Policy Research
Key Issues of the Health Care Debate
Employer-Based Health Insurance
Federal Employee Benefits Program
Non-Group Insurance Market
Tax Credits
Universal Health Coverage
2008 Election
Recent Elections
Blogs
For more information and resources on key health care issues discussed in presidential campaigns, go to issue modules and reference libraries provided by kaiserEDU.
Employer-Based Health Insurance
Blumenthal D. July 2006. Employer-Sponsored Health Insurance in the United States– Origins and Implications. New England Journal of Medicine 355(1):82-88.
This report explores how the United States came to have an employer-based system of health insurance and how reliance on employer-based insurance affects the U.S. health care system generally. It also discusses recent trends in employer-sponsored insurance and approaches that providers of such insurance are taking to the problems they confront.
Enthoven AC and Fuchs VR. Nov-Dec 2007. Employment-Based Health Insurance: Past, Present, and Future. Health Affairs 25(6):1538-47.
This paper reviews the rise, stabilization and decline of employment-based insurance; discusses the flaws of employment-based insurance and concludes with scenarios for possible future trajectories of employment-based insurance.
Lambrew JM and Gruber J. Winter 2006-2007. Money and Mandates: Relative Effects of Key Policy Levers in Expanding Health Insurance to All Americans. Inquiry 43(4):333-44.
This study examines the relative effects of three policy levers on health coverage and costs in plans aimed at covering all Americans. It assesses how the generosity of financial assistance, an employer mandate, and an individual mandate affect the level of uninsurance, distribution of coverage and federal costs.
Kaiser Family Foundation. September 2007. Employer Health Benefits 2007 Annual Survey.
This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including changes in premiums, employer contributions, cost-sharing provisions, emerging trends in coverage, and other relevant information.
Pierron W and Fronstin P, Employee Benefit Research Institute. February 2008. ERISA Pre-emption: Implications for Health Reform and Coverage.
This issue brief provides an overview of ERISA history, structure and current issues. It also discusses state reform efforts in covering the uninsured through “fair share” laws and how it is impacted by ERISA.
Health Affairs. Spring 1994. Mandates: The Road to Reform.
This issue of Health Affairs provides articles that focus on the subject of mandates and the health care reform plans sponsored by President Clinton to act on reform legislation that required employers to pay health insurance premiums for their workers.
Federal Employee Health Benefits Program
Butler SM and Moffit RE. Winter 1995. The FEHBP as a Model for a New Medicare Program. Health Affairs 14(4):47-61.
This paper describes how the FEHBP works and the role of the U.S. Office of Personnel Management (OPM). It then discusses transforming Medicare into a program similar to the FEHBP and the implications for such a reform.
Davis K, Cooper BS and Capasso R, The Commonwealth Fund. November 2003. The Federal Employee Health Benefits Program: A Model for Workers, Not Medicare.
This report describes FEHBP and how it has worked over the years, examines how it might work if applied to Medicare or small businesses and the uninsured, and assesses whether the model would be an improvement over current systems of health coverage.
McArdle FB. Summer 1995. Opening up the Federal Employees Health Benefits Program. Health Affairs 14(2):40-50.
This paper looks at using the FEHBP as a voluntary buy-in opportunity to help those who lack health insurance—without displacing or disrupting existing sources of health coverage or creating an expensive federal program.
Merlis M, Kaiser Family Foundation. May 2003. The Federal Employees Health Benefits Program: Program Design, Recent Performance, and Implications for Medicare Reform.
This paper provides a basic description of FEHBP’s structure, benefits, financing, and operations. It then moves on to assess FEHBP’s recent performance in a various areas, including cost increases, benefit changes, access to providers and risk selection. It concludes with a brief discussion of the implications of the FEHBP experience for Medicare reform proposals.
Non-Group Insurance Market
America’s Health Insurance Plans Center for Policy and Research. December 2007. Individual Health Insurance 2006-2007: A Comprehensive Survey of Premiums, Availability, and Benefits.
This report provides results from the 2006-2007 survey of member companies participating in the individual health insurance market. The survey is divided into three parts: premiums, underwriting and benefits.
