50 Million Uninsured: The Faces Behind the Headlines

According to figures released last month by the U.S. Census Bureau, some 50 million Americans lacked health insurance in 2010. That number is almost a million higher than for 2009, though the percentage of people uninsured remained largely unchanged.

Keeping Coverage Continuous: Smoothing the Path between Medicaid and the Exchange

When fully implemented, the Patient Protection and Affordable Care Act will increase the number of insured Americans through two primary strategies – expanding Medicaid and providing insurance through state-based insurance exchanges. As an individual’s household income exceeds the maximum for Medicaid eligibility, he or she will be eligible for subsidies to buy coverage through an exchange, up to a household income of 400 percent of the federal poverty level (FPL). This switch in eligibility also works in reverse. If a person’s household income shrinks below 133 percent of the FPL, he or she will become eligible for Medicaid.

Boomers Come of Age: Covering Early Retirees and Other 50-64 Year-Olds

Unemployment has hit everyone hard since the economic downturn began in 2007. And while workers age 50-64 tend to have lower rates of uninsurance than other age groups, they are especially hard hit by losing their jobs and with them their employer-sponsored health benefits. About 8.6 million adults ages 50 to 64 were uninsured in 2009, 1.1 million more than in 2008, a bigger percentage increase than other age groups.

The New Health Reform Law and Young Adults

Young adults have some of the highest uninsurance rates in America. In 2008, three in 10 uninsured Americans– almost 14 million people – were between 19 and 29 years of age. As the health reform legislation was developed, it became evident that covering the uninsured in this age group would be a major component of the effort to improve quality and lower costs in our health care system.

What’s in There? The New Health Reform Law and Private Insurance

As part of an ongoing series to explore the provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act, this briefing dealt with how the new health reform law affects access to private coverage. A range of specific provisions were covered, including the new federal high-risk pools, tax credits for small businesses, health insurance exchanges, the individual mandate, and employer obligations. The law’s provisions governing private health insurance mark a dramatic change from past practice, and much attention has been paid by opposing sides to the potential implementation and legal issues.

Health Insurance Exchanges: House or Senate Style?

Health insurance exchanges can potentially serve a variety of policy ends, from promoting transparency and competition among health plans, to pooling or reallocating risk and administering subsidies for those unable to afford health insurance premiums. Exchanges can also play a role in health insurance oversight. Many of these functions are being carried out by the Massachusetts Connector, the exchange set up by that state’s reform law. Both House and Senate reform bills include an exchange, but the proposals differ in several important aspects. This briefing, cosponsored by the Alliance and The Commonwealth Fund, considered those differences.

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.

Health Insurance Cooperatives

Health insurance cooperatives, or co-ops, have drawn attention as an alternative way for Americans to buy health insurance. Owned by their members, co-ops are seen by some as more palatable than a government-run public plan. What exactly are health insurance co-ops? What’s been their track record? Why do they succeed, or fail? Why do proponents like them, and what objections do opponents have? This new toolkit from the Alliance for Health Reform addresses these questions and others and also includes fast facts, links to 31 resources including case studies, story ideas for reporters, 34 selected experts with contact information, links to 17 selected websites, and a glossary.

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?

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?

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.

Tax Treatment of Health Insurance: A Primer

The United States tax system subsidizes the purchase of employer-sponsored health insurance for more than 160 million non-elderly people at a “cost” of approximately $200 billion a year. This tax subsidy is a major reason why most Americans have health insurance coverage through either their own employer or that of a family member. In recent months, the tax treatment of health insurance has gained a lot of attention – both during the presidential campaign and in health reform debates in Congress.

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.