Health Insurance

Contents Data Health Insurance Dynamics Obtaining Coverage: Transitions out of the Uninsured State Changing and Losing Coverage: Transitions into the Uninsured State Conclusion Policy Impl

Medicare Advantage (MA) is the current program under which beneficiaries can enroll in private health plans rather than having their care covered through Medicare's traditional fee for service (FFS) program. Payments to MA plans in many areas are now substantially greater than the cost of treating comparable beneficiaries in the traditional program.

This Brief reviews the history and current status of federal special needs plans (SNPs) authority, with particular attention to provisions of interest to state Medicaid programs that have or are considering entering into contracts with SNPs to integrate or coordinate Medicaid long-term care services with Medicare primary, acute and prescription drug services for dually eligible beneficiaries.

  Strategies for Increasing TANF Work Participation Rates Summary Report December 2008 By: LaDonna Pavetti, Jacqueline Kauff, Michelle K. Derr, Jeffrey Max, Ann Person, and Gretchen Kirby Mathematica Policy Research

  Strategies for Increasing TANF Work Participation Rates Providing Unpaid Work Experience Opportunities for TANF Recipients: Examples from Erie County, New York; Montana; and Hamilton County, Ohio December 2008 By: Michelle K. Kerr Mathematica Policy Research

  Strategies for Increasing TANF Work Participation Rates Using Data to Monitor and Improve the Work Participation of TANF Recipients: Examples from New York City and Utah December 2008 By: Jeffrey Max and Gretchen Kirby Mathematica Policy Research

Medicare’s Sustainable Growth Rate (SGR) is a target rate of growth in spending for physicians’ services. Payments for physicians’ services are supposed to automatically adjust in response to actual spending falling either above or below the target.

Several proposals to increase health coverage for the currently uninsured rely on encouragements to utilize and potentially expand the individual insurance market. In broadening health insurance coverage, it is important to understand the regulatory environment under which these proposals would be implemented.

IntroductionAlthough the majority of Americans with health insurance obtain their coverage through group health plans offered through their employers, many individuals obtain their coverage through the nongroup (or individual) insurance market.

The study provides public programs, employers and private insurers with effective best practices used in Medicare, Medicaid, SCHIP, and the private insurance market to improve participation in health insurance coverage.