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Health insurance in the United States

Health insurance in the United States Insurance Company Details

Health insurance in the United States Plans details Review

  • Federal Employees Health Benefits Program
  • Indian Health Service
  • Medicaid / State Health Insurance Assistance Program (SHIP)
  • Medicare
  • Prescription Assistance (SPAP)
  • Military Health System / TRICARE
  • State Children’s Health Insurance Program (CHIP)
  • Program of All-Inclusive Care for the Elderly (PACE)
  • Veterans Health Administration
  • Consumer-driven healthcare

    • Flexible spending account (FSA)
    • Health Reimbursement Account
    • Health savings account (HSA)

      • High-deductible health plan (HDHP)
      • Medical savings account (MSA)
    • Private Fee-For-Service (PFFS)
  • Health insurance in the United States
  • Managed care (CCP)

    • Exclusive provider organization (EPO)
    • Health maintenance organization (HMO)
    • Preferred provider organization (PPO)
  • Medical underwriting
  • Flexible spending account (FSA)
  • Health Reimbursement Account
  • Health savings account (HSA)

    • High-deductible health plan (HDHP)
    • Medical savings account (MSA)
  • Private Fee-For-Service (PFFS)
  • High-deductible health plan (HDHP)
  • Medical savings account (MSA)
  • Exclusive provider organization (EPO)
  • Health maintenance organization (HMO)
  • Preferred provider organization (PPO)
  • Emergency Medical Treatment and Active Labor Act (1986)
  • Health Insurance Portability and Accountability Act (1996)
  • Medicare Prescription Drug, Improvement, and Modernization Act (2003)
  • Patient Safety and Quality Improvement Act (2005)
  • Health Information Technology for Economic and Clinical Health Act (2009)
  • Patient Protection and Affordable Care Act (2010)
  • Healthcare in California

    • Healthy San Francisco
    • Healthy Way LA
    • My Health LA
  • Fair Share Health Care Act (Maryland)
  • Healthy Howard (Howard Co., Maryland)
  • Healthy San Francisco
  • Healthy Way LA
  • My Health LA
  • v
  • t
  • e

Health insurance in the United States is any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include “health coverage”, “health care coverage”, and “health benefits”.
In a more technical sense, the term “health insurance” is used to describe any form of insurance providing protection against the costs of medical services. This usage includes private insurance and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children’s Health Insurance Program, which both provide assistance to people who cannot afford health coverage.

In addition to medical expense insurance, “health insurance” may also refer to insurance covering disability or long-term nursing or custodial care needs. Different health insurance provides different levels of financial protection and the scope of coverage can vary widely, with more than 40% of insured individuals reporting that their plans do not adequately meet their needs as of 2007.

The share of Americans without health insurance has been cut in half since 2013. Many of the reforms instituted by the Affordable Care Act of 2010 were designed to extend health care coverage to those without it; however, high cost growth continues unabated. National health expenditures are projected to grow 4.7% per person per year from 2016 to 2025. Public healthcare spending was 29% of federal mandated spending in 1990 and 35% of it in 2000. It is also projected to be roughly half in 2025.

Health insurance in the United States Enrollment and the uninsured

Gallup issued a report in July 2014 stating that the uninsured rate for adults 18 and over declined from 18% in 2013 to 13.4% by in 2014, largely because there were new coverage options and market reforms under the Affordable Care Act. Rand Corporation had similar findings.

Health insurance in the United States Trends in private coverage

The proportion of non-elderly individuals with employer-sponsored cover fell from 66% in 2000 to 56% in 2010, then stabilized following the passage of the Affordable Care Act. Employees who worked part-time (less than 30 hours a week) were less likely to be offered coverage by their employer than were employees who worked full-time (21% vs. 72%).

A major trend in employer sponsored cover has been increasing premiums, deductibles, and co-payments for medical services, and increasing the costs of using out-of-network health providers rather than in-network providers.

Health insurance in the United States Trends in public coverage

Public insurance cover increased from 2000–2010 in part because of an aging population and an economic downturn in the latter part of the decade. Funding for Medicaid and CHIP expanded significantly under the 2010 health reform bill. The proportion of individuals covered by Medicaid increased from 10.5% in 2000 to 14.5% in 2010 and 20% in 2015. The proportion covered by Medicare increased from 13.5% in 2000 to 15.9% in 2010, then decreased to 14% in 2015.

