Insured and Uninsured
Sustaining expansions to health insurance coverage is the largest health care reform obstacle facing states, according to a Web exclusive for the journal Health Affairs.
Jonathon Oberlander, an associate professor in the departments of social medicine and health policy and administration at the University of North Carolina-Chapel Hill, analyzed the experiences of the Oregon Health Plan, an effort to expand health insurance coverage to Oregon residents in part by limiting covered services. Legislation to create OHP was approved in 1989, but the required federal waivers were not received until 1993.
Oberlander writes that the rate of uninsured declined from 18% in 1992 to 11% in 1996 but that subsequent expansions of the program and related premium requirements have resulted in Oregon's uninsurance rate rising to 17%. According to Oberlander, the situation could be attributed in part to political circumstances and economic conditions in Oregon.
However, Oberlander writes that state-based health care reform efforts must address changing political conditions such as:
- Early supporters of the programs retiring from politics;
- Political alliances fracturing; and
- Financial constraints increasing.
The November-December 2006 issue of Health Affairs published several articles related to employer-sponsored health insurance and other group health insurance options. Titles and links to the studies appear below.
- "The 'Graying' of Group Health Insurance" (Keenan et al., Health Affairs, November-December 2006);
- "The Commercial Health Insurance Industry in an Era of Eroding Employer Coverage" (Robinson, Health Affairs, November-December 2006);
- "Tax Subsidies for Employment-Related Health Insurance: Estimates for 2006; (Selden/Gray, Health Affairs, November-December 2006); and
- "Association Health Plans: What's All the Fuss About?" (Kofman et al., Health Affairs, November-December 2006).