Health Affairs. October 2002. The Nongroup Insurance Market. Web Exclusive.
This web exclusive provides articles that focus on the nongroup insurance market.
• Pauly MV and Nichols L. The Nongroup Insurance Market: Short on Facts, Long on Opinions and Policy Disputes.
• Chollet D. Perspective: Expanding Individual Health Insurance Coverage: Are High-Risk Pools the Answer?
• Hall MA. Perspective: Of Magic Wands and Kaleidoscopes: Fixing Problems in the Individual Market.
• Harrington S and Miller T. Perspective: Competitive Markets for Individual Health Insurance.
• Patel V. Perspective: Raising Awareness of Consumers’ Options in the Individual Health Insurance Market.
• Pollitz K and Sorian R. Perspective: Ensuring Health Security: Is the Individual Market Ready for Prime Time?
• Serota S. Perspective: The Individual Market: A Delicate Balance.
Kaiser Family Foundation. June 2001. How Accessible is Individual Health Insurance for Consumers in Less-Than Perfect Health?
This report documents the findings of a study examining access to health insurance coverage in the individual market for people with health problems.
Kaiser Family Foundation. April 2008. How Private Health Coverage Works: A Primer.
This primer provides a basic overview of private coverage for health care. It describes what private health coverage is, and discusses the types of organizations that provide it, its key attributes, and how it is regulated.
Merlis M, National Health Policy Forum. April 2005. Fundamentals of Underwriting in the Nongroup Health Insurance Market: Access to Coverage and Options for Reform.
This background paper reviews the practice of underwriting, state and federal regulation of insurers offering nongroup health coverage and several proposed options for improving access to coverage for those in poor health.
Ziller EC, Coburn AF, McBride T and Andrews C. Nov-Dec 2004. Patterns of Individual Health Insurance Coverage, 1996-2000. Health Affairs 23(6):210-221.
This paper uses data from the 1996-2000 Survey of Income and Program Participation to examine how long the individually insured maintain their coverage; sources of coverage before and after enrolling in an individual health plan; and characteristics of those who rely on individual insurance coverage.
Tax Credits
Dorn S, Urban Institute. February 2008. Health Coverage Tax Credits: A Small Program Offering Large Policy Lessons.
This paper describes congressional proposals to reauthorize Trade Adjustment Assistance, which would increase the percentage of premiums covered by the tax credit. It also suggests additional approaches both to address health coverage tax credit’s problems and to prevent similar difficulties with future tax credits aimed at a larger group of uninsured Americans.
Fuchs B, Merlis M and James J, National Health Policy Forum. August 2002. Expanding Health Coverage for the Uninsured: Fundamentals of the Tax Credit Option.
This paper provides the basics for understanding the current debate over tax credits as a vehicle for reducing the number of uninsured Americans and discusses the major issues related to administering a tax credit.
Gruber J and Levitt L. Jan-Feb 2000. Tax Subsidies for Health Insurance: Costs and Benefits. Health Affairs 19(1):72-85.
Using a detailed microsimulation model, the authors investigate the question of how much health insurance coverage would expand by using federal tax credits.
Pauly M and Herring B. Jan-Feb 2001. Expanding Coverage via Tax Credits: Trade-Offs and Outcomes. Health Affairs 20(1):9-26.
This paper discusses various options for using refundable tax credits to reduce the number of uninsured persons. It also discusses the issues surrounding the costs of these various options.
Reschovsky JD and Hadley J. Jan-Jun 2004. The Effect of Tax Credits for Nongroup Insurance on Health Spending by the Uninsured. Health Affairs Suppl Web Exclusive:W4-113-27.
This article provides a comparison of how much low-income uninsured people currently spend out of pocket for health with predictions of how much they would spend if they took advantage of a tax credit.
Zelenak L. Summer 2001. A Health Insurance Tax Credit for Uninsured Workers. Inquiry 38(2):106-20.
This paper describes a new system of tax credits that could be used to help low-income workers pay for health insurance. The system would be designed to subsidize health insurance coverage for workers who are currently uninsured, or who pay high premiums for nongroup insurance.
