Recognizing the achievements of the Social Health Maintenance Organization (SHMO) demonstration sites.
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"Longlife insurance" combines nursing home, home health, and deferred annuity benefits. It costs less than life care, allows the elderly to remain in their own homes, and protects assets. Adverse selection is limited because the plan is attractive to both frail and healthy elders. An analysis of 18,600 respondents in the Social Security Administration's New Beneficiary Survey indicates that 67 percent of all retirees could afford a typical longlife insurance plan. However, less than one-half of all females living alone, 24 percent of minorities, and 8 percent of the disabled could pay privately.
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The American Council of Life Insurance is a national trade association that represents the interests of legal reserve life insurance companies in legislative, regulatory and judicial matters at the federal, state and municipal levels of government and at the National Association of Insurance Commissioners. Its member companies hold more than 90 percent of the life insurance in force in the United States.
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It is now an open question whether Medicare will provide adequate health coverage to the baby-boom generation as it begins turning 65 just over a decade from now. The source of uncertainty is not whether America has the resources to sustain the program; we do. The real challenge comes instead from proposals to save Medicare. Far from preserving its benefits, the major restructuring proposals under discussion would radically alter the principles on which Medicare rests and erode the protection it affords.
Policymakers interested in subsidizing low-income people's purchase of private insurance face two major questions: will such subsidies lead to adverse selection, and how large do the subsidies have to be to induce large numbers of eligible people to purchase the insurance? This study examines New Jersey's short-lived experience with a premium subsidy program, Health Access New Jersey (Access Program). The program was for people in families with incomes below 250% of the poverty level who were not eligible for health insurance provided by an employer, or Medicaid or Medicare, and who wished to purchase policies in the state's individual health insurance market, the Individual Health Coverage Program. Surveying a random sample of Access Program policyholders, we compared their demographic and socioeconomic characteristics, as well as their health status, to those of other New Jersey residents who had family incomes below 250% of the poverty level to determine whether there was any evidence of adverse selection among the people who enrolled in the Access Program. The people who enrolled were not in worse health than uninsured people with incomes below 250% of the poverty level, but they were quite price sensitive. Most enrollees had incomes within the low end of the income eligibility distribution, reflecting the structure of rapidly declining subsidies as income increased.
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