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  Premium Assistance  


Premium Assistance in a Broad Coverage Reform Environment | Premium Assistance — Overview | Premium Assistance through Purchasing Pools| Case Studies| Under S-CHIP | Public Program Impact ("Crowd-Out")
Access to Coverage

"Premium Assistance" can help low-income working families to pay the employee contribution necessary to enroll (or remain enrolled) in employer-sponsored coverage that is available to them. This can stretch available resources to bring uninsured workers into coverage in a way that builds towards full reforms in 2014.

  • By complementing small employer contributions and federal small employer tax credits, premium assistance can allow states to serve more uninsured with the public funds available.

  • The strategy can also provide a critical mass of enrollment for early implementation of a small-employer Exchange.

  • Early implementation would bring a number of uninsured workers into coverage before 2014 and provide experience to inform the refinement and improvement of such Exchanges before full-scale operations begin in 2014, when small employers must partcipate in the Exchange if they want to continue receiving federal tax credits.

But states seeking to develop and implement premium assistance programs have faced significant challenges that arise from difference between public program and employer-coverage structures, and from other practical operational issues.

The Institute has provided analysis and assistance to several states (and, in some cases, localities) interested in developing premium assistance programs. This work informs our understanding of the issues involved. Our earlier reports (below) addressed the wide variety of policy, mechanical and operational issues surrounding premium assistance.

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Premium Assistance in a Broad Coverage Reform Environment

An Implementation and Alternative Scenario Analysis of California's Health Insurance Act of 2003(SB2) (IHPS 2005)For specific information on Premium Assistance, see "Full Report" of this paper, pages 55-57, Sections 3.5.2 and 3.5.3.

Premium Assistance — Overview

Premium Assistance: What Works? What Doesn't? (IHPS, April 2003)

Premium Assistance (Future of Children, Volume 13, Number 1, published by the Center for the Future of Children Spring, 2003)

Purchasing Private Health Insurance through Government Healthcare Programs: A Guide for States (IHPS, June 1999)

Treatment of Flexible Benefit Plans Under Employer Coverage Subsidy Programs (IHPS, November 1998)

Employer Coverage and the Children's Health Insurance Program Under the Balanced Budget Act of 1997: Options for States (IHPS, December 1997)

Extending Health Care Coverage for Modest-Income Children and Pregnant Women: Public & Employer Financed Coverage Lessons (IHPS, December 1996)

Health Care Financing Reform to Cover the Uninsured: A Guide to Joint Public and Private Financing Strategies (IHPS, December 1992)

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Premium Assistance through Exchanges

Potential Tasks for Implementing Premium Assistance through a Consumer Choice Health Purchasing Group (IHPS, May 2000)

Coordination of Title XXI Coverage with Employer-Based Coverage through Consumer-Choice Health Purchasing Groups (IHPS, January 1999)

Case Studies

Overview of the Iowa Health Insurance Premium Payment (HIPP) Program (IHPS, Feb 2000)

MassHealth Family Assistance Program: A Case Study of an Employer-Based Insurance Subsidy Program (IHPS, June 1999)

An Overview of the Oregon Family Health Insurance Program (IHPS, December 1998)

MinnesotaCare and "Crowding-Out" (IHPS, September 1998)

Special Enrollment Periods (IHPS, January 1998)

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Under CHIP
Coordinating Children's Health Insurance Programs with Employment-Based Coverage: Design and Implementation of Premium Assistance Programs (IHPS, October 1999)

Subsidizing Employer-Sponsored Insurance Under State Children's Health Insurance Programs: Working with a Supplemental Carrier (IHPS, October 1999)

Subsidy Payment Structure Alternatives (for Coordinating with Employer Coverage Under CHIP) (IHPS, May 1999)

Supplementing Cost-Sharing Provisions of Employer-Based Insurance Plans (IHPS, February 1999)

Likelihood of Exceeding Family Cost Sharing Limits (IHPS, December 1998)

Children and Employer-Based Coverage: The Data (IHPS, October 1998)

Benefits and Cost-Sharing: Meeting CHIP Rules When Subsidizing Employer-Sponsored Plans (IHPS, August 1998)

Meeting Cost-Sharing Requirements Under CHIP Premium Subsidy Programs (IHPS, July 1998)

Coordinating Children's Coverage Expansions with Employer Sponsored Insurance (IHPS, March 1998)

Alternative Approaches for Paying Child Health Insurance Subsidies (IHPS, January 1998)

Employer Coverage and the Children's Health Insurance Program Under the Balanced Budget Act of 1997: Options for States (IHPS, December 1997)

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Public Programs & "Crowd-Out" of Employer Coverage

Medicaid and Child Health Crowding Out: Synopsis of Resources (IHPS, December 1998)

MinnesotaCare and "Crowding-Out" (IHPS, September 1998)

Finding Practical Solutions to 'Crowding Out' (IHPS, January 1997)

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