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Paving the Difficult Road to Universal Insurance Coverage: Spotlight on U.S. Innovators

Posted on: Tuesday, 9 October 2007, 15:00 CDT

Research and Markets (http://www.researchandmarkets.com/reports/c70951) announced the addition of new Decision Resources report Paving the Difficult Road to Universal Insurance Coverage: Spotlight on U.S. Innovators to their offering.

The controversial issue of establishing universal health insurance has recently reclaimed the spotlight in the United States. Various states, members of Congress, President George W. Bush, and 2008 presidential hopefuls are proposing plans to make health insurance more accessible to the approximately 47 million U.S. residents who do not have coverage.

Get the Answers You Need to Shape Your Strategy

- Massachusetts, Maine, and Vermont are leading the way in expanding universal health care coverage.

How have these states achieved consensus on such a hot button issue? What are the key elements of these state health care plans? What are the implications for other reform efforts?

- Other states have expressed considerable interest in Massachusetts' groundbreaking universal coverage plan.

Which states have viable programs on the horizon? What have they learned from the Massachusetts planning and implementation process that will help them develop their own successful new universal coverage plans?

- As this flurry of state health reform activity continues, proposals at the federal level aim to complement state efforts or to set in motion sweeping national reform. Which initiatives have gained national support? Which of the universal coverage bills in Congress target drug pricing?

- Universal coverage proposals may threaten to take greater control over drug prices. Would new initiatives give states the power to negotiate drug prices with manufacturers? Are proposals requiring drug-price negotiation likely to garner much support in the near future?

Scope

- Massachusetts: leading the way. Details on passage and implementation of the plan, the mandate for individual coverage, employer responsibilities, implications for other reform efforts, and future challenges.

- Maine: at the forefront of universal coverage. DirigoChoice plan details, cost-containment reforms, Maine Quality Forum, implications for other reform efforts, and future challenges.

- Vermont: implementation looming. Catamount Health plan details, employer responsibilities, chronic care initiatives, implications for other reform efforts, and future challenges.

- National solutions: universal coverage at the federal level. The Bush administration proposal, Medicare for All, Healthy Americans Act, and state/federal partnerships.

- Future perspectives: promise and problems. Value of compromise and cooperation, potential pitfalls for state initiatives, cost-control issues, and drug pricing.

Content Outline:

Executive Summary

Strategic Considerations

Stakeholder Implications

An Old Debate Takes on New Urgency

Massachusetts Provides a Model

Commonwealth Health Insurance Connector

Defining Minimal Creditable Coverage

Defining Affordability

Commonwealth Care Health Insurance Program

Medicaid Expansions and Restorations

Commonwealth Choice Health Insurance Program

Mandating Coverage for All

Employer Responsibilities

Learning from the Massachusetts Experience: Implications for Other Reform Efforts

Future Challenges

Communication

Affordability

Primary Care Provider Shortage

Employer Challenges

Sustainability and Cost-Containment

Maine and Vermont: Other Innovators at the Forefront

Maine

DirigoChoice

Cost-Containment Reforms

Maine Quality Forum

Learning from the Maine Experience: Implications for Other Reform Efforts

Future Challenges for Maine

Vermont

Catamount Health Insurance Plan

Employer Responsibilities

Chronic Care Initiatives

Learning from the Vermont Experience: Implications for Other Reform Efforts

Future Challenges for Vermont

In Search of a National Solution: Universal Coverage Proposals at the Federal Level

Bush Administration Tax Reform Proposal

Details of the Bush Proposal

Problems with the Bush Proposal

Starting a National Discussion

Universal Coverage Bills in Congress

Medicare for All

Healthy Americans Act

State/Federal Partnerships

Future Perspectives

Importance of Federal/State Partnerships

Potential Pitfalls for State Initiatives

A Key Issue: Addressing Costs

Controlling Current Costs and Spending Growth

Targeting Drug Prices

Increasing Patient Cost-Sharing

A Long Road Ahead

List of Tables

List of Figures

Companies Mentioned:

- Anthem Blue Cross and Blue Shield

- Biogen Idec

- Blue Cross and Blue Shield

- Blue Cross and Blue Shield of Massachusetts

- ConnectiCare

- Fallon Community Health Plan

- Harvard Pilgrim Health Care

- Health New England

- Janssen-Cilag

- MVP Health Care

- Neighborhood Health Plan

- Tufts Health Plan

- Wal-Mart Stores

Organizations/Agencies Mentioned:

- Bi-State Primary Research Association

- Centers for Medicare and Medicaid Services (CMS)

- Coalition to Advance Healthcare Reform (CAHR)

- Congressional Budget Office

- Commonwealth Fund

- General Accounting Office (GAO)

- Health Care Quality and Cost Council (HCQCC)

- Lewin Group

- Massachusetts Medical Society

- National Institute for Clinical Excellence (NICE)

- Project Hope

- Tax Foundation

- U.K. National Health Service (NHS)

- U.S. Department of Health and Human Services

(HHS)

- Vermont Public Interest Research Group (VPIRG)

Government Programs/Initiatives/Legislation Mentioned:

- Affordable Choices Initiative

- Blueprint for Health program (Vermont)

- Catamount Health (Vermont)

- Consolidated Omnibus Budget Reconciliation Act

(COBRA)

- Commonwealth Choice (Massachusetts)

- Commonwealth Care Health Insurance Program

(Massachusetts)

- Commonwealth Health Insurance Connector

Authority (Massachusetts)

- Dirigo Health Reform Act (Maine)

- DirigoChoice (Maine)

- Employee Retirement Income Security Act (ERISA)

- Federal Employees Health Benefits Program

(FEHBP)

- Global Commitment to Health

- Green Mountain health plan (Vermont)

- Health Partnership Act

- Health Partnership through Creative Federalism Act

- Healthy Americans Act

- Health Help Agencies (HHAs)

- 2006 Health Care Affordability Act (Vermont)

- Health Insurance Flexibility and Accountability

(HIFA)

- MaineCare

- Maine Quality Forum

- Maine Rx Plus

- Maryland Fair Share Health Care Fund Act ("Wal-

Mart Bill")

- Massachusetts Health Care Reform

- MassHealth

- Medicaid

- Medicare

- Medicare for All Act

- Medicare Trust Fund

- State Children's Health Insurance Program (SCHIP)

- Vermont Health Access Plan (VHAP)

For more information visit http://www.researchandmarkets.com/reports/c70951

Source: Business Wire

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