Health Insurance Memos
Health Insurance Articles
·????? Workers would retain coverage during layoffs and job transitions if all health insurance was obtained through state exchanges.
·????? Employers could subsidize state exchange insurance rather than offer their own policy.
·????? The proposal combines some elements of the ACA with Senator McCain’s 2008 health care proposal.
·????? The no-surprises act provides limited protections against surprise medical bills, which mostly occur in emergency room settings.
·????? Patients, with narrow network health plans often have limited access to specialists.
·????? Some states have used network adequacy regulations to reduce out-of-network bills.
·????? Network adequacy regulations often fail to provide access to highly specialized providers or cancer hospitals.
·????? A federal subsidy for relatively rare medically necessary out-of-network procedures could increase demand for less expensive narrow-network health plans.
·????? ?Short term health plans disprove the adage some insurance is better than no insurance.
·????? Short term health plans often provide limited coverage for life-saving procedures, caps on expenditures, and benefit denials.
·????? Short term health plans often do not cover mental health services, pregnancy, or prescription drugs.
·????? Many individuals with short-term health coverage take on substantial medical debt.
·????? Potential alternatives to short term health plans include
o?? ?A lower cost catastrophic but comprehensive health insurance option,
o?? ?An insurance plan with an annual cap combined with automatic Medicaid access for individuals with health expenditures exceeding the cap,
o?? ?An expanded public health insurance option.
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·????? People literally party when they reach their deductible.
·????? Adverse impacts of health savings accounts and high deductible plans include
o?? Tradeoff between saving for retirement and saving for health care.
o?? Skipping necessary procedures and drug regimens.
o?? Coverage declines and increased use of junk insurance for people with limited cash flow.
·????? Cash flow problems are most severe for low and mid income households who can’t fund a health savings account.
·????? A tax credit for health savings accounts instead of tax exemption for contributions would benefit households with modest income.
·????? Expanding access to health savings account contributions to households with lower deductible plans could reduce out-of-pocket expenditure, although this change would increase premiums.
·????? Exempt payments on drugs used to treat chronic diseases from deductibles would improve health outcomes, although this change would also increase premiums.
·????? Some middle-income young workers without access to employer health insurance receive no premium subsidies and cannot afford state-exchange premium payments.
·????? Some low-income households with an offer of “affordable” employer-based health insurance are precluded from claiming the premium tax credit for state exchange insurance, even when the state exchange insurance would be more affordable than the employer-based coverage.
·????? Disparities in health insurance outcomes can be addressed by combining employer-based and state-exchange health insurance markets, by modifying the premium tax credit, and through the creation of new low-cost but comprehensive health insurance option.
·????? The combination of state-exchange and employer-based health insurance markets would also allow workers to maintain the same insurance plan during job transitions and layoffs.? See the essay Is it time to merge employer-based and state exchange health insurance markets??
·????? Overview of four health care proposals
o?? Changing rules governing health savings accounts and flexible savings accounts.
o?? Changes rules governing the premium tax credit and the employer mandate.
o?? Outlaw short term health plans and create a new low-cost public option.
o?? Reduce risks and expand access for people with narrow network health plans.