New Georgia and Florida Health Plans Unlikely to Reduce Ranks of Uninsured
End Notes
[1] John E. McDonough, et al., “A Progress Report on State Health Access Reform, Health Affairs web exclusive, January 20, 2008.
[2] Center on Budget and Policy Priorities analysis of 2007 Current Population Survey data.
[3] See, for example, Linda J. Blumberg et al., “Setting a Standard of Affordability for Health Insurance Coverage,” Health Affairs web exclusive, June 4, 2007.
[4] Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2006 and 2007 Current Population Survey.
[5] Ron Bachman, “The Impact of Insuring 500,000 Georgians Previously Uninsured,” Center for Health Transformation, June 2008.
[6] In tax year 2008, federal law defines a “high-deductible” health plan as one with a deductible of at least $1,100 for individual coverage and $2,200 for family coverage. An overview of the major flaws with HSAs and high-deductible health plans along with citations to numerous studies and papers is at https://www.cbpp.org/pubs/hsa.htm.
[7] Office of Governor Sonny Perdue, “Governor Perdue Signs Healthcare Reform Bills,” May 7, 2008.
[8] Aaron Gould Sheinin, “Perdue signs high-deductible insurance plan bill,” The Atlanta Journal-Constitution, May 7, 2008.
[9] See Timothy Sweeney, “Analysis of HB 977,” Georgia Budget and Policy Institute, March 2008.
[10] Sweeney.
[11] Paul Gessing, “State should follow Georgia’s model on health care, Las Cruces Sun-News, June 3, 2008. See also, Ronald E. Bachman, “A Guide for State Legislators: Creating an HSA State,” Center for Health Transformation, March 2007.
[12] Georgia Department of Audits and Accounts, letter to Honorable Judson Hill, March 25, 2008. See also Sweeney, note 10. The $223 million projection assumed the local tax changes would take effect in July 2008, not January 2009 as finally enacted, so the actual revenue loss over this five-year period would be somewhat lower.
[13] The GAO study also found that high-income individuals are using HSAs as tax shelters. “Consumer-Directed Health Plans: Small But Growing Enrollment Fueled by Rising Cost of Health Care Coverage,” Government Accountability Office, GAO-06-514, April 28, 2006.
[14] Schoen et al., “How Many are Underinsured? Trends Among U.S. Adults, 2003 and 2007,” Health Affairs web exclusive, June 10, 2008.
[15] Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2006 and 2007 Current Population Survey.
[16] Senate Bill 2534, which Governor Crist signed on May 21, 2008. The law does not specify a maximum time period for exclusion of coverage for pre-existing conditions.
[17] There are some exceptions to the six-month requirement, such as people who have exhausted their coverage under COBRA or lost a job that offered health insurance.
18] Kevin Sack, “New Florida Law Allows Low-Cost Health Policies,” The New York Times, May 22, 2008.
[19] Like many states, Florida allows insurers selling in the individual health insurance market to vary premiums based on an individual’s health status. “Failing Grades: State Consumer Protections in the Individual Health Insurance Market,” Families USA, June 2008.
[20] “The Florida Revelation. . . ,” The Wall Street Journal, May 29, 2008; Sack.
[21] Jonathan Gruber, “Covering the Uninsured in the United States,” NBER Working Paper 13758, January 2008.
[22] Isabel Friedenzohn, “Limited-Benefit Policies: Public and Private-Sector Experiences,” State Coverage Initiatives, July 2004.
[23] Sack.
[24] The 2008 legislation establishing Cover Florida reauthorizes the Health Flex Plan through 2013 and raises the income limit for participants from 200 to 300 percent of the poverty line.
[25] Health Flex Plan Program: Annual Report, Agency for Health Care Administration, January 2008.
[26] Sherry Glied et al., “Bare-Bones Health Plans: Are They Worth the Money?” The Commonwealth Fund, May 2002; Kyung Song, “Bare-bones health plan left family swimming in debts,” The Seattle Times, February 28, 2008.
[27] The research on cost-sharing and premiums is summarized in Leighton Ku and Victoria Wachino, “The Effect of Increased Cost-Sharing in Medicaid: A Summary of Research Findings,” Center on Budget and Policy Priorities, July 7, 2005.
[28] David U. Himmelstein et al., “Illness and Injury as Contributors to Bankruptcy,” Health Affairs web exclusive, February 2005.