Key Issues in Analyzing Major Health Insurance Proposals

Key Issues in Analyzing Major Health Insurance Proposals
Title:
Key Issues in Analyzing Major Health Insurance Proposals
Format:
Paperback
USA Price: 
$14.00
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In stock
GPO Stock Number:
052-070-07542-2
ISBN:
9780160822193
Description

Describes some of the key assumptions used in estimating the effects of proposals to modify the U.S. health insurance system.

Concerns about the number of people who lack health insurance and about the high and rising costs of health insurance and health care have led to proposals that would substantially modify the health insurance system in this country. Because the Medicare program already provides nearly universal coverage to the elderly, those proposals generally focus on options for providing coverage to and reducing costs for the nonelderly population. Because most nonelderly people obtain their insurance coverage through an employer, proposals could affect that coverage in some way. They could, for example, provide new federal subsidies to pay some portion of health insurance premiums; impose mandates for individuals to purchase coverage or for employers to offer it; encourage alternatives to employment-based insurance or provide strong incentives to purchase coverage individually; or create new federally administered options for obtaining health insurance (including a single-payer system in which all citizens or residents would be offered coverage under Medicare).

This report describes some of the key assumptions that the Congressional Budget Office (CBO) would use in estimating the effects of key elements of such proposals on federal costs, insurance coverage, and other outcomes; the evidence on which those assumptions are based; and—if the evidence points to a range of possible effects rather than a precise prediction— the factors that would influence where a proposal falls within those ranges. In doing so, it also reviews many of the major issues that arise in designing such proposals. This document does not provide a comprehensive analysis of any specific proposal; rather, it identifies and discusses many of the critical factors that would affect estimates of various proposals. In accordance with CBO’s mandate to provide objective and impartial analysis, the report makes no recommendations.

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Table of Contents

Table of Contents:

Summary…………..ix

Introduction and Background……………1
Scope and Focus of This Report……………2
Health Insurance Coverage……….3
Health Care Spending…………18

Approached for Reducing the Number of Uninsured People….27
Methods of Subsidizing Premiums………….28
Subsidizing the Premiums Through the Tax System………….29
Subsidizing Premiums Through Spending Programs…………37
Effects of Premium Subsidies on Rates and Sources of Insurance Coverage……..43
Individual and Employer Mandates……..48
Automatic Enrollment Provisions……….54

Factors Affecting Insurance Premiums…………….59
Design of Benefits and Cost Sharing……….60
Management of Benefits……….63
Administrative Costs of Health Plans………69
Effects of Gaining Insurance Coverage on Health Care Use and Spending…71

Proposals Affecting the Choice of an Insurance Plan…….77
Regulating Insurance Premiums and Sales……….77
Revealing the Relative Costs of Health Plans………..84
Expanding Access to Federally Administered Plans……..91

Factors Affecting the Supply and Prices of Health care Services…..99
Background on the Supply of Health Care Providers……..99
Payment Methods and Providers’ Incentives……….102
Payment Rates……..105
Responses to Changes in Payment Rates or Demand for Services…….108
Uncompensated Care and Cost Shifting………112

Administrative Issues and Effects on Other Programs….117
Implementation Issues and Timelines……..117
Maintenance-of-Effort Requirements……120
Effects on Other Federal Programs……….123
Coverage of Certain Populations……125

Changes in Health Habits and Medical Practices….131
Modifying Health Habits……..132
Expanding the Use of Clinical Preventive Services……..136
Establishing a “Medical Home”…………….139
Adopting Disease Management Programs……….141
Comparing the Effectiveness of Medical Treatments………144
Adopting Health Information Technology………..147
Modifying Laws About Medical Malpractice………150

Effects on Total Health Care Spending, the Scope of the Federal Budget, and the Economy...155
Effects on National Health Expenditures…………156
Global Budgets for Health Care…………157
Impact of Proposals on the Composition of Compensation and Tax Revenues…160
Flow of Payments and Budgetary Treatment……….160
Macroeconomic Effects………….162

Audience

This report contains information that would be useful for those who are uninsured and looking for healthcare or those who need help selecting an insurance plan.

Product Details

Availability Details:
In Stock
USA Price:
$7.00
International Price:
$9.80
Publisher:
Congress, Congressional Budget Office
Key Phrases:
  • Health Insurance
Weight:
1.375
Quantity Price:
Discount
Cover:
Paper
Subject Bibliography:
119
Unit of Issue (US):
1
Unit of Issue (Non-US):
1
Record Creation Date:
12/18/2008
Last Status Update:
11/20/2018
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