Daily Archives: July 31, 2009

Lazy Sundays 3

Saturday is the first day of August, and it’s going to be a busy month both in and out of Washington. If you happen to live in a “swing state” — especially if you have a moderate Republican representative (e.g., Olympia Snowe and Susan Collins) or are home to one of the now infamous “Blue Dog” Democrats (If you’re representative is on this list, I’m looking at you)– be prepared for what is going to feel like part 2 of the ’08 election.

As interest groups try to influence the public and their elected officials on health reform, here’s a look at what you can expect.

Health Bill Boils Down to August Battle
by Ben Smith and Kenneth P. Vogel

The Future of Universal Health Care, as of Now
by Robert Reich

And to prepare you for the battle ahead, a lighthearted take on health reform from Walt Handelsman

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Posted by on July 31, 2009 in Good Reading


Stop-Gap: Providing Health Coverage at the Margin

Look for “Lazy Sundays 3” later today, but first, I welcome a guest contributor to the blog. I think you’ll enjoy what she has to say….

Katherine Rogers is currently working on a PhD in Public Policy and Administration at the George Washington University, where she also received a Master of Public Health degree in health policy. She has worked in state health policy and in international alcohol policy, and her current work focuses on adolescent health. She also holds degrees from Cornell University and the University of Pennsylvania.

Most people expect, across the years of their working lives, that if they work hard, they will improve their circumstances. Years of experience and education lead to promotions, raises, and better benefits. By the time you retire, you’re at the top of your game.

But all of that makes you very expensive for your employer, and in an era of job losses and slashed benefits, more and more older adults – a little too young to retire but too qualified and expensive to find employment – are losing their jobs and the benefits they offer.

For adults ages 55 to 64, this situation can have dire consequences for health care coverage and personal health. This group – the oldest in America not covered by Medicare – tends to have more health problems and more health care costs than other age groups (simply because of their age). It is tougher for them to find affordable insurance outside of employer-sponsored options; adults ages 60 to 64 are rejected by insurers three times as often as adults ages 35 to 39. The coverage that is offered might come with high deductibles or substantial coverage exclusions.

How can we help this group? One good option already being considered in most health reform plans is a Medicare buy-in.

Such a program has some drawbacks – without subsidies, it might be subject to adverse selection and may fail to attract lower-income adults, thereby failing to make a significant dent in the uninsured population in this age group. But it also is widely popular with the public (according to a recent Kaiser poll, 77 percent of the public supports it). The option becomes more feasible (and affordable) when we limit eligibility – by income, by insurance status, or by spouse’s insurance status (i.e., if an individual is over 65, their spouse could be eligible for Medicare as well).

We might also consider some other possibilities. We could prohibit or limit insurer coverage denials in this age group to boost private individual insurance coverage. Or we could establish some form of connector that pools older adults into cheaper private group coverage regardless of employment status.

Regardless of the policy implemented, the argument for reforming health insurance options for this group is emblematic of the argument for reform on a greater scale. If we’re attempting to frame health reform as a moral issue – to establish as a symbol of our culture that we value life and health for all of our residents – than who better to illustrate that than our oldest workers?

Consider Tom Waldron, who in 1972 began working for a company and worked there for decades – until he was laid off when the economy hit the skids last year. He’s 59, probably unattractive to employers who think he’ll just retire in a few years – and the job offers he gets are on a contract basis and won’t offer him health insurance.

Currently, our national policy to address this problem is, “Sorry, but we can’t help you until you turn 65.” We need to do better – and there’s a good chance that current health reform will enable us to do so.

– Katherine Rogers

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Posted by on July 31, 2009 in Uncategorized

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