Healthcare Marketplace

Continuation of Research on Consumer Directed Health Plans: HSA Simulation Model Refinement . 1. HSA Contributions

To be consistent with our previous work, in the new baseline simulations we assumed that individual HDHP policies had deductibles of $3,500 per year for single coverage and $7,000 for family coverage, and no cost-sharing (i.e.

Continuation of Research on Consumer Directed Health Plans: HSA Simulation Model Refinement . A. Methods

There are three major components to our methodological approach: 1) Model Estimation; 2) Choice Set Assignment and Prediction; and 3) Policy Simulation. As illustrated in Figure 1, often more than one database was required to complete the task. Integral to this analysis was the use of consumer directed health plan data from four large employ

Continuation of Research on Consumer Directed Health Plans: HSA Simulation Model Refinement . II. Refine Baseline Simulations

To complete our current study, we needed to revise and extend our methods. We also used additional data sources and elements to more fully account for the health status of individuals in our models using claims data from the employers participating in our consumer driven health plan analysis.

Continuation of Research on Consumer Directed Health Plans: HSA Simulation Model Refinement . B. Current Study

In October of 2005, we contracted with OASPE to extend and refine the simulations that were performed under our prior contract. There were three major aspects to this work:

Continuation of Research on Consumer Directed Health Plans: HSA Simulation Model Refinement . A. Prior Study

In a previous report for the Office of the Assistant Secretary (QASPE) of the Department of Health and Human Services (DHHS), 3 we simulated the effect of the Medicare Modernization Act of 2003 (MMA) on take-up of HDHP in the individual health insurance market. High deductible health plans feature a large deductible coupled with a Health Saving

Continuation of Research on Consumer Directed Health Plans: HSA Simulation Model Refinement . I. Introduction

Consumer directed health plans (CDHPs) are recent development in the US health insurance market. Their principal economic aim is to make the consumer more engaged in health care purchasing decisions through the provision of an account from which medical services can be purchased. This system is tied to traditional indemnity insurance, usually

Continuation of Research on Consumer Directed Health Plans: HSA Simulation Model Refinement . Executive Summary

High-deductible health plans (HDHPs) are attracting attention from consumers, employers, and policy-makers. These plans couple a large out-of-pocket deductible with a tax-advantaged health savings account (HSA) that can be used to pay for eligible medical expenses. If an enrollee spends all of the dollars in the HSA in a given year, she then s

Continuation of Research on Consumer Directed Health Plans: HSA Simulation Model Refinement

The focus of this study was on the non-price program features that influence the enrollment of non-elderly adults into voluntary state and local programs that subsidize coverage or care. The study consisted of two phases -- Phase 1 was a literature review to assess the current state of knowledge regarding the impact of non-price design features

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Eligible Uninsured Latinos: 8 in 10 Could Receive Health Insurance Marketplace Tax Credits, Medicaid or CHIP (Espanol)

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Essential Health Benefits: Comparing Benefits in Small Group Products and State and Federal Employee Plans

From: Essential Health Benefits: Comparing Benefits in Small Group Products and State and Federal Employee Plans

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

The process used is similar to that used by the Bureau of the Census to establish final family weights in the March CPS. A description of the CMS data is available at: http://www.cms.hhs.gov/NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp#TopOfPage We controlled for worker wage levels, industry, firm size and other characte

Cost and Coverage Impacts of the President’s Health Care Reform Proposal and a Congressional Tax Credit Proposal. 10-Year Estimates

We projected the cost of the two proposals over the 10-year period, 2009 through 2018. Note that when projecting program enrollment and costs, we assume a 40 percent phase-in for 2009 and an 80 percent phase in for 2010, with the program reaching ultimate enrollment beginning in 2011. Therefore, the 2009 impact estimates in our projections dif

Cost and Coverage Impacts of the President’s Health Care Reform Proposal and a Congressional Tax Credit Proposal. Single-Year Estimates of State Costs

Note that the net Federal, State and total public costs for both proposals are displayed by State in Figure 13 . Detailed estimates of the costs, similar to those displayed in Figure 15 and Figure 16 are displayed in the Appendix for each State. Below we describe the derivation of the net cost amounts for the States under each pro

Cost and Coverage Impacts of the President’s Health Care Reform Proposal and a Congressional Tax Credit Proposal. Single-Year Estimates of Federal Costs

President’s Proposal . The total amount of the federal tax revenue lost due to the new deduction would be $294.6 billion, including income and Social Security taxes ( Figure 16 ). These revenue losses would be largely offset by about $229.9 billion by requiring workers to count the value of their ESI coverage as taxable income. After

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

In this section we will discuss the impacts from both programs on Federal and State health spending. We first do so based upon our single year estimates assuming that the programs are fully implemented in 2009. We then present the estimated impacts over a 10-year projection period including an expected phase-in of the program over time.

Cost and Coverage Impacts of the President’s Health Care Reform Proposal and a Congressional Tax Credit Proposal. Changes in Private Insurance Coverage

President’s Proposal . Under current law, the tax exclusion for employer-sponsored health benefits effectively reduces the cost of insurance to workers. Creating a tax deduction of an equal amount for both employer and non-group coverage eliminates the relative tax advantage of providing coverage through the employer, resulting in a shi

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

President’s Proposal . We project that under current policy there will be about 48.8 million people without health insurance in 2009. Under the President’s proposal, about 10.9 million people would become newly covered under the tax deduction, 8.6 million under Affordable Choices, and another 0.8 million children under SCHIP ( Figure 1

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

Below we describe the impact of the President’s proposal and the Congressional tax credit proposal on health insurance coverage nationally and by state.

Assumptions used for the State-Level Estimates

Cost and Coverage Impacts of the President’s Health Care Reform Proposal and a Congressional Tax Credit Proposal. Assumptions used for the State-Level Estimates

As mentioned earlier, aside from developing national estimates, we also modeled the President’s proposal and the Congressional tax proposal for each state. Again, we used the HBSM to estimate the state impacts. The policy options were modeled using similar assumptions and methods as described above for the national estimates. This facilita

Key Modeling Assumptions for Tax Deduction and

Cost and Coverage Impacts of the President’s Health Care Reform Proposal and a Congressional Tax Credit Proposal. Key Modeling Assumptions for Tax Deduction and Tax Credit

We modeled the effect of the President’s tax deduction proposal and the Congressional tax credit proposal on coverage using a uniform methodology. We estimated the impact of these tax incentive methodologies in HBSM based upon a multivariate model of how the likelihood of taking coverage is affected by changes in the net cost of insurance to t

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