Affordability and Health Reform: If We Mandate, Will They (and Can They) Pay?

The health reform proposals being considered in both houses may impose responsibilities on both individuals and employers to have, and help pay for, coverage. Subsidies for some small businesses and for individuals with incomes up to 400 percent of the federal poverty level have been proposed. But will individuals and businesses be able to pay the amounts required of them above the subsidies? If those costs are onerous, Congress may exempt many people from the coverage requirement or significantly reduce the penalties for noncompliance.

Rural Health: Laying the Foundation for Health Reform

Health care delivery poses unique challenges in rural communities. Provider shortages are particularly acute in rural America, where levels of educational achievement are generally lower and there are fewer opportunities to receive medical training. Unemployment and uninsurance rates are higher in rural areas than elsewhere. Join us for a discussion about how some aspects of pending reform proposals — coverage expansions, subsidies, delivery system improvements and health information technology including telemedicine — may have a substantial impact on rural health care.

Public Opinion on Health Reform: What Do the Polls Mean?

Public support for health reform waxes and wanes depending, not only on what’s being proposed in the reform proposals, but also on who asks the question and how it is asked. Some recent polls indicate a majority of Americans support health care reform now; is that still the case? Do people want to pay for covering the uninsured – and if so, how much? What do seniors think about paying for health reform partly through changes to Medicare? Some polls indicate that most people like their physician but not the system. What if health reform means changing the system Americans now enjoy?

The Uninsured: What Do the New Numbers Mean for Health Reform?

As Congress hashes out proposals to expand coverage to tens of millions of uninsured Americans, the latest count of the number of uninsured is a significant factor. Though some believe economic recovery is underway, Americans are still losing jobs by the hundreds of thousands each month. With the loss of jobs, so goes health insurance. How does this reality affect health reform and the notion of building on the current system? Has the complexion of who is uninsured changed? What has been the role of public programs in the recession?

Ask the Experts About Reform: Where Are We Now and Where Are We Headed?

Before the Congressional summer recess began, four committees approved major reform bills; negotiations continue among some members of another. Now Congress returns having heard an earful from constituents about health care. We are clearly at a crucial stage in our consideration of how, and to what extent, we should reshape our health care system. What is the status of major reform bills?

Expanding Access to Care: More than Just an Insurance Card?

Health care access, particularly access to primary care, is on the minds of all who are following health reform efforts in Congress. President Obama has said that expanding access to health care to more Americans is one of the main goals of reform. Democrats and Republicans from both houses agree that any reform plan must increase access. But how can that goal be accomplished, particularly in a time when reducing health care costs and increasing quality are also priorities?

Show Me the Money: Options for Financing Health Reform

As the key congressional committees draft health reform legislation, they are keenly mindful of the costs of various provisions. Congress will look to an array of options, including both savings from the health care system and new revenues, to finance coverage expansions and reforms to both the delivery system and insurance markets. What options hold the most promise? How do the Congressional Budget Office (CBO) and the Office of Management and Budget (OMB) go about “scoring” various financing options? Are there credible options for financing reform? Is there room for bipartisan cooperation in paying for reform? This July 31 briefing, cosponsored by The Commonwealth Fund, addressed these and related questions.

Scoring Savings: How Can Quality Improvement Reduce Health Care Costs?

As the health reform debate heats up in summertime Washington, discussions center around how to make our current system more efficient, provide better value for the dollars spent, and extend coverage to those without it. The Senate Finance Committee options papers and the House tri-committee report devote whole sections to proposals to reduce health care costs. These proposals consider ways to find savings from working more efficiently, and slowing the growth curve — savings that could help pay the substantial cost of comprehensive health reform.

Health Reform for New Health Reform Reporters

For reporters who normally cover topics other than health reform, today’s reform debates can mean playing catch-up. They may be facing a new vocabulary – public plan option, health insurance cooperative, employer mandate, individual mandate. Maybe they’re trying to figure out what all this means for readers, viewers or listeners.

Health Insurance Exchanges: See How They Run

Various proposals to expand coverage to uninsured Americans and reform the health insurance market include the establishment of a health insurance exchange. The most widely discussed example of such an exchange is in Massachusetts, and it arrived recently with Massachusetts’ 2007 health reform efforts. Many are looking to the Connector, as the Massachusetts program is known, to inform their discussions of a national insurance exchange. But is that the only model?

Public Plan Option: Fair Competition or a Recipe for Crowd-Out?

One of the various proposals to expand coverage to the more than 45 million uninsured Americans is referred to as the “public plan option.” Though proposed only as part of a broader effort to expand coverage, the option is viewed in varying lights. Some see it as a tool for providing consumers affordable coverage by stimulating competition on the basis of quality and efficiency. Others see it as unfair competition for private insurers and, in the extreme, as a path to a single-payer system.

Covering the Uninsured: Options for Reform

Forty-five million Americans were uninsured in 2007. They may have worked for an employer that didn’t offer coverage, or were eligible for coverage on the job but could not pay their share of the premiums. Perhaps they were denied coverage in the individual market. Whatever the reason for not having coverage, their lack of insurance limited their access to care, contributed to poorer health outcomes, and may have led to personal bankruptcy.

How Wide Has the Window Opened for Health Reform?

Now that we know the next occupants of the White House and the composition of the next Congress, many Americans expect to see an effort to enact significant reform of America’s health system. Congress isn’t waiting for the White House green light. Sens. Ron Wyden and Bob Bennett, as well as Sen. Max Baucus have already released health reform plans. Sen. Edward Kennedy is poised to do so.

Lessons on Coverage from Abroad: How Do the Dutch, German and Swiss Health Care Systems Do It?

The pre-election debate put health care reform ideas front and center. Now policymakers have to deal with translating theory into action under challenging economic conditions. Why completely reinvent the wheel when there are existing universal coverage systems that may have components the U.S. can learn from? This briefing, cosponsored by The Commonwealth Fund, provided an in-depth look at the very different approaches of Switzerland, Germany and Holland to providing near-universal coverage to their citizens.

Massachusetts Health Reform: A Giant Step Toward Universal Coverage?

The upcoming presidential election and the domestic economic scene have captured the top-of-mind attention of both voters and the media. But not far below the top is a profound concern about health care. Will I lose my job and with it my health insurance? Can I afford the ever-increasing costs of rising premiums, higher deductibles and copays? Which candidate’s health plan will best alleviate my concerns?