Health Care Insurance: Background, Coverage and Rising Costs

Eric M. Hahn (Editor)

Series: Health Care in Transition
BISAC: HEA028000



Volume 10

Issue 1

Volume 2

Volume 3

Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick


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On October 12, 2017, President Trump issued Executive Order (E.O.) 13813, entitled “Promoting Healthcare Choice and Competition Across the United States.” E.O. 13813 generally aims “to facilitate the purchase of insurance across state lines and the development and operation of a healthcare system that provides high-quality care at affordable prices for the American people.” Chapter 1 answers frequently asked questions (FAQs) about E.O. 13813 and subsequent rulemaking and provides background information about AHPs, STLDI, and HRAs.

The individual insurance market is 18 million Americans. It is those Americans who are getting hammered the most by the higher premiums and the higher co-pays and deductibles. Chapter 2 focuses on addressing high-cost individuals through reinsurance; continuing the cost-sharing reduction payments; and third, more flexibility for States.

Enrollment in private health insurance plans continued to be concentrated among a small number of issuers. A highly concentrated health insurance market may indicate less competition and could affect consumers’ choice of issuers and the premiums they pay. Chapter 3 describes changes in the concentration of enrollment among issuers in overall individual, small group, and large group markets, and individual and small group exchanges.

A majority of Americans have health insurance from the private health insurance (PHI) market. The first part of chapter 4 provides background information about health plans sold in the PHI market and briefly describes state and federal regulation of private plans. The second part summarizes selected federal requirements and indicates each requirement’s applicability to one or more of the following types of private health plans: individual, small group, large group, and self-insured.
(Imprint: SNOVA)


Chapter 1. Background Information on Health Coverage Options Addressed in Executive Order 13813
Bernadette Fernandez, Ryan J. Rosso and Vanessa C. Forsberg

Chapter 2. Stabilizing Premiums and Helping Individuals in the Individual Insurance Market for 2018: Governors

Chapter 3. Private Health Insurance: Enrollment Remains Concentrated among Few Issuers, including in Exchanges

Chapter 4. Federal Requirements on Private Health Insurance Plans

Bernadette Fernandez, Ryan J. Rosso and Vanessa C. Forsberg


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