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Self-Insured Group Health Plans
Plans that an employer assumes the financial risk or providing health care benefits to their employees.
Ref: www.ncbi.nlm.nih.gov/pmc/articles/PMC4191537/

Kathy StClair

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Blue Shield
The first Blue Shield plan was in 1939 (Physicians only, not hospital coverage) which emerged from lumbar & mining camps in the Pacific NW. The employers  wanted to provide medical care for their workers. Pts could pay up front & be reimbursed or he plan could pay physicians directly.
Blue Shield merged with Blue Cross in 1982. (Hospital plan) which is one of the largest healthcare ins associations in the US.

Kathy StClair

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1966 Major Developments in Health Insurance

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Group Health Insurance 1940- Prior to World War II, very few Americans had health insurance, and most policies covered only hospital room and board. When wages were frozen by the National War Labor Board and a shortage of workers occurred, employers looked for ways to get around wage controls in order to attract scarce workers, and offering health insurance was one option. It was a way to recruit workers during a labor shortage. It was not subject to income tax or Social Security payroll taxes. Health insurance premiums paid by employers are deductible for employers as a business expense and are excluded, without limit from workers’ taxable income.  

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Group Health Insurance 1940- Prior to World War II, very few Americans had health insurance, and most policies covered only hospital room and board. When wages were frozen by the National War Labor Board and a shortage of workers occurred, employers looked for ways to get around wage controls in order to attract scarce workers, and offering health insurance was one option. It was a way to recruit workers during a labor shortage. It was not subject to income tax or Social Security payroll taxes. Health insurance premiums paid by employers are deductible for employers as a business expense and are excluded, without limit from workers’ taxable income.  

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-Tracy St Joy

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vickie

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vickie

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Hospital Survey and Construction Act 1946 hill-burton act

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1980

The Department of Health & Human Services was borne with the departure of the Office of Education and the Department of Health, Education and Welfare

It is the mission of the U.S. Department of Health & Human Services (HHS) to enhance and protect the health and well-being of all Americans. They fulfill that mission by providing for effective health and human services and fostering advances in medicine, public health, and social services.

1981

OBRA (Omnibus Budget Reconciliation Act) expanded Medicare and Medicaid

The Omnibus Reconciliation Act of 1981 (OBRA 81) reduced federal matching payments to states by specified percentages during period FY 1982-1984 as part of required federal budget savings. OBRA 81 repealed a requirement that states pay Medicare hospital payment rates, but also allowed states to make additional payments to hospitals serving a disproportionate share of Medicaid and low-income patients. These hospitals become known as disproportionate share hospitals

While section 1115 waiver authority predated the Medicaid program, OBRA 81 established two new types of Medicaid waivers. The first, section 1915(b) freedom-of-choice waivers, allowed states to pursue mandatory managed care enrollment of certain Medicaid populations. Prior to this new waiver, less than one percent of the managed care population is enrolled in managed care. The second, section 1915(c) HCBS waiver, allowed states to cover home and community-based long-term care services for the elderly and individuals with disabilities at risk of institutional care.

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The Health Maintenance Organization Assistance Act of 1973

From the book: "...authorized federal grants and loans to private organizations that wished to develop health manintenance organizations (HMOs), which are responsible for providing health care services to subscribers in a given geographic area for a fixed fee."

From various sources: An HMO is a company that allows patients to have access to medical services and health insurance from a "menu" at a predetermined cost. -David

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Brooke

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Brooke

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The Labor Management Relations "Taft-Hartley" Act of 1947

From the book: "...amended the National Labor Relations Act of 1932, restoring a more balanced relationship between labor and management. An indirect result of Taft-Hartley was the creation of third-party administrators (TPAs), which administer health care plans and process claims, thus serving as a system of checks and balances for labor and management." (Cengage, 2016)

From various sources: The Taft-Hartley act, went under law, despite Presidential veto, in order to correct unfair and unsafe labor and work-place practices. The law also prevented labor unions from forming to monopolize on an industry.                                                                    -David

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The Health Care Financing Administration (HCFA) was formed within the Department of Health and Human Services (DHHS) to combine health care financing and quality assurance programs into a single agency.

The Medicare and Medicaid programs were also transferred to the newly created agency. HCFA is now called the Center for Medicare and Medicaid Services, or CMS.

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OSHA- Congress created the Occupational Safety and Health Administration (OSHA) in 1970 to assure safe and healthful working conditions for working women and men by setting and enforcing standards and by providing training, outreach, education and assistance. It is a part of the United States Department of Labor and the administrator is the Assistant Secretary of Labor for Occupational Safety and Health. They answer to the Secretary of Labor, who is a member of the cabinet of the President of the United States. It covers most private sector employers and their workers. The jurisdictions covered are the 50 states as well as, District of Columbia, Puerto Rico, the Virgin Islands, American Samoa, Guam, Northern Mariana Islands, Wake Island, Johnston Island, and Outer Continental Shelf Lands as defined in the Outer Continental Shelf Lands Act.

-Tracy ST Joy

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Insurance companies began offering Major Medical Insurance, which provided coverage for catastrophic or prolonged illnesses and injuries.

Most of these programs incorporate large deductibles and lifetime maximum amounts.

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Civilian Health Civilian and Medical Program of the Uniformed Services. (CHAMPUS) is a US federal funded health program that provides beneficiaries with medical care, for those available in US military and Public Health Service facilities. All CHAMPUS beneficiaries switch to using Medicare at age 65. CHAMPUS is like Medicare in that the government contracts with private parties to administer the program. CHAMPUS was revamped as a managed care system and renamed TRICARE.

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The Federal Employees' Compensation Act (FECA), is a US federal law, enacted on September 7, 1916. It established compensation to federal CIVIL SERVICE employees for wages lost due to job-related injuries. This act became the start for "disability insurance" across the country and the beginning of broad-coverage health insurance.

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Medicare

Medicare is a health insurance that provides services to people 65 or older, people under 65 with certain disabilities, and people of any age with End- Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). Originally administered by the Social Security Administration. There are four different parts to Medicare:

1)      Medicare Part A (Hospital Insurance)

2)      Medicare Part B (Medical Insurance)

3)      Medicare Part C (Medicare Advantage)

4)      Medicare Part D (Medicare prescription drug coverage)

~Christina

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First Health Insurance Policy

The first commercial insurance company in the United States was The Franklin Health Assurance Company of Massachusetts. The purpose was to provide private health care coverage for injuries not resulting in death. It offered the first accident insurance. As we see it today, this was the earliest form of workers’ compensation.

~Christina