This paper presents an overview of recent U.S. fiscal developments and discusses possible implications of the sharp turn around in the government’s fiscal position. Against this back ground, it also reviews key policy challenges that will need to be addressed to cope with the mounting...

Despite the increasing interest in universal health care, little is known about the optimal way to finance, design, and implement it. This paper attempts to fill this gap by providing some general policy recommendations on this important issue. While most of the paper addresses the Eastern...

This article outlines strategies proposed to expand health insurance, many of which have been tried in limited ways, and describes experiences with these attempts. The discussion is organized from the perspective of two opposing points of view: (1) approaches that would support private coverage...

Medicare Advantage (MA), a voluntary program that provides beneficiaries with an alternative way to access traditional Medicare benefits, replaced the Medicare+Choice program in 2004 and became fully operational in 2006. This issue brief reviews recent trends in the program and includes...

Examines the relationship between rising Medicare risk and Medicare+Choice enrollment and the claims experience reported by Medigap insurers between 1996 and 1999. Concludes that adverse selection into Medicare HMOs has probably reduced average medical claims in standard Medigap plans, with a...

Recently, some states have revisited the concept of reinsurance to spread risk in insurance markets, improve the predictability of claims, and reduce the markup of premiums that insurers charge as a buffer against unanticipated claims. This brief examines efforts in Arizona, Connecticut, Idaho,...

This article examines the lessons and limits of Medicare Advantage, private health plans, and market competition as proposed solutions to traditional Medicare's rising costs and growing eligibility rolls. Gold reviews Medicare's 30-year experience with voluntary private-plan...

This chartbook provides a snapshot of Medicaid pharmacy benefit use and reimbursement in 2003 and shows key trends from 1999 to 2003.

This report provides state-level data on annual and quarterly enrollment in SCHIP and Medicaid, from fiscal years 1998 through 2001. It augments the 39;47 annual reports on SCHIP enrollment trends by (1) using information on program characteristics to analyze differences in state enrollment...

Mathematica evaluated five health care reform proposals for the state of Washington in 2008. The proposals featured, respectively: reduced regulation in the current market; Massachusetts-style insurance reforms with a health insurance connector; a health partnership program similar to the...