Publications: Health Insurance

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Starting on the Path to a High Performance Health System: Analysis of Health System Reform Provisions of House of Representatives and Senate Health Reform Bills

November 20, 2009 - This preview of a forthcoming Commonwealth Fund report offers a summary and chartpack outlining the payment and delivery system reform provisions in the bills, as well as their potential impact on health expenditures. Also available is a chartpack from another upcoming Fund report on coverage and affordability provisions in the two bills.

Fund Report

Access to Care and Use of Preventive Services by Hispanics: State-Based Variations from 1991 to 2004

November 13, 2009 - Access to doctors and use of mammography, cholesterol testing, and other preventive services improved for both white and Hispanic patients nationally from 1991 to 2004, Fund-supported researchers reported in the journal Medical Care. Gaps in access to care, however, widened between whites and Hispanics in individual states, including Texas and Florida.

In the Literature

Access to Health Insurance at Small Establishments: What Can We Learn from Analyzing Other Fringe Benefits?

November 9, 2009 - A Commonwealth Fund–supported study in the journal Inquiry found that workers employed by small businesses are less likely than those in large ones to be offered health insurance. Administrative costs are a major reason why so many smaller firms do not offer health benefits to their employees.

In the Literature

UPDATED—The Comprehensive Congressional Health Reform Bills of 2009: A Look at Health Insurance, Delivery System, and Financing Provisions

October 23, 2009 - This report prepared by Commonwealth Fund researchers analyzes the similarities, differences, potential impacts, and costs of the three comprehensive health reform bills passed by key U.S. congressional committees. Also see interactive tables for side-by-side comparisons of the system reform and insurance provisions.

Fund Report

Testimony--The Growing Problem of Underinsurance in the United States: What It Means for Working Families and How Health Reform Will Help

October 15, 2009 - In testimony before the U.S. House of Representatives' Committee on Energy and Commerce on October 15, 2009, Commonwealth Fund vice president Sara R. Collins discussed the growing number of Americans with such high out-of-pocket costs relative to their income that are effectively underinsured.

Testimony

Massachusetts Health Reform: Employer Coverage from Employees' Perspective

October 1, 2009 - This Commonwealth Fund-supported study of the state's health reform finds that employer-based coverage in Massachusetts has increased, as has the scope and quality of coverage as assessed by workers. However, some employees in small firms have seen a significant rise in premiums and out-of-pocket expenses.

In the Literature

Testimony--Changing Course: Trends in Health Insurance Coverage, 2000-2008

September 11, 2009 - This morning, the U.S. Bureau of the Census released the alarming news that the number of uninsured Americans hit 46.3 million in 2008, up from 45.7 million in 2007. In this testimony before the U.S. House of Representative's Joint Economic Committee, Commonwealth Fund president Karen Davis highlights the good and bad news in the new data and how it underscorces the need for health reform.

Testimony

Out of Options: Why So Many Workers in Small Businesses Lack Affordable Health Insurance, and How Health Care Reform Can Help

September 9, 2009 - Small business owners and employees are among those who stand to benefit the most from provisions in some of the current health reform proposals under consideration by Congress, according to this Commonwealth Fund study.

Issue Brief

Paying the Price: How Health Insurance Premiums Are Eating Up Middle-Class Incomes--State Health Insurance Premium Trends and the Potential of National Reform

August 20, 2009 - The rapid rise in health insurance premiums has severely strained U.S. families and employers in recent years. This Commonwealth Fund analysis of federal data finds that if premiums for employer-sponsored insurance grow in each state at the projected national rate of increase, then the average premium for family coverage would rise 94 percent by 2020.

Data Brief

High-Deductible Health Insurance Plans: Efforts to Sharpen a Blunt Instrument

August 6, 2009 - Americans enrolled in deductible-based health insurance plans are more likely than those with no deductible to alter their care-seeking behavior, according to a Commonwealth Fund-supported survey. Complex benefits design plays a role, the authors say.

In the Literature

Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2009 Update

August 6, 2009 - Young adults between the ages of 19 and 29 represent one of the largest and fastest-growing segments of the U.S. population without health insurance. Often dropped from their parents' policies or from public insurance programs at age 19 or on graduation day, they are left to find insurance on their own while making the often uneasy transition from high school to college or the working world.

Issue Brief

Chronic Burdens: The Persistently High Out-of-Pocket Health Care Expenses Faced by Many Americans with Chronic Conditions

July 23, 2009 - This Commonwealth Fund study shows that nearly 40 percent of nonelderly adults with three or more chronic conditions had out-of-pocket expenses and premiums exceeding 5 percent of income for two consecutive years, compared with 20 percent of people who had a single chronic condition and 14 percent who had no chronic conditions.

Issue Brief

Failure to Protect: Why the Individual Insurance Market Is Not a Viable Option for Most U.S. Families

July 21, 2009 - The individual health insurance market is not a viable option for the majority of uninsured adults, according to this new Commonwealth Fund analysis. Seventy-three percent of people who tried to buy insurance on their own in the last three years did not purchase a policy, primarily because premiums were too high.

Issue Brief

Has the Time Come for Cost-Effectiveness Analysis in U.S. Health Care?

July 17, 2009 - Three-quarters of key decision-makers from a diverse group of California-based health care organizations believe that cost-effectiveness criteria should be used when making insurance coverage decisions, according to this Commonwealth Fund-supported study. However, payers and the legal and policy communities would need to explore ways of reducing the litigation risk associated with cost-effectiveness analysis, the authors say.

In the Literature

How Health Care Reform Can Lower the Costs of Insurance Administration

July 16, 2009 - The United States leads all industrialized countries in the share of national health care expenditures devoted to insurance administration. This issue brief examines the sources of insurance administrative costs in this country, and describes how a private–public approach to health care reform could substantially lower such costs.

Issue Brief