Briefing Detail Page
The Nuts and Bolts of Health Insurance for the Aspiring Health Reformer
Friday, October 03, 2008
We expect that the coming debate on health reform will involve proposals to reshape the role private insurance plays in our health care system. But to evaluate proposals for change, one must first understand how private insurance works currently.
This October 3 briefing was designed for those wanting a refresher in how private health insurance works in America. How do states regulate insurance? How do insurers decide whom to insure and how much to charge? How does insurance differ for individuals, small employers and large employers? What are some of the gaps in the current coverage system? How do those with serious illnesses fare in the insurance system as it currently operates?
Speakers were: Steve Finan, associate director of policy for the American Cancer Society; Karen Pollitz, project director with the Georgetown University Health Policy Institute; Sandy Praeger, insurance commissioner for the State of Kansas; and Pat Ryan, senior actuary for Wellmark Blue Cross and Blue Shield, the “Blues” plan for Iowa and South Dakota. Ed Howard, executive vice president of the Alliance, and Deanna Okrent, Alliance health policy associated, moderated.
Sponsors were the Alliance, The Blue Cross and Blue Shield Association and the American Cancer Society Cancer Action Network.
Ed Howard, Alliance for Health Reform, Moderator
Karen Pollitz, Georgetown University Health Policy Institute, Speaker
Pat Ryan, Wellmark Blue Cross and Blue Shield, Speaker
Sandy Praeger, Kansas Insurance Department, Speaker
Steve Finan, American Cancer Society Cancer Action Network, Speaker
Deanna Okrent, Alliance for Health Reform, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)
|Transcript, Event Summary and/or Webcast and Podcast|
Transcript: The Nuts and Bolts of Health Insurance for the Aspiring Health Reformer (Adobe Acrobat PDF), 10/3/2008
Event Summary: The Nuts and Bolts of Health Insurance for the Aspiring Health Reformer (Word Document), 10/8/2008
Full Webcast/Podcast: The Nuts and Bolts of Health Insurance for the Aspiring Health Reformer
|The transcript, full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.
Pollitz Presentation (PowerPoint), 10/3/2008
Ryan Presentation (PowerPoint), 10/3/2008
Praeger Presentation (PowerPoint), 10/3/2008
Finan Presentation (PowerPoint), 10/3/2008
(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)
Nowhere to Turn: How the Individual Health Insurance Market Fails Women (Adobe Acrobat PDF), Adobe PDF, 8/1/2008
The Nuts and Bolts of Health Insurance for the Aspiring Health Reformer (Word Document), , 10/8/2008
Sourcelist (Adobe Acrobat PDF), , 10/3/2008
|Offsite Materials (briefing documents saved on other websites)|
Consumer Guide to High-Risk Health Insurance Pools, National Association of Health Underwriters, 1/1/2008
Employer Health Benefits 2008 Annual Survey: Summary of Findings, Kaiser Family Foundation, 9/24/2008
Health Insurance Basics, Cornell University IRL School and Congressional Reserach Service, 9/18/2007
Health plans fined $13 million, Los Angeles Times, 7/18/2008
How Private Health Coverage Works: A Primer, Kaiser Family Foundation, 4/1/2008
How Risky is Individual Health Insurance?, Health Affairs, 5/6/2008
How the government currently helps people buy health insurance (Adobe Acrobat PDF),American Medical Association, 1/7/2008
Individual Market Portability Rules (Not Applicable to HIPAA Eligible Individuals), 2007, Kaiser Family Foundation, 12/1/2007
Issue Brief: High Risk Pools (Adobe Acrobat PDF),National Council for Community Behavioral Healthcare, 1/10/2008
Private Health Insurance, The Urban Institute Health Policy Center, 5/31/2008
Risk Pooling and Regulation: Policy And Reality In Today's Individual Health Insurance Market, Health Affairs, 6/1/2007
Small Group Health Insurance Market Guaranteed Issue, 2007, Kaiser Family Foundation, 12/1/2007
State Authorization of Tax Credits or Deductions to Small Employers Offering Health Insurance, Kaiser Family Foundation, 2/1/2008
State Health Care Reform: A Brief Guide to Risk Adjustment in Consumer Driven Health Insurance, The Heritage Foundation, 7/28/2008
State High Risk Pool Plan Options and Enrollment, 2007, Kaiser Family Foundation, 7/1/2007
State Mandated Benefits: Cancer Screening for Women, 2008, Kaiser Family Foundation, 3/15/2008
