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Medicare and Health Policy

Tuesday, September 15, 2009

Role of Health Insurance Regulation

Timothy Stoltzfus Jost
Robert L. Willett Family Professor of Law and Ethan Allen Faculty Fellow, Washington and Lee University: School of Law

The Regulation of Private Health Insurance examines the current role of health insurance regulation and the role that it could play in a reformed health care system. It begins by exploring the nature of health insurance and alternative approaches to regulation. It next considers the current status of state and federal health insurance regulation, both describing the development of health insurance regulation and examining arguments in support of and in opposition to regulatory interventions. Finally, it considers the kind of insurance regulation that will be needed in a reformed health care system, as well as the question of whether authority for insurance regulation should be placed at the federal or state level. It concludes that the best approach would be to develop national standards for health insurance enforced primarily at the state level.

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Posted on September 15, 2009  |  Write the first comment
Monday, July 13, 2009

Simplifying Administration of Health Insurance

Mark Merlis
Health Policy Consultant

The high administrative costs of the U.S. health insurance system have been a focus of discussion for decades. Simplifying Administration of Health Insurance finds ways to define and classify administrative costs, both of insurers and of other participants in the system, and summarizes the fragmentary estimates of how large these costs are. It discusses current efforts to reduce administrative costs, many of which have focused on standardizing and simplifying transactions among insurers, providers, and employers. Finally, it considers how various reform proposals, whether or not directly targeted at administrative costs, might reduce—or add to—the complexity of the current system.

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Posted on July 13, 2009  |  Write the first comment
Friday, July 10, 2009

Restructuring Health Insurance Markets

Elliot K. Wicks
Senior Economist, Health Management Associates

Restructuring Health Insurance Markets examines six structural changes that could expand health insurance coverage, with special focus on the administrative issues: changes in rating rules, high risk pools, standard benefit plans, reinsurance, Section 125 plans, and insurance exchanges. It considers what benefits these changes might produce, how they can be most effectively structured, and how they can be implemented. From an administrative standpoint, it is critical that any set of policies be considered as a whole, with careful attention to their interactions, both to enhance their chances for success and to avoid unnecessary administrative burdens and duplication.

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Posted on July 10, 2009  |  Write the first comment
Friday, June 26, 2009

Administering Health Insurance Mandates

C. Eugene Steuerle
Vice President, Peter G. Peterson Foundation

Paul N. Van de Water
Senior Fellow, Center on Budget and Policy Priorities

Mandates form an integral part of many proposals to expand health insurance coverage. Often, however, too little attention is paid to how and whether they can be administered.

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Posted on June 26, 2009  |  Write the first comment
Wednesday, June 24, 2009

Paying a Fair Share for Health Coverage and Care

Jill Bernstein
Health Policy Consultant

Expanding health coverage will involve changes in the premiums and taxes people pay for health insurance and the amounts they pay out-of-pocket for specific health care services. Payment arrangements must generate sufficient revenue, promote efficiency in health care delivery, assure access to care for people who have low income or are in poor health, and minimize administrative costs and burden. Paying a Fair Share for Health Coverage and Care evaluates alternative approaches—including social insurance programs, means-tested premium assistance, and income-related cost sharing—according to these criteria.

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Posted on June 24, 2009  |  Write the first comment