May 2009
Lewin contact: John Sheils
Statement for the Senate Committee on Finance
Submitted by: John Sheils, Vice President, The Lewin Group
May 12, 2009
Health reform can be funded with new revenues and savings to existing federal programs. In this analysis we examine two tax-based options that would both raise revenues and reduce health spending. These include placing limits on the tax exclusion for employer health benefits and a large increase in the tax on tobacco products. We also discuss potential savings to existing federal safety-net programs under expansions in coverage that could be redirected to help pay for health reform.
We estimate that these three proposals would raise about $1.25 trillion in revenues and savings to federal programs over the 2010 through 2019 period. This is roughly equal the amount of funding required to pay for the health reform program proposed by President Obama in the 2008 campaign ($1.17 trillion). These provisions would also reduce national health spending by about $461.0 billion over this period.
Expertise Area: Health Reform
April 2009
Lewin contact: John Sheils
The Cost and Coverage Impacts of a Public Plan
Testimony before the House Ways and Means Committee Hearing on Health Reform in the 21st Century: Employer Sponsored Insurance
Submitted by: John Sheils, Vice President, The Lewin Group
April 29, 2009
President Obama and Senator Baucus have proposed to create an “exchange” offering individuals and employers a selection of health plans. They also propose to create a new “public plan” that would compete for enrollment with private insurance plans in the exchange.
Premiums under the public plan would be up to 30 percent less than private insurance plans if Medicare payment levels are used. Due to this substantial cost advantage, we estimate that up to 119.1 million of the 171.6 million people who now have private employer or non-group coverage would move to the public plan (70 percent).
Expertise Area: Health Reform
April 2009
Lewin Contact: John Sheils
Combined Baucus And Wyden Plan Meets President's Health Reform Goals, Controls Costs And Expands Coverage To All Without Increasing Federal Deficit
This report identifies similarities and differences of the coverage provisions of the Healthy Americans Act (HAA, led by Senators Wyden and Bennett, with 14 bipartisan co-sponsors) and the proposal offered by Senator Baucus, and presents ideas on how these differences could be resolved. Lewin Group researchers identify the specific elements of both proposals taken together that would meet President Obama’s eight health reform goals stated in the budget proposal to Congress, forming a bill that achieves universal coverage and controls cost in the public and private sectors, without increasing the federal deficit. Finally, due to the complexity of reform, the paper discusses how the coverage provisions could be phased-in over a period of four years as suggested in the Baucus report.
Expertise Area: Health Reform
April 2009
Lewin contact: John Sheils
The Lewin Group released a report today titled “The Cost and Coverage Impacts of a Public Plan: Alternative Design Options.” This report examines potential impacts that a “public health plan” might have in competing for enrollment with the private insurance industry. A public plan is currently being considered in a number of health reform proposals being considered by President Obama and the U.S. Congress. This analysis enhances prior work done by The Lewin Group of the major party presidential candidate health reform proposals during the 2008 campaign, as well as more recent analyses of Congressional plans being considered. The report estimates the impact on cost and coverage based on different levels of eligibility and reimbursement rates.
Expertise Area: Health Reform
March 2009
Lewin contact: John Sheils
The purpose of this document is to describe the data and methods used to develop the Lewin Group Health Benefits Simulation Model (HBSM).
The Health Benefits Simulation Model is a micro-simulation model of the U.S. health care system. HBSM is a fully integrated platform for simulating policies ranging from narrowly defined Medicaid coverage expansions to broad-based reforms such as changes in the tax treatment of health benefits. The model is also designed to simulate the impact of numerous universal coverage proposals such as single-payer plans and employer mandates. The use of a single modeling system for these analyses helps assure that simulations of alternative proposals are executed with uniform and internally consistent methodologies.
Expertise Area: Health Reform
March 2009
Lewin contact: John Sheils
This report provides estimates of the cost and coverage impacts of the Healthy Americans Act as introduced on February 5, 2009 (S. 391). It provides estimates of cost effects for the federal government, state and local governments, private employers and families, assuming the program is fully implemented in 2011. It also provides estimates of the average cost impacts of the Act for families by income, age and current coverage status.
Client Area: Federal Government
Expertise Area: Health Reform
February 2009
The Commonwealth Fund
Lewin contact: John Sheils
This document presents the approach used by The Lewin Group to estimate the impact of the Commonwealth Fund’s health reform proposal entitled “Path to a High-Performance Health Care System.” The report describe the provisions of the plan and explains how Lewin simulated the plan’s impact on coverage and costs for households, employers, the federal government and state and local governments. It also presents the methodology used to estimate the cost impacts of a series of system savings initiatives included in the proposal.
The primary analytic tool used in the analysis is The Lewin Group Health Benefits Simulation Model (HBSM). The model is designed to show the impact of major health reform plans on major stakeholder groups. It provides estimates of enrollment and costs under alternative health reform plans that reflect the impact of financial incentives created under the plan. Lewin supplemented the model with separate analysis of the various system savings proposals. For each initiative, the report provides a description of the proposal, a review of the available research and evidence on the options and Lewin's estimates of the program’s impact over five-, ten- and fifteen-year periods.
Client Area: Foundations
Expertise Area: Health Reform
February 2009
Lewin contact: John Sheils
Presentation by John Sheils to Senate Republicans and Staff February 11, 2009.
Client Area: Federal Government
Expertise Area: Health Reform
January 2009
The Commonwealth Fund
Lewin contact: John Sheils
The Commonwealth Fund commissioned The Lewin Group to estimate the cost and coverage impacts for each of the proposals examined in this report.
Client Area: Foundations
Expertise Area: Health Reform
December 2008
Lewin contact: John Sheils
In this paper the authors show that bold comprehensive reforms offering immediate coverage for all Americans are actually less expensive than incremental efforts to build upon the existing system. It is possible to cover all Americans without increasing national health spending and without rationing care. Costs can be reduced for American consumers in general and the federal government in particular under broad-based universal coverage reforms. To demonstrate this the paper compares the cost of two comprehensive health reform plans -- the “Healthy Americans Act” developed by Senator’s Wyden and Bennett t and a government-based approach that would cover all Americans under an expanded Medicare program -- to the cost of the incrementally-based health reform proposals introduced by President-elect Obama and Senator McCain in the 2008 presidential election.
Expertise Area: Health Reform
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