Health insurance in the United States Status of the uninsured

The uninsured proportion was stable at 14–15% from 1990 to 2008, then rose to a peak of 18% in Q3 2013 and rapidly fell to 11% in 2015. The proportion without insurance has stabilized at 9%.

A 2011 study found that there were 2.1 million hospital stays for uninsured patients, accounting for 4.4% ($17.1 billion) of total aggregate inpatient hospital costs in the United States. The costs of treating the uninsured must often be absorbed by providers as charity care, passed on to the insured via cost-shifting and higher health insurance premiums, or paid by taxpayers through higher taxes.

Health insurance in the United States Death

Since people who lack health insurance are unable to obtain timely medical care, they have a 40% higher risk of death in any given year than those with health insurance, according to a study published in the American Journal of Public Health. The study estimated that in 2005 in the United States, there were 45,000 deaths associated with lack of health insurance. A 2008 systematic review found consistent evidence that health insurance increased utilization of services and improved health.

Health insurance in the United States Managed care

Rise of managed care in the US[clarification needed]
YearConventional
plans
HMOs PPOs POS
plans
HDHP/SOs
199814%27%35%24%
199910%28%39%24%
20008%29%42%21%
20017%24%46%23%
20024%27%52%18%
20035%24%54%17%
20045%25%55%15%
20053%21%61%15%
20063%20%60%13%4%
20073%21%57%15%5%
20082%20%58%12%8%
20091%20%60%10%8%
20101%19%58%8%13%
20111%17%55%10%17%
2012<1%16%56%9%19%
2013<1%14%57%9%20%
2014<1%13%55%23%27%
20151%17%50%26%26%
20162%23%35%32%28%

Health insurance in the United States Network-based managed care

  • A set of selected providers that furnish a comprehensive array of health care services to enrollees;
  • Explicit standards for selecting providers;
  • Formal utilization review and quality improvement programs;
  • An emphasis on preventive care; and
  • Financial incentives to encourage enrollees to use care efficiently.

Health insurance in the United States Supplemental coverage

  • Supplement a primary medical expense plan by paying for expenses that are excluded or subject to the primary plan’s cost-sharing requirements (e.g., co-payments, deductibles, etc.);
  • Cover related expenses such as dental or vision care;
  • Assist with additional expenses that may be associated with a serious illness or injury.

Health insurance in the United States Accidental death and dismemberment insurance

  • Insurance companies have high administrative costs. Private health insurers are a significant portion of the U.S. economy directly employing (in 2004) almost 470,000 people at an average salary of $61,409.
  • Health insurance companies are not actually providing traditional insurance, which involves the pooling of risk, because the vast majority of purchasers actually do face the harms that they are “insuring” against. Instead, as Edward Beiser and Jacob Appel have separately argued, health insurers are better thought of as low-risk money managers who pocket the interest on what are really long-term healthcare savings accounts.
  • According to a study by a pro-health reform group published February 11, the nation’s largest five health insurance companies posted a 56 percent gain in 2009 profits over 2008. The insurers (Anthem, UnitedHealth, Cigna, Aetna and Humana) cover the majority of Americans with health insurance.
  • Health care reform
  • Healthcare reform in the United States
  • Health insurance costs in the United States
  • Health insurance coverage in the United States
  • List of healthcare reform advocacy groups in the United States
  • Massachusetts health care reform
  • Medicare Rights Center
  • Medicaid estate recovery
  • Physicians for a National Health Program
  • Publicly funded health care
  • RAND Health Insurance Experiment
  • Sicko
  • Single-payer healthcare
  • United States National Health Care Act
  • Health economics
  • National health insurance
  • Public health
  • Universal health care
  • Welfare

Health insurance in the United States biography Net worth, Details Reference

  • Health Insurance | USA.gov
  • Health insurance in the United States
  • Medicare and Medicaid (United States)
  • Webarchive template wayback links
  • CS1 maint: BOT: original-url status unknown
  • CS1 errors: missing periodical
  • Pages with DOIs inactive as of 2020 January
  • CS1 maint: archived copy as title
  • NPOV disputes from August 2019
  • All NPOV disputes
  • Use mdy dates from February 2015
  • Wikipedia articles needing clarification from September 2017
  • All articles with vague or ambiguous time
  • Vague or ambiguous time from September 2017
  • All articles with unsourced statements
  • Articles with unsourced statements from September 2010
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Updated: April 22, 2020 — 11:35 pm

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