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Medicare at 50—Origins and Evolution

March 9, 2015 Comments off

Medicare at 50—Origins and Evolution
Source: Commonwealth Fund

Since 1965, Medicare has provided millions of older and disabled Americans with guaranteed access to affordable health care. The broad popularity of the program, however, belies the intensely ideological struggle that preceded its creation and that continues in the debate over its future. In the first report of a two-part series published in the New England Journal of Medicine, David Blumenthal, M.D., Karen Davis, and Stuart Guterman trace the origins of Medicare and discuss its accomplishments, the changes it has undergone, and the challenges that remain.

The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect

January 29, 2015 Comments off

The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect
Source: Commonwealth Fund

New results from the Commonwealth Fund Biennial Health Insurance Survey, 2014, indicate that the Affordable Care Act’s subsidized insurance options and consumer protections reduced the number of uninsured working-age adults from an estimated 37 million people, or 20 percent of the population, in 2010 to 29 million, or 16 percent, by the second half of 2014. Conducted from July to December 2014, for the first time since it began in 2001, the survey finds declines in the number of people who report cost-related access problems and medical-related financial difficulties. The number of adults who did not get needed health care because of cost declined from 80 million people, or 43 percent, in 2012 to 66 million, or 36 percent, in 2014. The number of adults who reported problems paying their medical bills declined from an estimated 75 million people in 2012 to 64 million people in 2014.

The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect

January 22, 2015 Comments off

The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect
Source: Commonwealth Fund

New results from the Commonwealth Fund Biennial Health Insurance Survey, 2014, indicate that the Affordable Care Act’s subsidized insurance options and consumer protections reduced the number of uninsured working-age adults from an estimated 37 million people, or 20 percent of the population, in 2010 to 29 million, or 16 percent, by the second half of 2014. Conducted from July to December 2014, for the first time since it began in 2001, the survey finds declines in the number of people who report cost-related access problems and medical-related financial difficulties. The number of adults who did not get needed health care because of cost declined from 80 million people, or 43 percent, in 2012 to 66 million, or 36 percent, in 2014. The number of adults who reported problems paying their medical bills declined from an estimated 75 million people in 2012 to 64 million people in 2014.

The Share of People with High Medical Costs Increased Prior to Implementation of the Affordable Care Act

January 22, 2015 Comments off

The Share of People with High Medical Costs Increased Prior to Implementation of the Affordable Care Act
Source: Commonwealth Fund

The percentage of Americans who spend more than 10 percent of their family income on out-of-pocket health care expenses increased to 19.2 percent in 2011, from 18.2 percent during 2007–09. Medical cost burdens were highest for people with private nongroup insurance coverage, who are among those most likely to benefit from the Affordable Care Act’s coverage expansions.

Variations in County Level Costs Between Traditional Medicare and Medicare Advantage Have Implications for Premium Support

January 12, 2015 Comments off

Variations in County Level Costs Between Traditional Medicare and Medicare Advantage Have Implications for Premium Support
Source: Commonwealth Fund

In comparing spending for beneficiaries enrolled in traditional Medicare with spending for those in private Medicare Advantage plans, researchers found that costs for Medicare Advantage are higher in about half of U.S. counties—corresponding to areas of the country where traditional Medicare costs are low. The relative costliness of Medicare Advantage varies by geographic area and by the type of plan. Policymakers should consider these findings when assessing the potential impact of proposals to redesign Medicare as a “premium support” program.

National Trends in the Cost of Employer Health Insurance Coverage, 2003–2013

December 19, 2014 Comments off

National Trends in the Cost of Employer Health Insurance Coverage, 2003–2013
Source: Commonwealth Fund

Looking at trends in private employer-based health insurance from 2003 to 2013, this issue brief finds that premiums for family coverage increased 73 percent over the past decade—faster than median family income. Employees’ contributions to their premiums climbed by 93 percent over that time frame. At the same time, deductibles more than doubled in both large and small firms. Workers are thus paying more but getting less protective benefits. However, the study also finds that while premiums continued to rise through 2013, the rate of growth slowed between 2010 and 2013, following implementation of the Affordable Care Act. While families experienced slower growth in premium contributions and deductibles over this period, sluggish growth in median family income means families are paying more in premiums and deductibles as a share of their income than ever before.

Implementing the Affordable Care Act: Revisiting the ACA’s Essential Health Benefits Requirements

December 10, 2014 Comments off

Implementing the Affordable Care Act: Revisiting the ACA’s Essential Health Benefits Requirements
Source: Commonwealth Fund

The Affordable Care Act broadens and strengthens the health insurance benefits available to consumers by requiring insurers to provide coverage of a minimum set of medical services known as “essential health benefits.” Federal officials implemented this reform using transitional policies that left many important decisions to the states, while pledging to reassess that approach in time for the 2016 coverage year. This issue brief examines how states have exercised their options under the initial federal essential health benefits framework. We find significant variation in how states have developed their essential health benefits packages, including their approaches to benefit substitution and coverage of habilitative services. Federal regulators should use insurance company data describing enrollees’ experiences with their coverage—information called for under the law’s delayed transparency requirements—to determine whether states’ differing strategies are producing the coverage improvements promised by reform.

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