Tarren R. Bragdon

  

Tarren R. Bragdon serves as the director of health reform initiatives at the Maine Heritage Policy Center. He also serves as a health policy analyst for the Empire Center for New York State Policy. During 2001 and 2002, he served as the special assistant to the President of the Maine Senate, providing policy research, analysis and advice on a variety of policy areas. In 2002, he worked extensively on the legislation and eventual enactment of the Maine Consumer Choice Health Plan, a state-administrated consumer choice insurance exchange of several private health plans that will be available to Maine individuals and small businesses.

From 1996 through 2000, Tarren served in the Maine House of Representatives.


Tuesday, August 26, 2008

1 in 9 Privately Insured Have an HSA 

By Tarren R. Bragdon

Categories:  HSAs, etc., Maine

According to a new survey by United Benefit Advisors Inc, an employee benefit advisory company, enrollment in Health Savings Accounts (HSAs) has almost doubled in the past year. Now 11% of those privately insured are enrolled in HSAs compared to 6% last year. HSA-compatible plans now account for 13% of all health plans offered by employers.

A Health Savings Account ties a savings account with a low premium, high deductible health plan. That means that the individual, not the insurance company, is controlling the first few thousand spentin health care consumption. Typically, after a $2,500-$3,000 deductible is met, the insurance company pays 100% of health care costs.

HSAs encourage the individual to take ownership of their own health, focus on preventative care, make good health choices and to be smart price and quality shoppers when using health care.

(Note: To learn more, read this overview of HSAs.)

Friday, July 4, 2008

Maine's Uninsured: 1 in 20 

By Tarren R. Bragdon

Categories:  Maine

The National Center for Health Statistics released a report last month finding thatfewer than 1 person in 20 in Maine has been uninsured for more than a year (half the U.S. average and half that reported last fall for Maineby the U.S. Census Bureau, page 22 of the report). However, Maine fares poorly with regards to adults with private health insurance - just 65% of Maine adults have private insurance compared with 70% nationally and 78% in nearby Connecticut (page 14).

Last fall, I authored a report on Maine's uninsured rate using U.S. Census Bureau figures, which tend to report the uninsured at that moment in time rather than the longer-term uninsured.

Given thevery low number of longer-term uninsured adults in Maine and our low rate of people with private health insurance,maybe the public policyfocus should be on expanding private health insurance choices, competition and enrollment and not on further expansions ofpublic programs like Medicaid.

Friday, June 27, 2008

Maine's Dirigo Plan: Promised Savings Fail to Show 

By Tarren R. Bragdon

Categories:  Maine

Voters in Maine were assured that the state-run Dirigo health plan would never require an increase in taxes. Those promises were repeatedly broken, most recently when Governor Baldacci signed the April 15th tax increase into law.

Yet there is no chance of Dirigo coming close to meeting its goal of covering Maine's uninsured, and despite that, politicians just passed millions of dollars in new taxes on beer, wine, soda, flavored water, and even health insurance claims.

A new report from the Maine Heritage Policy Center offers the facts about and failures of the plan. You can read the whole thing here.

Wednesday, June 25, 2008

Universal Coverage: Easy to Promise, Expensive to Have 

Massachusetts at One Year

By Tarren R. Bragdon

Categories:  Individual Mandates, Massachusetts

After the first year of Massachusetts'RomneyCare health reform, the public is seeing the effectiveness of the plan that has an individual and employer mandate combined with a Medicaid expansion and new subsidized private health insurance plans, reports Boston.com. The results are interesting and point to the challenge facing anyone who wants to use government to require universal health care, even in a relatively high-income, low-uninsured state like Massachusetts. Key findings include:

  • Overall uninsured rate dropped from 13% to 7%
  • 355,000 newly insured
  • 92,000 did not sign up for health insurance and face a $219 tax penalty that rises to over $900 in 2008
  • 60,000 were exempt from the health insurance mandate for their low incomes
  • The plan cost Bay State taxpayers $869 million this year, $150 million or 21%over the original budget

Massachusetts is suffering from Maine Dirigo Health's high cost overruns, but at least some of the uninsured are being covered.

Again, this is a preview of how expensive and difficult the easily-promised universal coverage really is.

Friday, May 30, 2008

State of Maine Denies Patients Latest Technology 

By Tarren R. Bragdon

Categories:  Certificates of Need (CON), Maine

This week the Maine Department of Health and Human Services (DHHS) denied capital improvement projects at three Maine hospitals, according the Portland Press Herald. Maine has one of the strictest Certificate of Need laws in the country, requiring bureaucratic approval of many privately-financed hospital expansions and improvements.

In 2004, the Federal Trade Commission stated that "The Agencies believe that, on balance, CON programs are not successful in containing health care costs, and that they pose serious anticompetitive risks that usually outweigh their purported economic benefits. Market incumbents can too easily use CON procedures to forestall competitors from entering an incumbent’s market....Indeed, there is considerable evidence that CON programs can actually increase prices by fostering anticompetitive barriers to entry."

