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Publications by Karen Pollitz for Health Policy Center

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Protecting High-Risk, High-Cost Patients: "Essential Health Benefits," "Actuarial Value," and Other Tools in the Affordable Care Act (Policy Briefs/Timely Analysis of Health Policy Issues)
Lisa Clemans-Cope, Linda J. Blumberg, Judy Feder, Karen Pollitz

The Affordable Care Act (ACA) will dramatically improve the nongroup and small group health insurance markets for everyone in them, including the high-risk population. But insurance reforms, guided by requirements for minimum or "essential health benefits," insurance plan actuarial value and other tools provided by the ACA, are and will remain a work in progress. This analysis suggests the way these tools-working together and reevaluated over time-can most effectively ensure that ACA implementation progresses toward the goals of adequate and affordable insurance protection, especially for the highest-need, highest cost patients.

Posted: June 14, 2012Availability: HTML | PDF

Cross-State Risk Pooling Under Health Care Reform: An Analytic Review of the Provisions in the House and Senate Bills (Research Report)
Linda J. Blumberg, Karen Pollitz

How health care risk is pooled is of defining importance to health care systems. This paper explores provisions in the House and Senate health reform bills that could pool risk across state lines. These provisions include options for states to jointly operate insurance exchanges and enter into interstate health insurance compacts, as well as the development of national health plan offerings. Using available literature and discussions with an array of experts in the fields of health policy, insurance, regulation, and purchasing pools, the paper summarizes the potential for cross-state pooling and the challenges faced in implementation of the specific strategies.

Posted: June 28, 2010Availability: HTML | PDF

Health Insurance Exchanges: Organizing Health Insurance Marketplaces to Promote Health Reform Goals (Policy Briefs/Timely Analysis of Health Policy Issues)
Linda J. Blumberg, Karen Pollitz

A health insurance exchange can make it possible to organize health insurance markets more efficiently and effectively than takes place today. Because so many different problems must be addressed in the insurance marketplace in order for all to have meaningful and affordable coverage, an entity like an exchange is needed to coordinate tasks and guide markets to comply with consumer protections and compete in cost-efficient ways. While not a panacea for all that ails the health system, carefully designed, an exchange can be a vehicle that facilitates and monitors the movement of the system toward many national health reform goals.

Posted: April 22, 2009Availability: HTML | PDF

 

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