Universal Health Coverage
Davis K. March 2001. Universal Coverage in the United States: Lessons from Experience of the 20th Century. J Urban Health 78(1):46-58.
This paper discusses how the current health care system developed, how the various proposals for universal health coverage gained and lost political and public support, and the pros and cons of the various alternatives available to expand coverage.
Emanuel EJ and Fuchs VR. March 2005. Health Care Vouchers- A Proposal for Universal Coverage. New England Journal of Medicine 352(12):1255-60.
This paper puts forth a proposal for a voucher system for universal health and discusses its features and the economic and political feasibility of such a proposal.
Oberlander J. October 2007. Learning from Failure in Health Care Reform. New England Journal of Medicine 357(17):1677-79.
This perspective piece discusses the renewed interest in comprehensive health care reform. The author reflects on what happened in the 1993 Clinton Health Security Act and what lessons today’s reformers could learn from its failure.
Session SY and Lee PR. April 2008. A Road Map for Universal Coverage: Finding a Pass through the Financial Mountains. J Health Polit Policy Law 33(2):155-97.
This article examines the question of what specific taxes could be used to finance universal coverage and discusses the challenges of a proposal to fund a universal health insurance voucher system with a value-added tax.
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Altman D, Kaiser Family Foundation. February 2008. Pulling It Together: Separating the Forest from the Trees in the Health Reform Debate.
The first installment of this new series draws from the compendium of presidential candidates’ statements on health reform to tease out the fundamental differences between Democrats and Republicans on health reform.
Altman D, Kaiser Family Foundation. March 2008. Pulling It Together: The Critical Path to Health Reform.
The second installment of this new series discusses the critical path and decision points in the policy process that will likely shape the future of health reform after the next presidential election.
Altman D, Kaiser Family Foundation. May 2008. Pulling It Together: Health IN the Economy.
Using the Foundation's latest polls, Drew Altman takes on questions such as "How are concerns about health and the economy linked? Does the rise of economic concerns present obstacles or opportunities for health reform?"
Blendon RJ, Altman D, Deane C et al. Jan 2008. Health Care in the 2008 Presidential Primaries. New England Journal of Medicine 358(4):414-22.
This article examines the role of health care in the 2008 presidential primary elections by drawing on data from multiple opinion surveys to better understand how Republicans and Democrats differ in their values, beliefs and attitudes with regard to health care and health care policy.
Brown L. Jan 2008. The Amazing Noncollapsing U.S. Health Care System- Is Reform Finally at Hand? New England Journal of Medicine 358(4):325-7.
This paper analyzes the current U.S. health care system and the possibility for reform.
Cohen JT, Neumann PJ and Weinstein MC. Feb 2008. Does Preventive Care Save Money? Health Economics and the Presidential Candidates. New England Journal of Medicine 358(7):661-3.
This article examines the cost-saving potential of prevention opportunities that presidential candidates are supporting to lower health care costs.
Fuchs VR. Nov-Dec 2007. What Are the Prospects of Enduring Comprehensive Health Care Reform? Health Affairs 26(6):1542-4.
This article discusses the obstacles to comprehensive health care reform and the prospects for enduring such reform, given these obstacles.
Jacobs LR. May 2008. 1994 All Over Again? Public Opinion and Health Care. New England Journal of Medicine 358(18):1881-83.
This perspective piece discusses public opinion on health care and peoples' attitudes on health care reform.
Lake CC et al. May-June 2008. Health Care in the 2008 Election: Engaging the Voters. Health Affairs 27(3):693-8.
This perspective piece offers seven observations on the key opportunities and pitfalls for health care reform advocates in this election year, based on the authors' analysis of the current political dynamic and recent public opinion research.
Oberlander J. Nov 2007. Election 2008: Presidential Politics and the Resurgence of Health Care Reform. New England Journal of Medicine 357(21):2101-4.
This article discusses how the political environment and strategies are changing based on recent actions by Congress. It describes the resurgence of health care reform in the upcoming 2008 presidential election and the positions of the leading Democrat and Republican candidates.
