scholarly journals Public Subsidies for Employees' Contributions to Employer-Sponsored Insurance

2001 ◽  
Vol 38 (2) ◽  
pp. 121-132 ◽  
Author(s):  
Mark Merlis
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Cost Effective ◽  
Tax Credits ◽  
Public Subsidies ◽  
Low Income Families ◽  
Employee Premium Contributions ◽  
Premium Contributions ◽  
Insurance Tax ◽  
Fair Balance

Proposals to provide or subsidize health insurance for low-income families must take account of the fact that many workers have access to employer-sponsored insurance (ESI), but decline it because of required employee premium contributions. This article considers a tax credit for the employee share of ESI in the context of a broader program of income-based health insurance tax credits. Helping uninsured workers pay for available ESI could be more cost-effective than subsidizing their coverage in the nongroup market. The credit would also be available to workers who were already covered, both for equity reasons and to reduce the incentives for employers to drop coverage or for workers to shift to subsidized individual plans. One key issue is how to prevent employers from reducing their current health plan contributions to take advantage of the new funding. Other design questions considered by the article include whether workers should be able to choose between ESI and nongroup coverage, whether minimum benefit standards should apply for employer plans, and how to achieve a fair balance in subsidies for group and nongroup coverage.

Markets for Individual Health Insurance: Can We Make Them Work with Incentives to Purchase Insurance?

2001 ◽  
Vol 38 (2) ◽  
pp. 133-145 ◽  
Author(s):  
Katherine Swartz
Keyword(s):  
Health Insurance ◽  
High Risk ◽  
Low Income ◽  
Low Risk ◽  
Tax Credits ◽  
Careful Examination ◽  
Insurance Markets ◽  
Individual Health ◽  
The Individual ◽  
Insurance Tax

Simple income-based incentives to purchase health insurance (tax credits or deductions, or subsidies) are unlikely to succeed in significantly reducing the number of uninsured because income is not a good predictor of the extent to which individuals use medical service. Proposals to provide incentives to low-income people so they will purchase individual health insurance need to address the inherent tension between the interests of low-risk and high-risk people who rely on individual coverage. If carriers are forced to cover all applicants and to community rate premiums, low-risk people will drop coverage or not apply for it because premiums will exceed their expected need for insurance. Concern for people who currently have access to individual coverage calls for careful examination of options to permit incentive programs to succeed with the individual insurance markets. In particular, attention should focus on using alternatives to simple income-based subsidies to spread the burden of high-risk people's costs broadly, rather than impose the costs on low-risk people who purchase individual coverage. This paper describes three such alternatives. One uses risk adjustments and two rely on reinsurance so that carriers are compensated for the higher costs of covering high-risk people who use incentives to buy insurance. One alternative also permits risk selection by insurance carriers.

scholarly journals Expanding Access through Public Coverage: Permitting Families to Use Tax Credits to Buy into Medicaid or SCHIP

2001 ◽  
Vol 38 (2) ◽  
pp. 146-158 ◽  
Author(s):  
Alan R. Weil
Keyword(s):  
Health Insurance ◽  
Health Plan ◽  
Low Income ◽  
Health Program ◽  
The State ◽  
Tax Credits ◽  
Tax Credit ◽  
Flow Problems ◽  
Insurance Program ◽  
Low Income Families

A new tax credit to help low-income families and individuals purchase health insurance can address the problem of affordability, but will not overcome other barriers these populations face in obtaining coverage. This paper proposes that families have the option of using a new tax credit to buy into a state-administered system such as Medicaid or the State Children's Health Insurance Program. This option has three advantages. First, it allows families to remain with a single health program and health plan as their income fluctuates. Second, it provides an alternative to the complex and confusing individual insurance market. This alternative is community rated, does not use underwriting, and allows health plan behavior to be monitored closely by the state. Third, it allows the state to act as a financial buffer—helping overcome the barrier to participation that cash-flow problems and year-end reconciliation concerns are likely to create among a low-income population. Many people would want to use their tax credit in the private market, but the buy-in option increases the likelihood that the tax credit approach would succeed.

A Health Insurance Tax Credit for Uninsured Workers

2001 ◽  
Vol 38 (2) ◽  
pp. 106-120 ◽  
Author(s):  
Lawrence Zelenak
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Tax Credits ◽  
Tax Credit ◽  
Poverty Level ◽  
The Cost ◽  
Insurance Tax ◽  
Age And Sex

This paper describes a new system of tax credits to help low-income workers pay for health insurance. The system would be designed to subsidize health insurance coverage for workers who are currently uninsured, or who pay high premiums for nongroup insurance. Anyone age 19 or older who is not covered by Medicaid, Medicare, or employer-sponsored health insurance would be eligible for a health insurance tax credit (HITC), administered through the Internal Revenue Service. The base amount of the proposed credit would be $2,000 per year for each covered individual, but this amount would be adjusted for the individual's age and sex, according to the effect of age and sex on the cost of insurance coverage. The base amount of the credit would be reduced by $150 for every $1,000 by which a person's income exceeded 200% of the federal poverty level, thus limiting HITC eligibility to lower-income workers. To encourage participation in the credit program, most of the credit would be available through an advance payment system, with final reconciliation after year's end.

