Gateway to Think Tanks
来源类型 | REPORT |
规范类型 | 报告 |
SHOPping Around | |
Terry Gardiner; Isabel Perera | |
发表日期 | 2011-07-06 |
出版年 | 2011 |
语种 | 英语 |
概述 | Terry Gardiner and Isabel Perera provide a roadmap for states, policymakers, health reform advocates, and small-business leaders as they begin to create SHOP exchanges. |
摘要 | Download this report (pdf) Download the introduction and summary (pdf) Read the full report in your web browser A significant amount of focus on the Affordable Care Act—comprehensive health care legislation that Congress passed last year—revolves around the requirement that each state establish an American Health Benefit Exchange that can help individuals who do not have access to employer-provided health insurance purchase qualified health plans. Perhaps less attention has been paid to the provision of the Affordable Care Act that also calls for states to establish a Small Business Health Options Program, referred to as a “SHOP exchange.” The fundamental mission of SHOP exchanges is to create a well-functioning health insurance marketplace providing an array of affordable, high-quality health insurance plans for small businesses and their employees. The Affordable Care Act requires each state to create its exchange by January 1, 2014. If the state fails to set up an exchange by then, the federal government will create one for it. States can also choose to combine the individual and small business or SHOP exchanges—an option with many proponents, because expanding the pool would create more competition among insurers, which would mean more choice and should result in better pricing for consumers. SHOP exchanges can help the large number of small businesses and their employees who continue to struggle with escalating health costs. Health insurance premiums for these employers have grown 113 percent over the last decade. But because of their smaller scale and thinner margins, they are less able than other employers to absorb these increasing costs. These costs lead to high uninsured rates among this population. Nearly 23 million of the 45 million Americans without health insurance in 2007 were small-business owners, employees, or their dependents, according to Employee Benefit Research Institute estimates. In other words, about 50 percent of uninsured Americans are part of the small-business community. SHOP exchanges can help these businesses find the best care—if they’re set up right. It will be up to the states to implement them, and there are many issues to consider in this process. The exchanges will be competing with insurance offered in the outside market, so they’ll need to offer health plans that are high quality and cost competitive. They’ll also need to be able to maximize participation from the beginning to gain scale, avoid adverse selection (the upward price spiral that occurs when one plan or market disproportionately attracts high-risk employees), and succeed. This report provides a roadmap for states, policymakers, health reform advocates, and small-business leaders as they begin to create these exchanges. It starts with an overview of the problems small businesses face affording health care and then addresses the details of the SHOP exchange and how it will help. The report then examines the implementation process, beginning with some basic principles policymakers will need to consider when creating an exchange. These include:
Next, the report focuses on five key decisions states will need to make at the outset that will determine the shape, structure, and character of the exchange. These include:
The final section delves into the variety of issues states will face as they set up exchanges. These are in no particular order but are all critical issues states will need to confront:
Throughout the paper we also include numerous examples of public and private exchanges for small employers that are already up and running. These can offer lessons for states as they begin the process. We cannot stress enough how important it is for policymakers to think about the topics covered in this paper before they start setting up the exchanges. If they fail to take into account such issues as maximizing participation or making the exchange cost competitive, based on the history of small-employer exchanges and pools, they risk low enrollment and potential failure. We believe the recommendations in this report will help states begin to design exchanges that suit their unique small-business populations and help provide these businesses and their employees with the high-quality, affordable care they need and deserve. Terry Gardiner directs Small Business Majority’s policy development and works on long-term strategic planning, and Isabel Perera is the Special Assistant for Health Policy at American Progress. Download this report (pdf) |
主题 | Health Care |
URL | https://www.americanprogress.org/issues/healthcare/reports/2011/07/06/10040/shopping-around/ |
来源智库 | Center for American Progress (United States) |
资源类型 | 智库出版物 |
条目标识符 | http://119.78.100.153/handle/2XGU8XDN/435089 |
推荐引用方式 GB/T 7714 | Terry Gardiner,Isabel Perera. SHOPping Around. 2011. |
条目包含的文件 | 条目无相关文件。 |
个性服务 |
推荐该条目 |
保存到收藏夹 |
导出为Endnote文件 |
谷歌学术 |
谷歌学术中相似的文章 |
[Terry Gardiner]的文章 |
[Isabel Perera]的文章 |
百度学术 |
百度学术中相似的文章 |
[Terry Gardiner]的文章 |
[Isabel Perera]的文章 |
必应学术 |
必应学术中相似的文章 |
[Terry Gardiner]的文章 |
[Isabel Perera]的文章 |
相关权益政策 |
暂无数据 |
收藏/分享 |
除非特别说明,本系统中所有内容都受版权保护,并保留所有权利。