Health Care » Reliability

Once a woman has chosen a plan that is affordable and provides adequate coverage for her or her family, there is little assurance that it will be there over the long haul.

There is significant instability in the insurance market, with an average of two million Americans losing or changing their health insurance every month.

Often this is outside of an individual’s hands; insurance plans change their offerings or provider networks, an individual loses her job or has to cut back to part-time work to care for a child or aging parent, or public programs cut or change eligibility requirements.

Low-income Americans are most likely to be affected; more than two-thirds went without health coverage at some point from 1996 to 2000. The recession will make matters worse, as workers lose jobs and employers cut back on benefits.

Our Recommendations

To help increase the reliability and stability of health coverage, especially for women and low-income individuals, the government must eliminate barriers to enrollment in public programs.

States should not require time-consuming face-to-face interviews to determine eligibility. They should implement continuous eligibility and seamless and convenient enrollment and redetermination processes critical components to ensuring that those who are eligible for public programs get and stay enrolled. And any new health insurance exchange should provide mechanisms to automatically match women and families to any programs for which they might be eligible, such as Medicaid, the Children’s Health Insurance Program, or subsidized private coverage.

Another way to ensure stability and continuity in the marketplace is through a public health insurance plan option. A public health insurance option can help provide a “benchmark,” to give consumers something against which to compare private plan options. It can also serve as a source of stability and continuity in the marketplace, particularly for rural and underserved areas, or areas in which there has been significant plan consolidation. In addition, it can help keep premiums low over the long term by implementing payment and delivery system reform to promote prevention and chronic care management, reduce administrative costs, and standardize claims, payment and other processes.

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(This information and more is included in our detailed report, Health Care Reform: What Women Need.)