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1 Health Insurance Coverage for People under Age 65: Definitions and Estimates for 2015 to 2018 1 (April 2019)

handle is hein.congrec/hicovppl0001 and id is 1 raw text is: ~APRIL 2019 Health Insurance Coverage for People Under Age 65: Definitions and Estimates for 2015 to 2018 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 years for which his- torical outcomes are available serve as the starting points for CBO's projections of health insurance coverage. This report provides details about those starting points. 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; Describes the individual data sources CBO uses to compile preliminary estimates of historical outcomes, and the limitations of those sources; and Compares preliminary estimates of historical outcomes with CBO's integrated estimates of coverage (that are consistent with each other and that sum to accurately depict the total population) for 2015 to 2018. 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.

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