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Trends in Health Insurance Coverage in the U.S.

Trends in Health Insurance Coverage in the U.S. Sherry Glied, Ph.D. Assistant Secretary for Planning and Evaluation. Declining Coverage – What are the Sources of the Problems?. Costs are rising relative to family incomes

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Trends in Health Insurance Coverage in the U.S.

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  1. Trends in Health Insurance Coverage in the U.S. Sherry Glied, Ph.D. Assistant Secretary for Planning and Evaluation

  2. Declining Coverage – What are the Sources of the Problems? • Costs are rising relative to family incomes • Costs of obtaining coverage are very high for small firms and for individuals • The small firm and individual insurance markets are subject to risk selection (by insurers) and averse selection (by insureds) • Limited capacity to smooth economic downturns

  3. Decreased Employer-Sponsored Coverage Is Closely Linked to Decreased Affordability 3 3 SOURCE: T Gilmer and R Kronick. “Hard times and health insurance: how many Americans will be uninsured by 2010?” Health Affairs, May 18,2009. Reprinted with permission.

  4. Decline in Private Firms Offering Coverage Is Concentrated Among Small Employers 4 4 4 SOURCE: ASPE Analysis of MEPS-IC Note: Significant change from 1999-2009 at p<0.05 level for small firms

  5. The Share of Americans Who Purchase in the Individual Market Is Declining 5 5 SOURCE: ASPE analysis of 1997 - 2007 MEPS-HC . Percentages reflect non-elderly persons with at least one-month of individual coverage during the year.

  6. Trends in the Purchase of Individual Coverage Vary by Age Source: AHRQ analysis of MEPS-HC

  7. Many People Hold Individual Insurance Coverage Only for Short Periods 7 7 SOURCE: AHRQ analysis of MEPS-HC

  8. Denial Rates in the Individual Market Are High for All Groups But Particularly for Those Over 55 8 8 SOURCE: America’s Health Insurance Plans, Individual Health Insurance 2009: A Comprehensive Study of Premiums, Availability, and Benefits (October 2009)

  9. Annual Unemployment Rate, 1997-2009

  10. Unemployment Rate, By AgeJanuary 2000 – October 2010

  11. Share of Children, Parents and Other Adults Enrolled in Medicaid

  12. Affordable Care Act Provisions Affecting Coverage • Immediate • Coverage of adult children to 26 • PCIPs • Small firm tax credits • 2014 • Exchanges • Premium tax credits and cost sharing reductions • Medicaid Expansions

  13. Research Agenda • Developing capacity to routinely track key indicators of Affordable Care Act outcomes • Developing baseline data and structure for external and internal evaluation of Affordable Care Act and its components

  14. sherry.glied@hhs.gov 202-690-7858 www.aspe.hhs.gov Sherry Glied, Ph.D. Assistant Secretary for Planning and Evaluation U.S. Department of Health and Human Services

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