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 Collection: Congressional Research Service Reports
Federal Employees Health Benefits Program (FEHBP): Available Health Insurance Options

Federal Employees Health Benefits Program (FEHBP): Available Health Insurance Options

Date: November 13, 2013
Creator: Mach, Annie L. & Cornell, Ada S.
Description: This report discusses the Federal Employees Health Benefits Program (FEHBP), a program administered by the Office of Personnel Management (OPM), which is statutorily given the authority to contract with qualified carriers offering plans and to prescribe regulations necessary to carry out the statute, among other duties.
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Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Date: May 6, 2014
Creator: Mach, Annie L. & Fernandez, Bernadette
Description: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each Affordable Care Act (ACA) market reform.
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Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Date: March 13, 2014
Creator: Mach, Annie L. & Fernandez, Bernadette
Description: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each Affordable Care Act (ACA) market reform.
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Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Private Health Insurance Market Reforms in the Affordable Care Act (ACA)

Date: July 24, 2014
Creator: Mach, Annie L. & Fernandez, Bernadette
Description: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each Affordable Care Act (ACA) market reform.
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Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA)

Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA)

Date: February 10, 2016
Creator: Mach, Annie L. & Fernandez, Bernadette
Description: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each ACA market reform, grouped under the following categories: obtaining coverage, keeping coverage, cost of purchasing coverage, covered services, cost-sharing limits, consumer assistance and other health care protections, and plan requirements related to health care providers.
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Individual Mandate and Related Information Requirements under ACA

Individual Mandate and Related Information Requirements under ACA

Date: July 22, 2013
Creator: Mach, Annie L.; Scales, Manon & Mulvey, Janemarie
Description: Report that describes the individual mandate under Section 1501 and Section 10106 of the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended).
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Contractors and HealthCare.gov: Answers to Frequently Asked Questions

Contractors and HealthCare.gov: Answers to Frequently Asked Questions

Date: January 24, 2014
Creator: Manuel, Kate M.; Murrill, Brandon J. & Perry, Rodney M.
Description: This report provides answers to 20 frequently asked questions regarding contractors and HealthCare.gov, the federal online health insurance portal called for by the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148, as amended). Over 50 contractors, including CGI Federal and Quality Software Services, Inc. (QSSI), helped in building the site, which was reportedly largely unusable when it first became available to the public on October 1, 2013.
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World Health Organization: A Fact Sheet

World Health Organization: A Fact Sheet

Date: July 1, 1996
Creator: McHugh, Lois
Description: The World Health organization (WHO), established in 1948, is the United Nations system's authority on international public health issues. It assists governments in improving national health services and in establishing worldwide standards for foods, chemicals, and biological and pharmaceutical products. WHO concentrates on preventive rather than curative programs, including efforts to eradicate endemic and other widespread diseases, stabilize population growth, improve nutrition, sanitation, and maternal and child care. WHO is not an operational agency. It works through contracts with other agencies and private voluntary organizations.
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AIDS: International Problems and Issues

AIDS: International Problems and Issues

Date: January 6, 1988
Creator: McHugh, Lois B
Description: This issue brief discusses the AIDS (Acquired Immune Deficiency Syndrome) virus and its effects on the world, especially with regard to the welfare of developing nations and various facets of general international relations. Also discussed are the related issues for Congress and U.S. contributions to international AIDS relief efforts led by the World Health Organization (WHO).
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Medicare Beneficiary Access to Care: The Effects of New Prospective Payment Systems on Outpatient Hospital Care, Home Health Care, and Skilled Nursing Facility Care

Medicare Beneficiary Access to Care: The Effects of New Prospective Payment Systems on Outpatient Hospital Care, Home Health Care, and Skilled Nursing Facility Care

Date: February 2, 2000
Creator: Merck, Carolyn L
Description: This report discusses the Balanced Budget Act of 1997 (BBA 97), which required that prospective payment systems replace retrospective cost-based reimbursement systems for Medicare beneficiaries receiving care in hospital outpatient departments, from home health care agencies, and in skilled nursing facilities.
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Medicaid Reimbursement Policy

Medicaid Reimbursement Policy

Date: November 2, 2004
Creator: Merlis, Mark
Description: This report begins with a summary of basic federal requirements applicable to payments for all services and an overview of major developments in federal Medicaid reimbursement policy over the last 20 years. This overview provides a historical context for current policies and highlights some issues that have been perennial concerns for federal and state policymakers. The next four sections of the report provide a detailed discussion of Medicaid reimbursement for four basic categories of services or providers.
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The ACA Medicaid Expansion

The ACA Medicaid Expansion

Date: December 30, 2014
Creator: Mitchell, Alison
Description: This report provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the report describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrollment and expenditure estimates for the ACA Medicaid expansion are provided. Finally, the report reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.
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Medicaid Financing and Expenditures

