scholarly journals Reforming reform: public assessments of the affordability of health insurance policies

2017 ◽  
Author(s):  
Sherry Glied ◽  
Peter Muennig
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Household Income ◽  
Telephone Survey ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Insurance Policies ◽  
Alternative Plan ◽  
Health Insurance Premiums ◽  
Dollar Amount

Background: Republicans have moved rapidly to repeal the Affordable Care Act, replacing progressive elements of the plan with regressive elements. We draw on an earlier affordability exercise to evaluate how Americans might view these elements of health care reform.Methods: Immediately prior to passage of the ACA, we conducted a telephone survey of a representative sample of U.S. households. Respondents were presented vignettes representing different insurance plans, each held by people with differing life characteristics. Respondents were then asked to assess the affordability of the presented plans given the characteristics of the policyholders. Results: Respondents felt that households should be expected to pay about 5% of income for health insurance coverage, irrespective of their income. They also tended to view older households as less able to afford coverage than younger households, and households with sicker occupants as less able to afford healthcare than households with healthy occupants. Results did not differ between respondents in red states and those in blue states.Conclusions: Most Americans, including those who reside in red states, believe that subsidies for health insurance premiums should be based on a fixed percentage of household income, not a fixed dollar amount. These perceptions may make it challenging to replace the ACA with a less costly alternative plan.

The Impact of the Affordable Care Act Medicaid Expansions on the Sources of Health Insurance Coverage of Undergraduate Students in the United States

2021 ◽  
pp. 107755872110158
Author(s):  
Priyanka Anand ◽  
Dora Gicheva
Keyword(s):  
United States ◽  
Health Insurance ◽  
Undergraduate Students ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Medicaid Expansions

This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions—that is, some students substituted their private and employer-sponsored coverage for Medicaid.

Introduction

2017 ◽  
Author(s):  
Jessica M. Mulligan ◽  
Heide Castañeda
Keyword(s):  
Health Policy ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Demographic Characteristics ◽  
Social Identities ◽  
Immigration Status ◽  
Anthropological Approach ◽  
The Law

In this chapter, Jessica M. Mulligan and Heide Castañeda provide an overview of the Affordable Care Act focused on the coverage expansions that were at the heart of the law. The authors outline the ethnographic methods used in the book, arguing that an anthropological approach provides an experience-near perspective on implementation that too often is absent in mainstream treatments of health policy. The central theoretical concerns of the book are also introduced: stratified citizenship, risk, and responsibility. The term stratified citizenship describes how certain social identities and demographic characteristics—such as immigration status, income, gender, race, and state of residence—mediated how people were included or excluded from health insurance coverage through the ACA. Exposure to risks as well as inclusion in the new responsibilities created by the law were also unequally distributed.

Labor Market Consequences of State Mental Health Parity Mandates

2008 ◽  
Vol 11 (2) ◽  
Author(s):  
Attila Cseh
Keyword(s):  
Mental Health ◽  
Labor Market ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
State Mental Health ◽  
Mental Health Parity ◽  
Insurance Premiums ◽  
Health Insurance Premiums ◽  
State Mental

This paper analyzes the effects of state mental health parity mandates on the labor and insurance markets. In particular, I investigate the effect of parity regulations along five margins: having employer provided health insurance coverage, employer contributions to health insurance premiums, the probability of full-time employment, working hours, and wages for a sample of private workers in firms with less than 100 employees using the Annual Demographic Surveys (March CPS) for the years 1999-2004 (and also in an extended sample of CPS 1992-2004). It is hypothesized that if parity mandates are costly they will have an impact on at least one of the above margins. I find no evidence for any of the most feared impact: a reduction in the probability of having employer-provided health insurance coverage or that state mental health parity mandates have decreased the generosity of employers' contributions to health insurance premiums. The results also lack any evidence of an impact on labor market composition or of costs having been passed onto workers in terms of lower wages.

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