Cost and Coverage Impacts of the President’s Health Care Reform Proposal and a Congressional Tax Credit Proposal. Footnotes

05/19/2008

  1. The process used is similar to that used by the Bureau of the Census to establish final family weights in the March CPS.
  2. A description of the CMS data is available at:  http://www.cms.hhs.gov/NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp#TopOfPage
  3. We controlled for worker wage levels, industry, firm size and other characteristics when matching these firms.
  4. HBSM baseline data based upon Lewin Group Analysis of the February and March CPS data for 1997.
  5. This required imputing premiums based upon employer survey data developed by the Kaiser Family Foundation (KFF) and the Health Research and Education Trust.
  6. See Sheils, J., Haught, R., “Health Insurance and Taxes:  The Impact of Proposed Changes in Current Federal Policy”, (report to The National Coalition on Health Care), The Lewin Group, October 18, 1999.
  7. While the RWJF data includes premium information for employers that offer coverage, no data is provided on the premiums faced by firms that do not offer coverage. To model the price effect we imputed premiums to non-insuring firms with a multivariate model of how premium levels vary with the workforce and firm characteristics that we estimated from the RWJF data on insuring establishments.
  8. Stombom, B., Buchmueller, T., Feldstein, P. “Switching Costs, Price Sensitivity and Health Plan Choice,” Journal of Health Economics, 21 (2002), 89-116.
  9. Stombom, B., Buchmueller, T., Feldstein, P. “Switching Costs, Price Sensitivity and Health Plan Choice,” Journal of Health Economics, 21 (2002), 89-116.
  10. Centers for Medicare & Medicaid Services.  “Health Expenditures by State.”  <Available as of June 9, 2007 at: http://www.cms.hhs.gov/NationalHealthExpendData/05_NationalHealthAccountsStateHealthAccounts.asp#TopOfPage.>
  11. National Association of State Budget Officers.    2005.  2002-2003 State Health Expenditure Report.
  12. The process used is similar to that used by the Bureau of the Census to establish final family weights in the March CPS.
  13. A description of the CMS data is available at:  http://www.cms.hhs.gov/NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp#TopOfPage
  14. We controlled for worker wage levels, industry, firm size and other characteristics when matching these firms.
  15. HBSM baseline data based upon Lewin Group Analysis of the February and March CPS data for 1997.
  16. This required imputing premiums based upon employer survey data developed by the Kaiser Family Foundation (KFF) and the Health Research and Education Trust.
  17. See Sheils, J., Haught, R., “Health Insurance and Taxes:  The Impact of Proposed Changes in Current Federal Policy”, (report to The National Coalition on Health Care), The Lewin Group, October 18, 1999.
  18. While the RWJF data includes premium information for employers that offer coverage, no data is provided on the premiums faced by firms that do not offer coverage. To model the price effect we imputed premiums to non-insuring firms with a multivariate model of how premium levels vary with the workforce and firm characteristics that we estimated from the RWJF data on insuring establishments.
  19. Stombom, B., Buchmueller, T., Feldstein, P. “Switching Costs, Price Sensitivity and Health Plan Choice,” Journal of Health Economics, 21 (2002), 89-116.
  20. Stombom, B., Buchmueller, T., Feldstein, P. “Switching Costs, Price Sensitivity and Health Plan Choice,” Journal of Health Economics, 21 (2002), 89-116.
  21. Centers for Medicare & Medicaid Services.  “Health Expenditures by State.”  <Available as of June 9, 2007 at: http://www.cms.hhs.gov/NationalHealthExpendData/05_NationalHealthAccountsStateHealthAccounts.asp#TopOfPage.>
  22. National Association of State Budget Officers.    2005.  2002-2003 State Health Expenditure Report.
  23. For example, some states restrict the amount by which premiums may vary with age and health status in the small group market, but permit insurers to vary premiums with age, health status, and other risk factors in the individual market. 
  24. This is an estimate of the average monthly enrollment in employer plans.
  25. We assume that the employer would start to offer coverage if employer coverage could be less costly that non-group coverage in cases where at least 75 percent of the workers in the firm would have taken non-group coverage. 
  26. Workers get the full amount of the deduction regardless of the actual premiums, while the value of the tax exclusion is limited to only the cost of insurance. 
  27. We assume that the employer would start to offer coverage if employer coverage could be less costly that non-group coverage in cases where at least 75 percent of the workers in the firm would have taken non-group coverage. 
  28. The net public cost per family would be $642 in 2009 ($563 in federal costs and $79 in state costs).
  29. The net public cost per family would be $49 in 2009 ($275 in federal costs and a $226 reduction in state costs).
  30. We should note that this total for each state is the minimum between 50 percent of the current DSH spending amount or the total funds
  31. Estimate based upon projections of health care cost growth developed by the Office of the Actuary at the Centers for Medicare & Medicaid Services. 
  32. Previously, the GDP index was fixed-weighted.  Under a fixed-weight measure, the contribution to GDP of what is produced in the current year would be determined based upon its worth in a base year.  Alternatively, chain weights move the base year along through time.  For example, under chain weights, a computer in 2000 is worth the average of what it cost in 1999 and 2000 and a computer in 2001 is worth the average of 2000 and 2001, etc….  This mitigates biases that may occur from valuing products based on their worth in a distant benchmark year. 
  33. For example, some states restrict the amount by which premiums may vary with age and health status in the small group market, but permit insurers to vary premiums with age, health status, and other risk factors in the individual market. 
  34. This is an estimate of the average monthly enrollment in employer plans.
  35. We assume that the employer would start to offer coverage if employer coverage could be less costly that non-group coverage in cases where at least 75 percent of the workers in the firm would have taken non-group coverage. 
  36. Workers get the full amount of the deduction regardless of the actual premiums, while the value of the tax exclusion is limited to only the cost of insurance. 
  37. We assume that the employer would start to offer coverage if employer coverage could be less costly that non-group coverage in cases where at least 75 percent of the workers in the firm would have taken non-group coverage. 
  38. The net public cost per family would be $642 in 2009 ($563 in federal costs and $79 in state costs).
  39. The net public cost per family would be $49 in 2009 ($275 in federal costs and a $226 reduction in state costs).
  40. We should note that this total for each state is the minimum between 50 percent of the current DSH spending amount or the total funds
  41. Estimate based upon projections of health care cost growth developed by the Office of the Actuary at the Centers for Medicare & Medicaid Services. 
  42. Previously, the GDP index was fixed-weighted.  Under a fixed-weight measure, the contribution to GDP of what is produced in the current year would be determined based upon its worth in a base year.  Alternatively, chain weights move the base year along through time.  For example, under chain weights, a computer in 2000 is worth the average of what it cost in 1999 and 2000 and a computer in 2001 is worth the average of 2000 and 2001, etc….  This mitigates biases that may occur from valuing products based on their worth in a distant benchmark year. 

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