About IHPS
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Welcome to IHPS

The Institute for Health Policy Solutions (IHPS) is an independent, not-for-profit organization with the overarching goal of achieving affordable coverage by and for all Americans. We develop and analyze workable innovations to address health system problems.

Our work now focuses on analysis and technical assistance toward implementation of Health Insurance Exchanges and related health reforms.

This work draws on our extensive experience regarding coverage for uninsured working families and related health insurance market issues. We develop approaches that serve the public interest and are made more effective by taking into account pertinent market dynamics. An important role is assisting interested policy makers and organizations that are positioned to pursue such promising strategies.

Our activities include: technical assistance for program policy design; strategic planning; analysis and development of coverage innovations; and applied research. We undertake collaborative analysis with other experts, as well as share insights and foster mutual interest in promising solutions.

To better achieve our goals, we often work with individuals and organizations whose roles and capabilities complement our own. IHPS is a freestanding 501(c)(3) institute that relies on outside support — grants and contracts — to fund our work.

Quick Links to Recent Reports and Presentations

"Tobacco Rating Issues and Options for California under the ACA" (IHPS, June 21, 2012).Illustrates the potential impact, particularly on lower income individuals, of the ACA provision which allows health insurers to charge up to 50% more for people who use tobacco. Identifies and assesses the implications of several alternative approaches states might adopt."

"Income Volatility Creates Uncertainty about the State Fiscal Impact of a Basic Health Progrm (BHP) in California "(IHPS, September 2, 2011). Based on analysis of income-change data from the Survey of Income and Program Participation (SIPP) by John Graves, Ph.D.

"Fiscal Risks from Differences in BHP vs. Federal Tax Credit Income-Test Timing "(IHPS, September 2, 2011). 2-page brief explains state fiscal risks associated with differences between BHP public-subsidy-model program and federal tax-credit policies.

"Continuity for (Former) Medi-Cal Enrollees and Affordability for the Low-Income Exchange Population: Background and an Alternative Approach"(IHPS, June 29 2011). Includes an assessment of the Basic Health Program (BHP) option. See also "Income Volatility" data brief, above.

Small-Employer ('SHOP') Exchange Issues in California (IHPS, March 2011)

New Paradigm Plans (IHPS, July 2011)

"Health Reform: What Legislators Need to Know about Exchanges," Presentation to a National Conference of State Legislators Webinar, June 2, 2010. Slides.
NCSL Webinar page with link to audio.

"Structuring Exchanges: An Overview of State Issues and Options," Presentation via Video Conference to a legislative briefing by the Evidence-Based Health Policy Program, University of Wisconsin – Madison, May 27, 2010.

What Health Insurance Exchanges or Choice Pools Can and Can't Do About Risks and Costs (IHPS, May 2009)

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Health Reform and Exchange Design

IHPS provides technical assistance towards the design and implementation of Health Insurance Exchanges and related reforms.

During 2009, we provided analysis and technical assistance toward development of workable and effective federal reform provisions .

In 2010 and 2011, we have provided technical assistance to:
● California towards design of its Exchange (funded by CHCF);
● the Oregon Health Authority for Exchange and market constructs;
● and to other state and federal policy makers and agencies

A New England Journal of Medicine Perspectives article co-authored by John Graves (Vanderbilt), Rick Curtis (IHPS) and Jonathan Gruber (MIT) reports on a longitudinal analysis of whether a Basic Health Program for adults from 139%-200% FPL would reduce churning and improve continuity of coverage source and associated provider care. It compares coverage stability for subsidized persons under this option to the baseline ACA construct of Exchange coverage for those from 139-400% FPL. Findings indicate that a BHP would increase “churning” across coverage sources, i.e. it would reduce the proportion of individuals who would retain their source of coverage over the 2 years following their initial determination of eligibility.

For California, in 2010 and 2011, we completed two white papers. One white paper describes and assesses distinguishing dimensions important to the design of a successful small-employer ("SHOP") Exchange .

The other describes and assesses several alternatives that might improve the continuity and affordability problems faced by low-income adults who move back and forth across the Medicaid-Exchange threshold. It discusses the downside risks associated with one alternative--the Basic Health Program options--and presents an alternative that avoids those risks. An associated data brief expands on how income volatility creates fiscal risks for a State BHP.

For links to IHPS presen-tations and reports about Exchanges and choice pools, click here.