May 2004
The Rapides Foundation
In 2003, The Rapides Foundation contracted with The Lewin Group to conduct an intensive assessment of the programmatic and financial environment of primary and hospital services for the medically indigent and describe options for an affordable and more effective system of delivery.
Client Area: Foundations
Expertise Area: Health Reform
February 2004
The tax expenditure for health benefits is the amount of revenues that the federal government foregoes by exempting health benefits and spending from the federal income and Social Security taxes, including (1) employer health benefit contributions for workers and retirees, (2) health benefit deductions for the self-employed, (3) health spending under flexible spending plans, and (4) the tax deduction for health expenses. In this article, The Lewin Group estimated the amount of the tax expenditure in 2004 using its Health Benefits Simulation Model (HBSM), a microsimulation model of the U.S. health care system.
Expertise Area: Health Reform
December 2003
New York State Insurance Department
The State of New York launched the Healthy New York program in January 2001 to give working families access to affordable health insurance coverage. The Lewin Study examines the impact of Healthy NY and analyzes the enrollment, premium costs, cost experience by the HMOs, surveys the enrollees and gathers input from participating employers and participating health plans.
Client Area: State and Local Governments
Expertise Area: Health Reform
October 2003
Maryland Citizens' Health Initiative Education Fund
Lewin contact: John Sheils
In December of 2002, the Maryland Citizens' Health Initiative Education Fund Inc., released a plan to provide health insurance coverage to all Marylanders. The program requires all Maryland residents to obtain a minimum level of health insurance coverage for themselves and their children or pay a substantial tax penalty. To assist the low-income population, the program also provides subsidized coverage to adults living below 350 percent of the Federal Poverty Level (FPL), and children living below 400 percent of the FPL. In addition, the program requires that all insurers in the individual and small group market provide at least a minimum level of coverage with guaranteed issue, no pre-existing condition limitations, and with no variation in premiums by health status.
Client Area: Associations
Expertise Area: Health Reform
October 2003
Robert Wood Johnson Foundation
Lewin contact: John Sheils
The Covering America project, made possible by a grant from the Robert Wood Johnson Foundation and directed by the Economic & Social Research Institute (ESRI), promotes serious thinking and debate about comprehensive policies to extend health care coverage to uninsured Americans. In June 2001 the project published a set of 10 comprehensive health coverage proposals. The Robert Wood Johnson Foundation commissioned The Lewin Group to analyze the 10 proposals and prepare estimates of the number of people who would be covered by public and private health insurance and the costs of extending coverage. Appendices to the summary report provide a detailed explanation of the methodology used for the study, and detailed cost and coverage estimates for each proposal. Additional publications prepared for the Covering America project are posted on the ESRI website. Appendix A: The Health Benefits Simulation Model (HBSM): Uniform Methodology and Assumptions Appendix B: Reforming the Tax Treatment of Health Care to Achieve Universal Coverage, by Stuart M. Butler Appendix C: Assessing the Combination of Public Programs and Tax Credits, by Judith Feder, Larry Levitt, Ellen O'Brien, and Diane Rowland Appendix D: A Private/Public Partnership for National Health Insurance, by Jonathan Gruber Appendix E: Medicare Plus: Increasing Health Coverage by Expanding Medicare, by Jacob S. Hacker Appendix F: Expanding Health Insurance Coverage: A New Federal/State Approach, by John F. Holahan, Len M. Nichols, and Linda J. Blumberg Appendix G: A State-Based Proposal for Achieving Universal Coverage, by Richard Kronick and Thomas Rice Appendix H: An Adaptive Credit Plan for Covering the Uninsured, by Mark V. Pauly Appendix I: Near-Universal Coverage Through Health Plan Competition: An Insurance Exchange Approach, by Sara J. Singer, Alan M. Garber, and Alain C. Enthoven Appendix J: The Medical Security System: A Proposal to Ensure Health Insurance for all Americans, by Alan R. Weil Appendix K: A Plan for Achieving Universal Health Coverage: Combining the New with the Best of the Past, by Elliot K. Wicks, Jack A. Meyer, and Sharon Silow-Carroll
Client Area: Foundations
Expertise Area: Health Reform
July 2003
Wisconsin AFL-CIO
Lewin contact: John Sheils
The Lewin Group esimated the impact of adopting a Wisconsin Health Care Plan to provide health insurance to all workers and their dependents in Wisconsin. This paper describes the WHCP proposal and summarizes the assumptions used to estimate its effects. It proivdes presents estimates of the program's impact on health spending for households, emplyers, and the state and federal governments. A description of the data and methods used is presented in the report Appendices.
Expertise Area: Health Reform
December 2002
Office of Vermont Health Access
Lewin contact: John Sheils
The Lewin Group analyzed an 1115 waiver concept that would provide vouchers for the purchase of health insurance to people who are currently eligible under the Vermont Health Access Plan (VHAP) and State Children's Health Insurance Program (SCHIP). In this analysis, Lewin estimates the number of persons who would be covered under the voucher program and the cost of providing the benefits called for under the proposal. The paper also provides estimates of the impact of the waiver on the number of persons in the state of Vermont who do not have health insurance.
Client Area: State and Local Governments
Expertise Area: Health Reform, Medicaid and CHIP
October 2002
The Commonwealth Fund
Lewin contact: John Sheils
The Lewin Group developed an analysis of the cost and coverage impacts of a proposal to expand insurance coverage developed by the Commonwealth Fund. Results from the analysis were featured in a recent article in Health Affairs by Karen Davis and Cathy Schoen of the Commonwealth Fund. The proposal includes an expansion of employer sponsored coverage through a "pay-or-play" program in which employers must either provide coverage to their workers or pay a tax covering their workers under a new public program. The proposal also expands upon the existing Medicaid/SCHIP programs, provides premium subsidies to middle-income people for the purchase of insurance, creates a Medicare buy-in for people over age 60 and permits people to obtain coverage from health plans offered through the Federal Employees Health Benefits Program (FEHBP).
Client Area: Foundations
Expertise Area: Health Reform
April 2002
California Health and Human Services Agency
Lewin contact: John Sheils
The California Health and Human Services Agency engaged The Lewin Group to analyze the cost and coverage impacts of nine proposals to expand health insurance coverage in the state. The analysis included estimating the portion of the 6.6 million uninsured persons in California who would become insured under each proposal.
Client Area: State and Local Governments
Expertise Area: Health Reform
March 2002
South Dakota Department of Health
Lewin contact: John Sheils
In 2001 South Dakota was one of nine states awarded one-year grants from the federal Health Resources and Services Administration (HRSA) to conduct a survey and study of the state's uninsured population. The state contracted with The Lewin Group to conduct the survey which included statewide telephone surveys of more than 20,000 households and also of 401 South Dakota employers. Eight focus group interviews were also conducted with selected high-risk populations such as farmers and ranchers, Native Americans and low-income households.
Client Area: State and Local Governments
Expertise Area: Health Reform
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