Medicaid Financing and Expenditures

Date: July 30, 2012
Creator: Mitchell, Alison
Description: This report provides an overview of Medicaid’s financing structure, including both federal and state financing issues. The Medicaid expenditures section of the report discusses economic factors affecting Medicaid, state variability in spending, and projected program spending. Other issues that are examined include congressional proposals to turn Medicaid into a block grant program, federal deficit reduction proposals affecting Medicaid, and state fiscal conditions affecting Medicaid financing and services.
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Centers for Medicare & Medicaid Services: President’s FY2013 Budget

Centers for Medicare & Medicaid Services: President’s FY2013 Budget

Date: April 9, 2012
Creator: Mitchell, Alison & Paulette, Morgan C.
Description: This report summarizes the President's budget estimates for each section of the CMS budget. Then, for each legislative proposal included in the President's budget, this report provides a description of current law and the President's proposal. The explanations of the President's legislative proposals are grouped by the following program areas: Medicare, Medicaid, program integrity, and health insurance programs.
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Health Insurance: Uninsured by State, 2000

Health Insurance: Uninsured by State, 2000

Date: January 11, 2002
Creator: Morgan, Paulette C
Description: None
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Health Insurance: Uninsured by State, 2001

Health Insurance: Uninsured by State, 2001

Date: November 19, 2002
Creator: Morgan, Paulette C
Description: None
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Health Care Spending: Past Trends and Projections

Health Care Spending: Past Trends and Projections

Date: April 8, 2004
Creator: Morgan, Paulette C.
Description: This report focuses on trends in personal health care spending, which includes spending on health care goods and services provided to individuals and excludes expenditures for administrative costs, research, and public health activities. Personal health care expenditures have grown considerably over the past 40 years. It is estimated that personal health spending will exceed $2.9 trillion in 2013.
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Medicare Advantage

Medicare Advantage

Date: March 3, 2009
Creator: Morgan, Paulette C.
Description: This report is an overview of the Medicare Advantage (MA) program, an alternative way for Medicare beneficiaries to receive covered benefits, and includes legislative history and analysis of recent trends.
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Medicare Advantage (MA)--Proposed Benchmark Update and Other Adjustments for CY2016: In Brief

Medicare Advantage (MA)--Proposed Benchmark Update and Other Adjustments for CY2016: In Brief

Date: February 25, 2015
Creator: Morgan, Paulette C.
Description: This report provides a brief background on how Medicare Advantage (Part C or MA) payments are determined through a comparison of a plan's estimated cost (bid) and the maximum amount Medicare will pay a plan (benchmark).
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Health and Safety Concerns Over U.S. Imports of Chinese Products: An Overview

Health and Safety Concerns Over U.S. Imports of Chinese Products: An Overview

Date: January 13, 2009
Creator: Morrison, Wayne M.
Description: This report provides an overview of concerns about the health, safety, and quality of imported Chinese products, and implications for U.S.-China trade relations.
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Health and Safety Concerns Over U.S. Imports of Chinese Products: An Overview

Health and Safety Concerns Over U.S. Imports of Chinese Products: An Overview

Date: May 8, 2008
Creator: Morrison, Wayne M.
Description: China is a major source of U.S. imports of consumer products (such as toys) and an increasingly important supplier of various food products. Reports of unsafe seafood, pet food, toys, tires, and other products imported from China over the past year or so have raised concern in the United States over the health, safety, and quality of imported Chinese products. This report provides an overview of this issue and implications for U.S.-China trade relations.
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Health and Safety Concerns Over U.S. Imports of Chinese Products: An Overview

Health and Safety Concerns Over U.S. Imports of Chinese Products: An Overview

Date: November 13, 2008
Creator: Morrison, Wayne M.
Description: China is a major source of U.S. imports of consumer products (such as toys) and an increasingly important supplier of various food products. Reports of unsafe seafood, pet food, toys, tires, and other products imported from China over the past year or so have raised concern in the United States over the health, safety, and quality of imported Chinese products. This report provides an overview of this issue and implications for U.S.-China trade relations.
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Factors Affecting the Demand for Long-Term Care Insurance: Issues for Congress

Factors Affecting the Demand for Long-Term Care Insurance: Issues for Congress

Date: May 27, 2009
Creator: Mulvey, Janemarie
Description: This report will discuss the role of long-term care insurance (LTCI) in financing long term care (LTC) costs and current trends in the LTCI industry; factors affecting the demand for LTCI, including cost and complexity of the product and adequacy of consumer protections; and key features of legislative proposals in the 111th Congress to address these issues.
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Health Care Flexible Spending Accounts

Health Care Flexible Spending Accounts

Date: June 13, 2012
Creator: Mulvey, Janemarie
Description: Health care Flexible Spending Accounts (FSAs) are benefit plans established by employers to reimburse employees for health care expenses such as deductibles and copayments. The contributions to and withdrawals from FSAs are tax-exempt. On June 7, 2012, the House passed H.R. 436, the Health Care Cost Reduction Act of 2012, which would allow up to $500 of unused balances in health FSAs to be distributed back to the account holder after the plan year ends and to allow over-the-counter prescriptions to be a qualified medical expense. The bill has been sent to the Senate for its consideration. Similar bills in the Senate have been referred to the Senate Finance Committee (S. 1368 and S. 1404). This report discusses these bills in greater detail.
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