An Introduction to Health Insurance: What Should a Consumer Know?

[Excerpt] Congress has seen a renewed interest in questions related to the market for private health insurance since the passage of the Patient Protection and Affordable Care Act (ACA; P.L. 111- 148, as amended). Recent health insurance marketplace changes include a different way to purchase health insurance (exchanges) and a new system of categorizing the generosity of plans’ health coverage based on the names of various metals (e.g., bronze and silver). Some consumers may face different choices of health insurance plans than in the past. Not all consumers are comfortable with the various concepts governing which health insurance plan might be best for them. This report provides an overview of private-sector (as opposed to government-provided) health insurance. It serves as an introduction to health insurance from the point of view of consumers under the age of 65 who purchase a health insurance plan. No background in health insurance is assumed, and all terms are defined. The report therefore can be viewed as an introduction to the more comprehensive discussion of health insurance found in the Congressional Research Service (CRS) health insurance primer

THE PRIVATE HEALTH INSURANCE MARKET IN THE EUROPEAN UNION

Private health insurance serves three distinct functions in western European health systems. The first is as an alternative for mandatory (statutory) social health insurance arrangements. The second function is to supplement statutory insurance, providing coverage for services not covered by social insurance. A third function of private health insurance is to provide what can be termed complementary coverage, in which insured persons purchase additional private insurance even while they have to participate in existing social schemes.private health insurance, statutory health insurance, substitutive health insurance, complementary health insurance, supplementary health insurance.

Race, Ethnicity and the Dynamics of Health Insurance Coverage

Using matched data from the 1996 to 2004 Current Population Survey (CPS), we examine racial patterns in annual transitions into and out of health insurance coverage. We first decompose racial differences in static health insurance coverage rates into group differences in transition rates into and out of health insurance coverage. The low rate of health insurance coverage among African-Americans is due almost entirely to higher annual rates of losing health insurance than whites. Among the uninsured, African-Americans have similar rates of gaining health insurance in the following year as whites. Estimates from the matched CPS also indicate that the lower rate of health insurance coverage among Asians is almost entirely accounted for by a relatively high rate of losing health insurance. In contrast to these findings, differences in health insurance coverage between Latinos and whites are due to group differences in both the rate of health insurance loss and gain. Using logit regression estimates, we also calculate non-linear decompositions for the racial gaps in health insurance loss and gain. We find that two main factors are responsible for differences in health insurance loss between working-age whites and minorities: job loss and education level. Higher rates of job loss account for 30 percent of the health insurance gap for African-Americans and Asians, and 16 percent of the health insurance gap for Latinos. Lower levels of education explain roughly 15 percent of the gap for African-Americans and Latinos (Asians' higher levels of education serve to close the gap). Higher rates of welfare and SSI participation among African-Americans also serve to widen the gap in health insurance loss by 8 percent.race, health insurance, insurance dynamics

Rates of public health insurance coverage for children rise as rates of private coverage decline

This brief uses data from the 2008, 2009, and 2010 American Community Survey to document changes in rates of children’s health insurance, between private and public. The authors report that, nationally, private health insurance for children decreased by just under 2 percentage points, while public health insurance increased by nearly 3 percentage points. Rural places and central cities witnessed significant declines in rates of private health insurance for children in nearly every region. Rates of public insurance coverage rose in every region and place type. Children’s health insurance coverage overall continued to rise in 2010, increasing by 0.6 of a percentage point since 2009, and 1.9 percentage points since 2008

The Purpose and Limits of Social Health Insurance

This contribution seeks to answer two related questions. First, what is the purpose of social health insurance? Or put in slightly different terms, what are the reasons for social (or public) health insurance to exist, even to dominate private health insurance in most developed countries? And second, what are the limits of social health insurance? Can one say that there is "too much" social health insurance in the following two senses: Should the balance be shifted towards the private alternative? And is the degree of coverage excessive?social health insurance, private health insurance, insurance coverage

Assessing Attitudinal Barriers to Health Insurance Enrollment and Facilitation in Vulnerable Populations

Introduction: Homeless individuals bear a disproportionately high burden of disease. Lack of health insurance amongst homeless populations is a significant barrier to healthcare access. Methods: This study explored barriers and facilitators to health insurance via a survey-format that focused predominantly on attitudes towards health insurance and enrollment assistance. Results: Majority of respondents endorse a facilitator to guide the enrollment process at their location of healthcare. While 43.8% of participants reported they knew where to go for enrollment assistance, 43.7% did not. 100% of participants agreed that health insurance is important, while only 43.1% were insured. Conclusion: Distrust regarding facilitation in the previous literature is overstated. Confusion during enrollment process is a merited concern. Data from this study showed that the population prioritizes health insurance. Financial barriers remain significant. This population has overall positive attitude towards health insurance enrollment and facilitation. Low-level outreach is warranted

The Impact of Health Insurance for Children: Evidence from Vietnam

Although there are numerous studies on impact evaluation of overall health insurance, little is known on the impact of health insurance on health care utilization and out-of-pocket health care spending of children, especially in developing countries. This paper measures the impact of child health insurance on health care utilization and spending of children from 6 to 14 years old in Vietnam using two recent nationally representative surveys. Unlike previous empirical studies which found a positive effect of health insurance on health care utilization in Vietnam, we did not find a statistically significant effect of school health insurance as well as free health insurance for children on outpatient health care contacts. However, the school health insurance and free health insurance help the insured children decrease out-of-pocket spending per outpatient contact by around 14 and 26 percent, respectively.Child health insurance, impact evaluation, health care utilization, out-of-pocket spending, Vietnam

After a Parent Left Employment, One in Five Children Lost Private Insurance

This brief focuses on children’s loss of private health insurance after a parent left his or her job voluntarily or involuntarily between May 2008 and the end of 2012. Author Kristin Smith reports that more than one in four privately insured children had a parent leave employment voluntarily or involuntarily between 2008 and 2012. Within eighteen months after a parent transitioned out of employment, 19 percent of privately insured children lost their private health insurance; of this 19 percent, 11 percent moved to public health insurance and 8 percent became uninsured. Children living in the highest income quintile more often transitioned to no insurance, while children living in the lowest income quintile more often transitioned to public health insurance. Hispanic children were more likely to transition to public health insurance than to become uninsured. Children in rural and urban areas were equally likely to have a parent leave employment; they were also equally likely either to become uninsured or to gain public health insurance