Publications: Health Insurance

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Health Care in the Two Americas: Findings from the Scorecard on State Health System Performance for Low-Income Populations, 2013

September 18, 2013 - The Commonwealth Fund's Scorecard on State Health System Performance for Low-Income Populations, 2013, identifies opportunities for states to improve their health systems for economically disadvantaged populations and provides state benchmarks of achievement.

Fund Report

Challenges Facing Medicaid Expansion in the U.S.

September 13, 2013 - The authors of this study, all 2012–13 Commonwealth Fund Harkness Fellows, provide an international perspective on the challenges facing the Medicaid expansion.

In Brief

Impact of Medical Loss Regulation on the Financial Performance of Health Insurers

September 10, 2013 - A Commonwealth Fund–supported study tracked the early effects of the new "medical loss ratio" regulation on the nation's insurers by examining changes in their financial performance from 2010—the year before the rule went into effect—to 2011.

In the Literature

In States' Hands: How the Decision to Expand Medicaid Will Affect the Most Financially Vulnerable Americans

September 5, 2013 - If the states that have so far not chosen to expand Medicaid eligibility don't eventually do so, as many as two of five recently uninsured adults in those states will likely have no new affordable health insurance options next year, according to a new Commonwealth Fund study.

Issue Brief

Covering Young Adults Under the Affordable Care Act: The Importance of Outreach and Medicaid Expansion

August 21, 2013 - Data from the Commonwealth Fund Health Insurance Tracking Surveys of Young Adults, conducted in November 2011 and March 2013, suggest that as young adults (ages 19–29) gain awareness of the new coverage options available in January 2014, they will eventually enroll in large numbers.

Issue Brief

Undocumented and Uninsured: Barriers to Affordable Care for Immigrant Populations

August 15, 2013 - While many in the United States will gain health insurance coverage as a result of the Affordable Care Act, undocumented immigrants are one group that will not see much benefit from the law. That's because the approximately 11 million undocumented immigrants residing in the U.S. are excluded from participation in the new insurance marketplaces and state Medicaid expansions.

Fund Report

Implementing the Affordable Care Act: Key Design Decisions for State-Based Exchanges

July 11, 2013 - Consumers and small businesses in states that have chosen to run their own health insurance marketplaces―a central component of the health reform law―will likely have a greater choice of health plans, as well as more information about the quality of those plans, than residents of states with federally run marketplaces, a new Commonwealth Fund report finds.

Fund Report

Insuring the Future: Current Trends in Health Coverage and the Effects of Implementing the Affordable Care Act

April 26, 2013 - Eighty-four million people―nearly half of all working-age U.S. adults―went without health insurance for a time last year or were underinsured because of high out-of-pocket costs relative to income, according to a new study based on findings from the Commonwealth Fund's 2012 Biennial Health Insurance Survey.

Fund Report

Testimony—The Affordable Care Act's Pre-Existing Condition Insurance Plan Program: A Critical Bridge to 2014, But Not a Long-Term Solution for Universal Coverage

April 3, 2013 - In invited testimony before the Committee on Energy and Commerce, Sara Collins testified that the program has been a critical bridge to 2014, but its limitations demonstrate why high-risk pools are an inadequate substitute for the comprehensive insurance market reforms and expanded health insurance options to go into effect under the Affordable Care Act next January.


Insurers' Medical Loss Ratios and Quality Improvement Spending in 2011

March 22, 2013 - Health insurance companies reported spending an average of less than 1 percent of the premiums they collected from policyholders in 2011 on activities directly supporting improvement of health care quality, according to a new Commonwealth Fund study.

Issue Brief

Implementing the Affordable Care Act: Choosing an Essential Health Benefits Benchmark Plan

March 12, 2013 - This issue brief examines state action to select an essential health benefits benchmark plan and finds that 24 states and the District of Columbia selected a plan. All but five states will have a small-group plan as their benchmark.

Issue Brief

A Hospital System’s Wellness Program Linked to Health Plan Enrollment Cut Hospitalizations but Not Overall Costs

March 5, 2013 - In this Commonwealth Fund–supported study, researchers examine the effects of a wellness program begun in 2005 for employees and dependents of a hospital system in St. Louis, Mo.

In the Literature

Implementing the Affordable Care Act: State Action on the 2014 Market Reforms

February 1, 2013 - Because states are the primary regulators of health insurance, this issue brief examines new state action on a subset of protections—such as guaranteed access to coverage and a ban on preexisting condition exclusions—that go into effect in 2014.

Issue Brief

State Trends in Premiums and Deductibles, 2003–2011: Eroding Protection and Rising Costs Underscore Need for Action

December 12, 2012 - Average premiums for employer-sponsored family health insurance plans rose 62 percent between 2003 and 2011, rising far faster than incomes did in all states, according to a new Commonwealth Fund analysis that tracks trends in job-based coverage state by state.

Issue Brief

Trends in Employer-Sponsored Health Insurance Premiums and Employee Contributions in Major Metropolitan Areas, 2003–2011

December 12, 2012 - Analysis of employer-sponsored health insurance costs in 41 U.S. metropolitan areas shows a 61 percent average increase in premiums for family coverage from 2003 to 2011, and a 21 percent increase over the past three years.

Data Brief