Roper W. Nov-Dec 2007. Here We Go Again– Lessons on Health Reform. Health Affairs 26(6):1551-2.
This article describes the renewed attention on health care reform in the upcoming 2008 election and the lessons from past politically-driven reform efforts.
Steinbrook RS. Aug 2007. Election 2008– Campaign Contributions, Lobbying, and the U.S. Health Sector. JAMA 357(8):736-9.
This article discusses campaign contributions for presidential candidates and the impact of contributions from people who are affiliated with the health sector and political action committees associated with the health sector.
Steuerle CE, Urban Institute. Feb 2008. Clinton Versus Obama on Health Mandates.
This commentary discusses the differences between Clinton’s and Obama’s views on health mandates.
Stevenson DG. May 2008. Planning for the Future- Long-Term Care and the 2008 Election. NEJM 358(18):1985-87.
This perspective piece looks at the 2008 presidential race and how long-term care policy is an important campaign issue, particularly in regards to financing.
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Blendon R, Brodie M, Altman D et al. Jan-Jun 2005. Voters and Health Care in the 2004 Election. Health Affairs Suppl Web Exclusives: W5-86-W5-96.
This paper examines fourteen national surveys and exit polls, taken before and after the 2004 election, to determine the views of the electorate regarding health care and its importance on the national agenda.
Blendon R, Altman D, Benson J and Brodie M. September 2004. Health Care in the 2004 Presidential Election. New England Journal of Medicine. 351(13):1314-22.
This article examines the importance of health care as an issue in the presidential election of 2004, how this ranking compares with the importance of health care in past elections and which issues voters regard as the most important health care issues before the election.
Epstein A, Hamel MB and Drazen J. September 2004. Election 2004. New England Journal of Medicine 351:1314–1322.
This editorial describes the New England Journal of Medicine’s series on health care policy and the 2004 election and the topics that will be addressed - the Medicare drug benefit and drug re-importation, expansion of coverage for the uninsured, control of the cost of private insurance and the affordability of care, and the financing and long-term viability of Medicare.
Kaiser Family Foundation. September 2004. Health Care and the 2004 Election.
A series of briefs are provided on the impact of the 2004 election on a range of health care topics, as well as side-by-side comparisons of the candidates’ plans. Briefs are available on health care costs, the uninsured, Medicare coverage and financing, women’s health policy, health disparities, medical malpractice, and prevailing public sentiment on health care for this election.
Lancet Editors. January 2003. 2004 US Election Campaign: Health at Home and Abroad. The Lancet 363:179.
This editorial highlights the influence of the Presidential election on two key issues - covering the uninsured and the role of the U.S. in international health policy.
Oberlander J. October 2004. US Health Policy: Tilting at Windmills- Health Reform and the 2004 US Presidential Election. Canadian Medical Association Journal 171(9).
This analysis describes the need for U.S. health reform and discusses the trends in insurance and health care spending. It also describes health policy plans presented by the 2004 presidential candidates.
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Blogs by political pundits and health policy experts discuss and analyze the role of health care in the upcoming election.
Cato Institute Blog
This is the official blog of the Cato Institute where Cato scholars comment about the latest headlines and public policy developments including those in health care and the election.
Health Care Policy and Marketplace Review
This blog reviews the latest developments in federal health policy and marketplace activities in the health care financing business.
Talking Points Memo Election Central
This blog headed by John Marshall discusses the latest news headlines about the upcoming election, including health care issues.
The Wall Street Journal Health Blog
This blog offers news and analysis on health and the business aspects of health.
The Health Care Blog
This blog, "Everything You Always Wanted to Know about the Health Care System, But Were Afraid to Ask," is published by Matthew Holt, a consultant and publisher of an email digest of health care news for executives and hospital administrators.
Health Affairs Blog
The blog provides an ongoing dialogue of health policy issues, including posts from leading policy analysts, responses from a variety of health care stakeholders, and staff-written posts on policy briefings and news reports.
WebMD Election 2008 News Blog
This blog compiles health news, views and trends from the 2008 presidential election campaign trail.
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