About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline
LOG IN
LOG IN

1 How CBO Defines and Estimates Health Insurance Coverage for People under Age 65 1 (May 2018)

handle is hein.congrec/cbodehi0001 and id is 1 raw text is: MAY 2018 How CBO Defines and Estimates Health Insurance Coverage for People Under Age 65 In the United States, most people under age 65 are covered by private health insurance that they or their family members obtain through their employers (referred to as employment-based, or group, coverage). A smaller number of people buy private health insurance individ- ually (through what is known as the nongroup market). Nongroup policies are available through the health insurance marketplaces established under the Affordable Care Act (ACA) or outside of them, through brokers or directly from insurers. Two of the major sources of public insurance coverage for people under 65 are Medicaid and the Children's Health Insurance Program (CHIP). The federal government subsidizes private and public insurance coverage through various tax preferences and federal programs. Because those subsidies affect the federal budget in many ways, defining what constitutes coverage and estimating health insurance coverage for people under 65 are important steps in the process of preparing the Congressional Budget Office's baseline budget projections. The most recent year for which actual coverage data are available serves as the starting point for CBO's projections of health insurance cov- erage. This report provides details about that starting point. Specifically, the report: Describes how CBO defines health insurance coverage (private and public) for people under 65 who are not institutionalized and who are not members of the active-duty military; a Explains how the agency estimates the number of insured and uninsured people in that population for the most recent year for which data on actual coverage exist; and * Describes where CBO obtains the data to estimate coverage, the limitations of those sources, and how the agency adjusts its estimates because of those limitations. (For a discussion of related work by CBO and other researchers, see the Appendix.) How Does CBO Define Private Insurance Coverage? Health insurance policies vary widely, ranging from those that offer substantial coverage for a variety of health care services to those that are limited in scope or offer a small amount of coverage. Therefore, in preparing any estimate of the number of people covered by health insurance, it is useful and important to identify where to draw the line when distinguishing between policies that provide comprehensive coverage and those that do not. An important function of insurance is to provide finan- cial protection against high-cost, low-probability events (such as car accidents, fires, or floods). Consistent with that notion, in the context of health care costs, CBO broadly defines private health insurance coverage as a policy that, at a minimum, covers high-cost medical events and various services, including those provided by physicians and hospitals. This type of coverage is often referred to as comprehensive major medical coverage. The agency grounds its coverage estimates on that widely accepted definition, which encompasses most private health insurance plans offered in the group and nongroup markets. The definition may include some short-term, limited-duration policies that provide com- prehensive major medical coverage for a specified period and plans with very high deductibles. The desirability or adequacy of such coverage will vary on the basis of

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Short-term subscription options include 24 hours, 48 hours, or 1 week to HeinOnline.

Purchase Access

Contact us for annual subscription options:

Contact Us

Already a HeinOnline Subscriber?

Log In

profiles profiles most