In 2005, researchers at the Urban Institute estimated the out-of-pocket health care expenses for adults with high health costs or chronic conditions and identified a set of policy options for addressing the problem of insuring these individuals. Researchers published their findings in an issue brief and a longer discussion paper.
The researchers identified three approaches to the problem of insuring high-cost individuals that merit further study:
- Establish statewide purchasing pools open to everyone, with premiums set at the statewide average.
- Increase federal subsidies to state high-risk pools and establish federal standards for benefits and eligibility.
- Randomly assign high-risk individuals to private insurers, and provide government subsidies for their care.