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Affordability and Health Reform: If We Mandate, Will They (and Can They) Pay?

Friday, November 20, 2009

The health reform proposals being considered in both houses may impose responsibilities on both individuals and employers to have, and help pay for, coverage.

Subsidies for some small businesses and for individuals with incomes up to 400 percent of the federal poverty level have been proposed. But will individuals and businesses be able to pay the amounts required of them above the subsidies? If those costs are onerous, Congress may exempt many people from the coverage requirement or significantly reduce the penalties for noncompliance.

If that occurs, will enough healthy individuals purchase new coverage to adequately spread risk? How generous will subsidies in the final reform package be? What costs – both premiums and out-of-pocket – will individuals and families face? How will small employers be able to afford coverage for their employees?

To address these questions and others, the Alliance for Health Reform and The Commonwealth Fund sponsored a November 20 briefing. Panelists were: Sara Collins of The Commonwealth Fund, DeAnn Friedholm of Consumers Union and Stuart Butler of the Heritage Foundation. Ed Howard of the Alliance and Rachel Nuzum of The Fund co-moderated.


 Ed Howard, Alliance for Health Reform, Moderator
Rachel Nuzum, The Commonwealth Fund, Moderator
 Sara Collins, The Commonwealth Fund, Speaker
 DeAnn Friedholm, Consumers Union, Speaker
 Stuart Butler, The Heritage Foundation, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Affordability and Health Reform: If We Mandate, Will They (and Can They) Pay? (Adobe Acrobat PDF), 11/20/2009
Event Summary: Event Summary (Adobe Acrobat PDF), 11/20/2009
Full Webcast/Podcast: Affordability and Health Reform: If We Mandate, Will They (and Can They) Pay?

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

DeAnn Friedholm Presentation (PowerPoint), 11/20/2009
Sara Collins Presentation (PowerPoint), 11/20/2009

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Agenda (Adobe Acrobat PDF), Alliance for Health Reform, 11/19/2009
Speaker Biographies (Adobe Acrobat PDF), Alliance for Health Reform, 11/20/2009
Source List (Adobe Acrobat PDF), Alliance for Health Reform, 11/20/2009
Event Summary (Adobe Acrobat PDF), , 11/20/2009

Offsite Materials (briefing documents saved on other websites)

Affording Shared Responsibility For Universal Coverage: Insights From California, Health Affairs, 3/24/2009
Comparing the House and Senate Subsidies, Washington Post, 10/27/2009
The Public Option and Insurance Exchange in The House Bill, Health Affairs, 10/30/2009
Access and Affordability: An Update On Health Reform in Massachusetts, Fall 2008, Health Affairs, 5/28/2009
Wealth, Income, And The Affordability of Health Insurance, Health Affairs, 3/16/2009
The Burden of Health Care Costs for Working Families — Implications for Reform (Adobe Acrobat PDF),New England Journal of Medicine, 7/30/2009
How Health Care Costs Contribute to Income Disparity in the United States, McKinsey Global Institute, 3/20/2009
The Baucus Plan: Implications for Small- and Medium-Sized Firms, Heritage Foundation, 10/20/2009
The Affordability Factor, The National Journal, 11/2/2009
What Is Affordable Health Care? (Adobe Acrobat PDF),The Commonwealth Fund, 10/28/2009
Finance Committee Health Reform Bill Makes Improvements, But Still Falls Short, Center on Budget and Policy Priorities, 10/13/2009
Mandates and Affordability , New York Times, 10/31/2009
How Many Are Underinsured? Trends Among U.S. Adults, 2003 And 2007, Health Affairs, 6/26/2009
Side-by-Side Comparison: Health Reform Bills, Kaiser Family Foundation, 11/13/2009
Insurance Reforms Must Include a Strong Individual Mandate (Adobe Acrobat PDF),Blue Cross Blue Shield, 10/14/2009


Sara Collins, vice president for affordable health insurance at The Commonwealth Fund, compares the House and Senate reform bills in areas such as premium subsidies and out-of-pocket costs. From the Nov. 20 briefing cosponsored by the Fund.

Stuart Butler, vice president for domestic and economic policy studies at the Heritage Foundation, notes that the House and Senate health reform bills could reduce wages for some employees and could make it harder to fund other priorities. From the Nov. 20 briefing cosponsored by The Commonwealth Fund. (15 min.)

DeAnn Friedholm, director of health care reform for Consumers Union, says reformers should focus on how real people are faring in today's health care system and how they will fare under a reformed system. From the Nov. 20 briefing cosponsored by The Commonwealth Fund. (15 min.)


Webcast: The Emerging Biosimilars Market

Watch the webcast of our June 20 panel discussion on biosimilar biological medications.

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Open Enrollment Preview: Checking the Vitals of the Marketplaces

The Affordable Care Act's health insurance marketplaces rely on robust competition to control costs and to provide consumer choice. But the decisions of several large insurers to scale back their 2017 marketplace participation, and the failure of many health insurance co-ops will leave marketplace shoppers in many states with fewer choices than they had in 2016. Furthermore, those insurers remaining in the exchanges have often found their marketplace customers to be less healthy than they projected, and they are raising premiums in response. Our briefing focuses on these trends, what they mean for the long-term viability of the marketplaces, and what public policy steps can be taken to bring more healthy people into the risk pool and to encourage insurer participation in the individual market.

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