Voluntary Public Health Insurance for Low-Income Families: The Decision to Enroll

1995 ◽  
Vol 20 (4) ◽  
pp. 955-972 ◽  
Author(s):  
Carolyn W. Madden ◽  
Allen Cheadle ◽  
Paula Diehr ◽  
Diane P. Martin ◽  
Donald L. Patrick ◽  
...  
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Low Income ◽  
Public Health Insurance ◽  
Low Income Families

scholarly journals Developing a route filtering system for street network development by integrating GIS and space syntax: a case study from tehran, Iran

2018 ◽  
Author(s):  
Omid Rismanchian 1 ◽  
Simon Bell 1 ◽  
Safoora Mokhtarzadeh
Keyword(s):  
Spatial Pattern ◽  
Low Income ◽  
Space Syntax ◽  
Cost Effective ◽  
Street Network ◽  
Deprived Neighbourhoods ◽  
Natural Movement ◽  
Spatial Isolation ◽  
Low Income Families

Throughout the urban development process over the last seven decades in Tehran, Iran many self-generated neighbourhoods have developed, in which the majority of the residents are low-income families. The main spatial attribute of these deprived neighbourhoods in space syntax terms is spatial isolation from the surrounding, more affluent areas, which is accompanied by inadequate urban infrastructure and a lack of accessibility and permeability. This paper discusses a method of developing a route filtering system for identifying the most suitable streets for the creation of a pedestrian-friendly network, using an example of a deprived area, in order to integrate it with the surrounding urban fabric. The theory of ‘Natural Movement’ formed the basis of the research, the spatial pattern being analysed through Space Syntax using Depthmap software and GIS. The results showed that it is possible to identify the underlying spatial pattern using this approach and this could form a very cost effective basis for developing a pedestrian friendly street network, in order to release the deprived area from its spatial isolation. 

‘The Pragmatist’s Solution to Poverty’

2019 ◽  
pp. 125-144
Author(s):  
Peter Sloman
Keyword(s):  
Low Income ◽  
Income Tax ◽  
Tax Credits ◽  
Basic Income ◽  
British Government ◽  
Conservative Government ◽  
System P ◽  
Low Income Families ◽  
The Cost ◽  
Negative Income Tax

The ‘rediscovery of poverty’ prompted a wide-ranging debate over how the British government could best support low-income families. One radical response came from Edward Heath’s Conservative government, which published plans to replace the whole system of personal tax allowances with refundable tax credits—the closest any British government has come to introducing a Universal Basic Income. This chapter examines the origins of the Tax Credit Scheme in 1971–2, which was devised by special adviser Arthur Cockfield in response to the rising cost of tax administration and the difficulty of establishing a selective Negative Income Tax in Britain. As the plans took shape, however, the cost of introducing the reforms on a no-losers basis became a source of growing concern within government. Indeed, Treasury officials were relieved when Labour’s victory in the February 1974 election made it possible to jettison the scheme and focus on simplifying and computerizing the PAYE system.

Why Members Dropout? An Evaluation of Factors Affecting Renewal in Micro Health Insurance

2017 ◽  
Vol 19 (2) ◽  
pp. 292-303 ◽  
Author(s):  
B. Savitha
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Dropout Rate ◽  
Point Of View ◽  
Low Risk ◽  
Micro Health Insurance ◽  
Factors Affecting ◽  
The Social ◽  
The Family ◽  
Low Income Families

Micro health insurance (MHI) is an important mechanism to fight iatrogenic poverty in India. Its sustainability and viability depends, to a greater extent on the renewal of membership. This article evaluates the factors that influence renewal decisions in Sampoorna Suraksha Programme (SSP) in Karnataka. This study shows income class and chronic illness in the family to determine the renewability. The findings indicate adverse selection since low-income low-risk and high-income low-risk families dropout. From the social welfare point of view, renewal from high-risk low-income families is welcome; yet this should not jeopardize resource mobilization of SSP. Sustainable and viable operations of SSP depends on continued membership of insured population that can be achieved through external financial assistance for the poorest, wider network of hospitals and increased awareness on health insurance. Dropout rate in any MHI scheme should be kept very low to achieve deeper penetration and wider coverage especially in India where large percentage of population falls outside the insurance ambit.

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