How auto-enrollment can achieve near-universal coverage: policy and implementation issues

How auto-enrollment can achieve near-universal coverage: policy and implementation issues

Collection:
Health Policy and Services Research
Author(s):
Blumberg, Linda J., author
Holahan, John, author
Levitis, Jason, author
Contributor(s):
Commonwealth Fund, issuing body.
Publication:
[New York, New York] : The Commonwealth Fund, June 2021
Language(s):
English
Format:
Text
Subject(s):
Eligibility Determination
Health Policy
Universal Health Insurance
United States
United States.
Genre(s):
Technical Report
Abstract:
Issue. Automatic enrollment is receiving increased policy attention as a means of achieving universal coverage. Auto-enrollment also could have eliminated insurance gaps that occurred during the COVID-19 pandemic. However, it could face resistance from some Americans who would newly be expected to pay premiums. The approach also raises difficult design and implementation issues. Goal. Explore how two auto-enrollment strategies, one affecting all legal residents and another affecting a narrower low-income population, might work. Methods. Based on lessons learned from the Affordable Care Act and understanding of subsidized insurance programs, we explore design and implementation issues, such as how to deem enrollment, how to collect premiums, and which exemptions to permit. We also use the Urban Institute's Health Insurance Policy Simulation Model (HIPSM) to estimate coverage and cost implications of each approach. Key Findings and Conclusions. Both the comprehensive and limited approach to auto-enrollment would require the development of new administrative systems and enhanced marketplace subsidies to improve coverage affordability. Each approach would operate more simply if accompanied by a public insurance option. We conclude that the administrative and financing challenges related to auto-enrollment can be addressed and that a balance between public costs and sufficient political support could be identified.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
Extent:
1 online resource (1 PDF file (14 pages))
Illustrations:
Illustrations
NLM Unique ID:
9918300867706676 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/9918300867706676