Fostering Rapid Advances in Health Care Learning from System Demonstrations (2003) / Chapter Skim
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5. State Health Insurance: Making Affordable Coverage Available to All Americans
5. State Health Insurance: Making Affordable Coverage Available to All Americans
Pages 69-80
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From page 69... ...
for undertaking two major activities: (~) achieving increased availability of affordable insurance coverage through public and/or private insurance programs, and (2)
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From page 70... ...
There are also numerous proposals under consideration by federal policy makers to use tax credits to help uninsured residents buy individual health insurance; analyses indicate that this strategy would likely help some uninsured, but alone would not achieve coverage for all residents (Gabel et al., 2002a; Hadley and Reschovsky, 2002~.
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From page 71... ...
Coverage for all citizens and legal residents in a state Affordable insurance coverage available to all citizens and legal residents in a demonstration state Stable insurance coverage no breaks in coverage and minimal switching from one insurance program to another Consumers having some degree of choice of insurance carriers and plans and geographically accessible providers within a plan Availability of comparative performance data for insurance carriers, plans, and providers to inform consumer deci.
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From page 72... ...
Establishment of a strong public-private partnership that provides a foundation and mechanism for states to address other community health and health care issues DEMONSTRATION ATTRIBUTES Each demonstration would involve two components: expansions of affordable insurance coverage options through public anchor private programs, and establishment of a statewide electronic enrollment clearinghouse. Coverage Expansions Demonstration states would choose to expand insurance coverage through either tax credits to be applied to private insurance plans, Medicaid/SCHIP expansions to cover families and adults, or a combination of the two.
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From page 73... ...
However, one of the key challenges is to set the credits at levels that provide enough additional assistance to individuals to encourage them to enroll in a health insurance program, while not having the unintended consequences of reducing employer contributions to premiums or increasing the proportion of employers who choose not to offer insurance coverage. The tax credit approach can also be structured to encourage continuity of patient relationships with health plans and providers.
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From page 74... ...
increases the likelihood of patients obtaining the right care at the right time in the right setting (Bindman et al., 1995; Starfield, ~ 986, ~ 995~. Insurance programs and health plans participating in the statewide demonstration project should be encouraged to ensure that each individual has access to a designated personal clinician capable of providing culturally appropriate services (e.g., simultaneous language translation services)
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From page 75... ...
The return on investment in this infrastructure would increase if all insurance programs participate, and the likelihood of this happening would be higher if leading private and public insurers are involved in the design up front. During the first 6 months of the demonstration projects, public and private insurers would need to work closely on system design issues.
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From page 76... ...
, a consortium led bv Computer Science Corporation that has been operational since 1998 (New England Healthcare EDI Network, 2002~. Membership is open to providers, health plans, and payers in Massachusetts and Rhode Island.
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From page 77... ...
and/or to offset the cost of state tax credits to the uninsured for premium assistance. The federal government could provide this additional support in the form of a block grant to a state tied to a state commitment to expand coverage to a prespecified number of individuals, or through existing Medicaid funding channels accompanied by flexibility to use the federal matching dollars to assist with paying premiums for private-sector plans.
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From page 78... ...
Other groups that might play an important role in building a broad base of support for and providing ongoing information about the demonstrations include the National Academy for State Health Policy, the National Association of insurance Commissioners, and the National Conference of State Legislatures. In each demonstration site, the support of the business community and private insurers would be critical to success.
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From page 79... ...
2002. "Tax Credits and the Affordability of Individual Health Insurance (Issue Brief Number 53 - July 2002~." Online.
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From page 80... ...
2001 . "Health Insurance Coverage: 2000." Online.
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