Publications: Health Insurance

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The Growing Financial Burden of Health Care: National and State Trends, 2001-2006

March 25, 2010 - The percentage of Americans facing high out-of-pocket health care expenses and insurance premiums continues to increase. In all income brackets, people with private insurance experienced an increase in their health care–related financial burden between 2004 and 2006, with the greatest increase occurring among middle- and higher-income individuals.

In the Literature

Long-Term Care Financing Reform: Lessons from the U.S. and Abroad

February 17, 2010 - Broad health care reform legislation being considered by Congress would effect a major change in the way the United States finances long-term care. This paper reviews the experiences of France, Germany, Japan, the Netherlands, and the United Kingdom, and highlights some of the lessons the United States can learn from each.

Fund Report

The Health Insurance Provisions of the 2009 Congressional Health Reform Bills: Implications for Coverage, Affordability, and Costs

January 7, 2010 - This Commonwealth Fund report analyzes the provisions of the health reform bills passed by the U.S. House of Representatives and Senate that seek to expand and improve health insurance coverage. Also see a a report on the system reform provisions in the bills and an overview report.

Fund Report

Health Insurance Exchanges in Health Care Reform: Legal and Policy Issues

December 31, 2009 - This report describes design and function issues raised by exchanges, prior experience with exchanges, the provisions of the pending House and Senate bills that affect exchanges, and policy issues raised by the legislation.

Fund Report

COBRA Subsidies for Laid-Off Workers: An Initial Report Card

December 23, 2009 - Enrollment in COBRA continuation coverage has increased substantially thanks to the COBRA subsidy, according to this Commonwealth Fund study. Implementation has gone smoothly, and most eligible people have heard about the subsidy, but many of those who are eligible still cannot afford to purchase COBRA coverage.

Issue Brief

Young, Uninsured, and Seeking Change: Health Coverage of Young Adults and Their Views on Health Reform--Findings from the Commonwealth Fund Survey of Young Adults, 2009

December 18, 2009 - This analysis of Commonwealth Fund survey data finds almost half of young adults, the largest uninsured population, are without insurance at some time during the year. An overwhelming majority of young adults think it is important for Congress and the President to pass health reform legislation. Provisions in the Congressional health reform bills could help young adults obtain and keep affordable, comprehensive coverage through transitions from school to work and from job to job.

Issue Brief

Medicare Buy-In for Older Adults: Commonwealth Fund Resources

December 10, 2009 - Commonwealth Fund publications, journal articles, testimony, and survey research on a topic now being discussed in Congress: allowing older adults to buy in to Medicare.


Starting on the Path to a High Performance Health System: Analysis of Health System Reform Provisions of Reform Bills in the House of Representatives and Senate

December 4, 2009 - This Commonwealth Fund report outlines the payment and delivery system reform provisions in the bills, as well as their potential impact on health expenditures.

Fund Report

Taxing Cadillac Health Plans May Produce Chevy Results

December 3, 2009 - It is often assumed that high-cost health insurance plans—referred to by some as "Cadillac" plans—provide rich benefits to users. But in this Commonwealth Fund–supported study in Health Affairs comparing high- and low-cost employer-based plans, Jon Gabel of the National Opinion Research Center and colleagues found that benefit design explains only a fraction of the variation in family coverage costs.

In the Literature

Group Insurance: A Better Deal for Most People Than Individual Plans

December 3, 2009 - In this Fund-supported Health Affairs study, employer-sponsored health plans were found to be much more affordable, and to offer more comprehensive coverage, than individual market plans. Deductibles average more than $2,100 for individual plans but less than $600 for employer-based plans, the researchers say.

In the Literature

Access to Care and Use of Preventive Services by Hispanics: State-Based Variations from 1991 to 2004

November 13, 2009 - Access to doctors and use of mammography, cholesterol testing, and other preventive services improved for both white and Hispanic patients nationally from 1991 to 2004, Fund-supported researchers reported in the journal Medical Care. Gaps in access to care, however, widened between whites and Hispanics in individual states, including Texas and Florida.

In the Literature

Access to Health Insurance at Small Establishments: What Can We Learn from Analyzing Other Fringe Benefits?

November 9, 2009 - A Commonwealth Fund–supported study in the journal Inquiry found that workers employed by small businesses are less likely than those in large ones to be offered health insurance. Administrative costs are a major reason why so many smaller firms do not offer health benefits to their employees.

In the Literature

UPDATED JANUARY 7—The Comprehensive Congressional Health Reform Bills of 2009: A Look at Health Insurance, Delivery System, and Financing Provisions

October 23, 2009 - This report prepared by Commonwealth Fund researchers analyzes the similarities, differences, potential impacts, and costs of the comprehensive health reform bills. Also see interactive tables for side-by-side comparisons of the system reform and insurance provisions.

Fund Report

Testimony--The Growing Problem of Underinsurance in the United States: What It Means for Working Families and How Health Reform Will Help

October 15, 2009 - In testimony before the U.S. House of Representatives' Committee on Energy and Commerce on October 15, 2009, Commonwealth Fund vice president Sara R. Collins discussed the growing number of Americans with such high out-of-pocket costs relative to their income that are effectively underinsured.


Massachusetts Health Reform: Employer Coverage from Employees' Perspective

October 1, 2009 - This Commonwealth Fund-supported study of the state's health reform finds that employer-based coverage in Massachusetts has increased, as has the scope and quality of coverage as assessed by workers. However, some employees in small firms have seen a significant rise in premiums and out-of-pocket expenses.

In the Literature