State Mandated Benefits: Depression Parity, 2007, Kaiser Family Foundation, 2/1/2007
State Mandated Benefits: Osteoporosis Screening, 2008, Kaiser Family Foundation, 3/15/2008
State Mandated Benefits: Direct Access to OB/GYNs, 2008, Kaiser Family Foundation, 2/1/2008
States That Allow Individuals to Deduct Health Savings Accounts Contributions, 2008, Kaiser Family Foundation, 2/1/2008
Tax Expenditures for Health Care (Adobe Acrobat PDF),Joint Committee on Taxation, 7/30/2008
Testimony on Rescission of Individual Health Insurance Policies, US Department of Health and Human Services, 7/17/2008
The Individual Market: A Delicate Balance, Health Affairs, 10/23/2002
Winning the Fight against Cancer: Expanding Access to Care, American Cancer Society Cancer Action Network, 4/1/2008
The Four A's of Access to Care, American Cancer Society Cancer Action Network, 8/1/2008
How Accessible is Private Health Insurance for consumers in less-than-perfect health? (Adobe Acrobat PDF),Kaiser Family Foundation, 6/1/2001
Maternity Care and Consumer-Driven Health Plans, Kaiser Family Foundation, 6/1/2007
Karen Pollitz, project director at the Georgetown University Health Policy Institute, offers an overview of how private health coverage works. (14 minutes) From the Oct. 3 briefing cosponsored by the Blue Cross Blue Shield Association and the American Cancer Society's Cancer Action Network.
Patrick Ryan of the Wallmark Blue Cross and Blue Shield explains why health insurers why insurers must attract enough healthy individuals to buy their coverage. (13 min.) From the Oct. 3 briefing cosponsored by the Blue Cross Blue Shield Association and the American Cancer Society's Cancer Action Network.
Sandy Praeger, the Kansas insurance commissioner, describes how states regulate health insurance. (12 min.) From the Oct. 3 briefing cosponsored by the Blue Cross Blue Shield Association and the American Cancer Society's Cancer Action Network.
Steve Finan of the American Cancer Society's Cancer Action Network offers a view of the health insurance system from the patient's perspective. (12 min.) From the Oct. 3 briefing cosponsored by the Blue Cross Blue Shield Association and the Cancer Action Network.
Alliance Search for New CEO
WASHINGTON, DC (Aug. 3) – Edward F. Howard, founding executive vice president and CEO of the Alliance for Health Reform in Washington, DC, will retire in March 2016. A nationwide search is underway for his successor.
Over the years, the Alliance has presented hundreds of seminars on Capitol Hill and elsewhere, has organized briefings for reporters around the country and has prepared dozens of issue briefs and “toolkits,” as well as a series of highly-regarded sourcebooks for reporters on health policy topics.
Dr. Robert Graham, Chairman of the Board, noted that the search for a new CEO is being coordinated by Association Strategies of Alexandria, Va. Those interested in learning more about this opportunity should email firstname.lastname@example.org or call 703/ 683-0580. You can also view the position profile on their website. The deadline for applications is Monday, October 12.
Toolkit on Biosimilars
The Alliance for Health Reform has released a new toolkit, “Biosimilars: Unpacking Complex Issues.”
The Affordable Care Act created an expedited licensure pathway for biosimilars, and, in March 2015, the U.S. approved the first biosimilar, leaving policy makers, regulators, providers and stakeholders to grapple with regulatory and financial questions.
Biosimilars are similar – but not identical – to biologic drugs, and cost less. Unlike traditional pharmaceuticals, biologic drugs are derived from living organisms and tissues, making them more complex and expensive to produce.
Toolkit on Connection Between Health and Housing
A new Alliance toolkit, “The Connection between Health and Housing: The Evidence and Policy Landscape,” provides a detailed look into federal, state and local initiatives, as well as cost implications for health and housing programs.
Attempts to tie health and housing policy are gaining momentum, amid evidence that housing, a social determinant of health, is an important factor in the health status of various populations. More than 610,000 people experience homelessness in the U.S., and over 250,000 individuals within that population have a severe mental illness or a chronic substance use disorder, according to the Department of Housing and Urban Development.