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Effects of a Public Option on Health Insurance Costs and Coverage
From the Webpage: "A public option for health care--that is, a government-sponsored health insurance plan with publicly determined provider payment rates--is attracting growing interest in policy circles. Multiple public option proposals have been introduced in Congress, and at least 18 states have considered legislation for some form of public option. Washington is the first state to adopt a plan to create a public option in its health insurance Marketplace. In addition, several Democratic presidential candidates in the 2020 election season proposed public option plans."
RAND Corporation
Wilks, Asa; Nowak, Sarah A.; Eibner, Christine . . .
2020
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Public Options for Individual Health Insurance: Assessing the Effects of Four Public Option Alternatives
From the Webpage: "The Affordable Care Act (ACA) brought substantial changes to the individual health insurance market. However, health care remains unaffordable for many, and enrollment in individual health insurance plans has declined since 2016. There is growing interest at the state and federal levels in a 'public option' for individual market insurance. In 2019, members of Congress introduced four bills that would create a federal public option, at least 18 states considered legislation for a public option or a Medicaid buy-in option, and several Democratic Party presidential candidates included public options in their platforms. Some proposals for a public option would create government-run insurance plans to compete with private insurance, and others would create plans administered by insurance carriers operating under government oversight and rate regulation."
RAND Corporation
Wilks, Asa; Nowak, Sarah A.; Eibner, Christine . . .
2020
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Projected Coverage and Subsidy Impacts If the American Rescue Plan's Marketplace Provisions Sunset in 2023
From the Background: "The American Rescue Plan (ARP) reduces the amount of income individuals and families are expected to contribute toward premiums for individual market coverage through the Marketplace exchanges and extends premium tax credits to households with income above 400 percent of the federal poverty level (FPL). Previous ASPE analyses have shown the impacts of the ARP in lowering Marketplace premiums and improving plan affordability through increased access to zero- and low-premium plans on the HealthCare.gov platform. [...] If the ARP premium tax credit provisions are extended, millions of people will continue to benefit from the enhanced and expanded premium subsidies. If the ARP premium tax credit provisions are allowed to sunset, these consumer benefits will be eliminated, likely leading to increases in the number of uninsured and higher out-of-pocket costs for individuals and families purchasing insurance through the Marketplace. This report projects the potential impacts if the ARP premium tax credits expire in 2023, with both national and state level estimates developed using the Comprehensive Assessment of Reform Efforts (COMPARE) microsimulation model."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. Office of Health Policy
Branham, Keith; Eibner, Christine; Girosi, Federico . . .
2022-03-23
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Temporary Safety-Net Policies and Pandemic-Related Insurance Loss in New York State
From the Webpage: "The coronavirus disease 2019 (COVID-19) pandemic-related recession and resulting job loss raised significant concerns that the U.S. uninsured population could increase, perhaps by millions. However, predictions about coverage loss have not materialized. Because this recession is the first economic downturn since the Affordable Care Act's (ACA's) major coverage provisions took effect in 2014, a possible explanation for the lack of coverage loss is that the ACA's safety-net provisions -- such as Medicaid expansion and Advance Premium Tax Credits (APTCs) for marketplace coverage -- did their job. However, it is also possible that other responses to the pandemic contributed to the maintenance of insurance levels. For example, more than half of covered workers who lost their jobs as a result of the pandemic retained their employer-sponsored insurance, perhaps because the layoffs were not expected to be permanent. Temporary policies to retain Medicaid enrollees appear to have increased insurance enrollment. Furthermore, some states opened their health care marketplaces for a special enrollment period in 2020, enabling people to newly enroll in insurance in the middle of the year. In 2021, the American Rescue Plan, which temporarily enhanced marketplace tax credits, also led to an enrollment bump. To explore this issue, RAND researchers (1) assess the importance of temporary provisions relative to long-standing policies in stabilizing health insurance enrollment despite heavy job loss and (2) run simulations using New York state as a case study."
RAND Corporation
Eibner, Christine; Liu, Jodi L.; Price, Carter C. . . .
2021
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