Publications: Health Insurance

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Testimony--Changing Course: Trends in Health Insurance Coverage, 2000-2008

September 11, 2009 - This morning, the U.S. Bureau of the Census released the alarming news that the number of uninsured Americans hit 46.3 million in 2008, up from 45.7 million in 2007. In this testimony before the U.S. House of Representative's Joint Economic Committee, Commonwealth Fund president Karen Davis highlights the good and bad news in the new data and how it underscorces the need for health reform.


Out of Options: Why So Many Workers in Small Businesses Lack Affordable Health Insurance, and How Health Care Reform Can Help

September 9, 2009 - Small business owners and employees are among those who stand to benefit the most from provisions in some of the current health reform proposals under consideration by Congress, according to this Commonwealth Fund study.

Issue Brief

Paying the Price: How Health Insurance Premiums Are Eating Up Middle-Class Incomes--State Health Insurance Premium Trends and the Potential of National Reform

August 20, 2009 - The rapid rise in health insurance premiums has severely strained U.S. families and employers in recent years. This Commonwealth Fund analysis of federal data finds that if premiums for employer-sponsored insurance grow in each state at the projected national rate of increase, then the average premium for family coverage would rise 94 percent by 2020.

Data Brief

High-Deductible Health Insurance Plans: Efforts to Sharpen a Blunt Instrument

August 6, 2009 - Americans enrolled in deductible-based health insurance plans are more likely than those with no deductible to alter their care-seeking behavior, according to a Commonwealth Fund-supported survey. Complex benefits design plays a role, the authors say.

In the Literature

Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2009 Update

August 6, 2009 - Young adults between the ages of 19 and 29 represent one of the largest and fastest-growing segments of the U.S. population without health insurance. Often dropped from their parents' policies or from public insurance programs at age 19 or on graduation day, they are left to find insurance on their own while making the often uneasy transition from high school to college or the working world.

Issue Brief

Chronic Burdens: The Persistently High Out-of-Pocket Health Care Expenses Faced by Many Americans with Chronic Conditions

July 23, 2009 - This Commonwealth Fund study shows that nearly 40 percent of nonelderly adults with three or more chronic conditions had out-of-pocket expenses and premiums exceeding 5 percent of income for two consecutive years, compared with 20 percent of people who had a single chronic condition and 14 percent who had no chronic conditions.

Issue Brief

Failure to Protect: Why the Individual Insurance Market Is Not a Viable Option for Most U.S. Families

July 21, 2009 - The individual health insurance market is not a viable option for the majority of uninsured adults, according to this new Commonwealth Fund analysis. Seventy-three percent of people who tried to buy insurance on their own in the last three years did not purchase a policy, primarily because premiums were too high.

Issue Brief

Has the Time Come for Cost-Effectiveness Analysis in U.S. Health Care?

July 17, 2009 - Three-quarters of key decision-makers from a diverse group of California-based health care organizations believe that cost-effectiveness criteria should be used when making insurance coverage decisions, according to this Commonwealth Fund-supported study. However, payers and the legal and policy communities would need to explore ways of reducing the litigation risk associated with cost-effectiveness analysis, the authors say.

In the Literature

How Health Care Reform Can Lower the Costs of Insurance Administration

July 16, 2009 - The United States leads all industrialized countries in the share of national health care expenditures devoted to insurance administration. This issue brief examines the sources of insurance administrative costs in this country, and describes how a private–public approach to health care reform could substantially lower such costs.

Issue Brief

Fork in the Road: Alternative Paths to a High Performance U.S. Health System

June 24, 2009 - A comprehensive approach to health insurance, provider payment, and care delivery system reforms has the potential to slow health care cost increases while achieving near-universal coverage. Yet, this new Commonwealth Fund analysis finds that the potential savings for families, businesses, and the federal government vary markedly, depending on whether or not a public insurance plan option is included and how such a plan is structured.

Fund Report

Front and Center: Ensuring that Health Reform Puts People First

June 11, 2009 - This report focuses on those who would benefit from such health reforms, including the estimated 116 million working-age adults, or two-thirds of all adults, who report that they are uninsured or underinsured, have medical bill or debt problems, or experience difficulties obtaining needed care.

Fund Report

Trends in Underinsurance and the Affordability of Employer Coverage, 2004–2007

June 2, 2009 - Out-of-pocket health care expenses for workers covered by employer-sponsored plans grew by more than one-third between 2004 and 2007, according to a Commonwealth Fund-supported study in Health Affairs. The higher costs are particularly burdensome for people who are sick or have modest incomes.

In the Literature

Access and Affordability: An Update on Health Reform in Massachusetts, Fall 2008

May 28, 2009 - More than two years after implementation of its landmark health insurance reforms, Massachusetts had achieved historically high levels of coverage and widespread improvements in access to care, according to this study—the latest in a series of reform updates, funded by the Blue Cross Blue Shield of Massachusetts Foundation, The Commonwealth Fund, and the Robert Wood Johnson Foundation.

In the Literature

The Massachusetts Commonwealth Health Insurance Connector: Structure and Functions

May 28, 2009 - This issue brief describes how the Connector works to promote administrative ease, eliminate paperwork, offer portability of coverage, and provide some standardization and choice of plans. Some of the structural components and functions of the Connector may be transferable to a national health reform model, say the authors.

Issue Brief

Achieving Health Care Reform—How Physicians Can Help

May 21, 2009 - Rather than wait and see how health reform legislation unfolds, physicians should help lead the effort to establish affordable, high-quality health care in this country, say Elliott S. Fisher, M.D, M.P.H., Donald M. Berwick, M.D., M.P.P., and Karen Davis, Ph.D., in a New England Journal of Medicine "Perspectives" column.

Literature Abstract