As Eastern Europe and other US states have abandoned the proven failure of central planning, Maine clings to this failed and costly strategy. What is most sad is that CON hurts patients - by driving up costs through reduced competition from new and innovative health care providers and by denying patients new technologies and treatments.

In model health reform legislation (PDF) released last summer, the Maine Heritage Policy Center recommends that Maine's CON laws be repealed. Health care costs will be reduced from the enthusing competition among current and new health care providers.

Maine DHHS cited increased private health insurance costs as partial justification of denying these projects. Oddly, the Governor and a majority of the Legislature had no problem on April 15 passing a new 1.8 percent claims tax on all private health insurance claims, increasing costs of health premiums by $61 for the average employee with single coverage and $162 for those with family coverage.

Friday, January 18, 2008

Affordable Insurance for New York 

By Tarren R. Bragdon

Categories:  New York

What's the best way to ensure that all New York State residents-adults and children alike-have access to affordable health-insurance coverage?

Over the past decade, the state government has answered that question by expanding publicly subsidized forms of health insurance, building on what was already the nation's most expensive Medicaid program, while maintaining insurance regulations that make private coverage both scarce and expensive.

There are better alternatives

Saturday, January 5, 2008

Wealthy State, Big Spending ... Many Uninsured 

The problem with New York

By Tarren R. BragdonJohn LaPlante

Categories:  Insurance Regulation, New York

"Why," asks Tarren Bragdon, "does New York spend more on Medicaid -- a health-care program for the poor -- than every other state but still have a larger portion of its population walking around without health insurance than states that spend far less?"

Writing in today's Wall Street Journal (link for subscribers), Bragdon explains that regulations on individual insurance are one reason. (Individual and family policies purchased outside the employer market cost about twice the national average.) 

These regulations include community rating, guaranteed issue, and a long list of mandated benefits.

Gov. Eliot Spitzer, meanwhile, wishes to further weaken the private market by expanding government health insurance programs--to families making as much as $80,000 a year.

Monday, December 3, 2007

State House Call Video: Tarren Bragdon on Affordable, Private Insurance 

By Tarren R. Bragdon

Categories:  Insurance Regulation

America's a wealthy country, but our approach to health care makes it hard for people to get health insurance outside of their workplace.

Tarren Bragdon, a health policy analyst who does work for both the Maine Heritage Policy Center and the Empire Center for New York State Policy, talks about the difficulty that residents of Maine and New York face in buying health insurance on their own.

Bragdon comments that he isn't interested in telling people what insurance they must buy, or even that they must buy it. But, he says, the goal of health care analysts should be to point to ways that they can enable people to buy a private, affordable health insurance plan.

Monday, November 5, 2007

Volunteer-Staffed, Free Clinics 

A Way to Reach the Uninsured

By Tarren R. Bragdon

In all the talk of universal coverage, few admit that a Medicaid card often does little to increase access to health care. However, volunteer-staffed free clinics are doing just that across the country. With minimal government funds and no Medicaid money, free clinics are mostly staffed by volunteer (often retired) physicians, nurses and health care professionals. They provide free primary and preventative care to the truly uninsured and referrals to participating volunteer specialists and other health care providers.

These clinics help connect the uninsured to free sample medications or patient assistance programs provided by drug companies. They epitomize a local, charitable community response to the real needs of the uninsured.

However, states can do more to encourage these clinics by providing medical liability protection for the volunteer medical staff. Those states that do – unlike New York – have more clinics and increased help to the uninsured, as I recently noted in a NY Post op ed.

After approving similar liability protection, Virginia (978,000 uninsured) now has 40 such free clinics, according to the National Association of Free Clinics. North Carolina (1.4 million uninsured) has a similar provision and more than 50 free clinics.

Volunteers in Medicine, based in Vermont, also provides a model for setting up free clinics in numerous states.

Check with the National Association of Free Clinics and Volunteers in Medicine about what the rules are in your state, how many clinics are in your state has and what you can do to increase that number.

Monday, October 15, 2007

Odd, People Will Buy Affordable Insurance if Given the Chance 

NY v FL shows impact of guarantee issue and community rating

By Tarren R. Bragdon

Florida has 1.4 million fewer residents than New York but almost 14 times more people buying insurance on their own, not through their employer, in the individual market.

In 2006, New York had just 57,000 people purchasing insurance in the individual market, thanks to community rating and guarantee issue in the individual market. New York’s individual policies start at $609 per month for an individual and $1,828 per month for family coverage.

By comparison, Florida has 790,000, according to the latest figures. Individual insurance premiums in Florida start as low as $35 a month for a 25-year-old man or $44 a month for 25-year-old female, according to ehealthinsurance.com.

Sen. Hillary Clinton has talked about taking NY’s destructive guarantee issue and community rating regulations nationwide as part of her universal coverage plan. The facts show these regulations will reduce coverage not expand it.

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