Publications: Health Insurance

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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.

Testimony

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.

Fund Report

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

Insurers' Responses to Regulation of Medical Loss Ratios

December 5, 2012 - The Affordable Care Act requires health insurers to pay out at least 80 percent of premiums for medical claims and quality improvement,a s opposed to administrative costs and profits. This issue brief examines whether insurers have reduced administrative costs and profit margins in response to this rule.

Issue Brief

The Impact of Reducing Cardiovascular Medication Copayments on Health Spending and Resource Utilization

November 30, 2012 - With Commonwealth Fund support, researchers set out to determine if removing drug copayments could lower costs and decrease the incidence of major coronary events for the larger population of at-risk people who take these medications but have not suffered heart attacks.

In Brief

Small Firm Self-Insurance Under the Affordable Care Act

November 28, 2012 - The Affordable Care Act changes the small-group insurance market substantially beginning in 2014, but most changes do not apply to self-insured plans. This exemption provides an opening for small employers with healthier workers to avoid broader sharing of health care risk. The authors of this brief conclude that regulation of stop-loss or reinsurance can prevent such adverse selection and increase stability in small-group insurance coverage.

Issue Brief

Jobs Without Benefits: The Health Insurance Crisis Faced by Small Businesses and Their Workers

November 1, 2012 - A new Commonwealth Fund study highlights a nearly decade-long trend of declining health insurance coverage and rising costs for workers in small businesses, particularly employees making less than $15 an hour.

Issue Brief

Despite the Recession's Effects on Incomes and Jobs, the Share of People with High Medical Costs Was Mostly Unchanged

October 24, 2012 - Almost one in five Americans younger than 65 lived in families with high medical costs in 2009, roughly the same as 2006 despite widespread job and health insurance losses and declining incomes, according to a Commonwealth Fund-supported study by the Center for Studying Health System Change published by Health Affairs.

In the Literature

Child-Only Coverage and the Affordable Care Act: Lessons for Policymakers

October 9, 2012 - The Affordable Care Act prohibited insurers from denying or limiting coverage for children in 2010. In response, some insurers ceased to offer coverage to children in need of individual health insurance, known as a "child-only" policy. This issue brief examines new state legislative and regulatory action to promote the availability of child-only policies.

Issue Brief

Health Care in the 2012 Presidential Election: How the Obama and Romney Plans Stack Up

October 2, 2012 - With President Obama and Governor Romney offering fundamentally different visions for the nation's health system, the presidential election provides a stark choice for U.S. voters. This analysis contrasts the potential impact of implementing the Affordable Care Act in full with Romney’s proposals to repeal the law, eliminate many of the new requirements for insurance markets, and make changes in Medicaid and Medicare.

Fund Report