Act

More information

Health Care in Rural America

Health Care in Rural America Health Care in Rural America Health care in rural communities has many aspects access to physicians, dentists, nurses, and mental health services; the financial circumstances of rural hospitals; federal

More information

The Risk of Losing Health Insurance Over a Decade: New Findings from Longitudinal Data. Executive Summary

The Risk of Losing Health Insurance Over a Decade: New Findings from Longitudinal Data. Executive Summary The Risk of Losing Health Insurance Over a Decade: New Findings from Longitudinal Data Executive Summary It is often assumed that policies to make health insurance more affordable to the uninsured would

More information

Medicare Reform: Providing Prescription Drug Coverage for Seniors

Medicare Reform: Providing Prescription Drug Coverage for Seniors Statement of Dan L. Crippen Director Medicare Reform: Providing Prescription Drug Coverage for Seniors before the Committee on Energy and Commerce Subcommittee on Health U.S. House of Representatives May

More information

Course Description: 1) Health insurance

Course Description: 1) Health insurance MEC 400G / 500I: Economic Issues and the Management of Healthcare Professor Gautam Gowrisankaran John M. Olin School of Business Washington University in St. Louis Fall 2005 Introduction: The purpose of

More information

HEALTH INSURANCE CONNECTORS SHOULD BE DESIGNED TO SUPPLEMENT PUBLIC COVERAGE, NOT REPLACE IT By Judith Solomon

HEALTH INSURANCE CONNECTORS SHOULD BE DESIGNED TO SUPPLEMENT PUBLIC COVERAGE, NOT REPLACE IT By Judith Solomon 820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org January 29, 2007 HEALTH INSURANCE CONNECTORS SHOULD BE DESIGNED TO SUPPLEMENT PUBLIC

More information

Health Economics Program

Health Economics Program Health Economics Program Issue Brief 2005-01 March 2005 Employer-Based Health Insurance in Minnesota: Results from the 2002 Employer Health Insurance Survey Introduction Employer-sponsored health insurance

More information

KAISER/COMMONWEALTH FUND 1997 SURVEY OF MEDICARE BENEFICIARIES Cathy Schoen, Patricia Neuman, Michelle Kitchman, Karen Davis, and Diane Rowland

KAISER/COMMONWEALTH FUND 1997 SURVEY OF MEDICARE BENEFICIARIES Cathy Schoen, Patricia Neuman, Michelle Kitchman, Karen Davis, and Diane Rowland KAISER/COMMONWEALTH FUND 1997 SURVEY OF MEDICARE BENEFICIARIES Cathy Schoen, Patricia Neuman, Michelle Kitchman, Karen Davis, and Diane Rowland December 1998 EXECUTIVE SUMMARY Central to the debate on

More information