United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1997-07-24 monographic deposited born digital 64 p. GA 1.13:HEHS-97-122 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-97-122 P0b002ee180388ce0 f:he97122 DGPO 2010-08-12 2011-03-24 GAOREPORTS-HEHS-97-122 machine generated eng fdlp REPORT GAOREPORTS-HEHS-97-122 HEHS-97-122 Health insurance Insurance premiums Health insurance cost control Fringe benefits Managed health care Health maintenance organizations Employee medical benefits Insurance regulation Health care programs Cost sharing (finance) Medicaid Program New Jersey New York Vermont Census Bureau Current Population Survey Chapter Report HEHS Pursuant to a congressional request, GAO reviewed major trends in the private health insurance market, during the 1980s and 1990s, focusing on: (1) the decline in private health insurance coverage and factors contributing to this decline; (2) trends in health insurance premiums and reasons for these trends; and (3) employer's efforts to control health benefits costs.<p/>GAO noted that: (1) private health insurance coverage has slowly but steadily declined; (2) between 1980 and 1995, the population under age 65 covered by private health insurance decreased from 79.5 percent to 70.5 percent; (3) coverage for children, early retirees, and near-poor families has declined faster than that for the overall population; (4) declining private health coverage has been accompanied by growth in the uninsured population and Medicaid enrollment, which in turn increased government health expenditures; (5) a major reason for declining private health coverage is the rising cost of health insurance; (6) this has absorbed a growing share of business and family incomes and has influenced employers and employees' health insurance decisions; (7) health insurance premiums, in contrast, have alternated between rapid growth and relative stability over the past two decades; (8) several reasons cited as contributing to the recent near-zero growth in health plan premiums include the cyclical nature of health insurance premiums, the expansion of managed care, the increasingly competitive market for health insurance, and low overall inflation; (9) nonetheless, the high level of health insurance costs and uncertainty about future increases remain a concern of employers and individuals purchasing coverage; (10) as employers have adopted various strategies to control the costs of health benefits, the costs consumers bear have increased and the types of health insurance products they receive has evolved; (11) since 1980, employees are more likely to be required to pay a share of their health plans' premiums, typically 20 to 30 percent; (12) in addition, most Americans are now enrolled in a network-based plan; (13) a network-based plan requires or encourages enrollees to use physicians and hospitals affiliated with the plan; (14) however, network-based plans often have lower deductibles, and most of these plans allow enrollees to use nonaffiliated providers at a higher cost; (15) nearly 40 percent of persons with private employer-based health insurance participate in a self-funded plan; (16) in such plans, unlike conventional health insurance, the employer assumes the risk for health claims and the plan is exempt from state insurance regulation; (17) if at some point health insurance costs start rising again, employers and insurers will face heightened pressure to control costs; and (18) this may lead to increas* https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-97-122/html/GAOREPORTS-HEHS-97-122.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-97-122/pdf/GAOREPORTS-HEHS-97-122.pdf GAO/HEHS-97-122 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-97-122 Chapter Report GAO/HEHS-97-122; Private Health Insurance: Continued Erosion of Coverage Linked to Cost Pressures; Health insurance Insurance premiums Health insurance cost control Fringe benefits Managed health care Health maintenance organizations Employee medical benefits Insurance regulation Health care programs Cost sharing (finance) Medicaid Program New Jersey New York Vermont Census Bureau Current Population Survey