fringe benefit FEHB Federal Employees Health Benefits States Employee Health Benefits Medicare 1965 TitleX VIII of the Social Security Act1966
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1 特 集 :アメリカの 社 会 保 障 アメリカの 医 療 保 障 システム 雇 用 主 提 供 医 療 保 険 の 空 洞 化 とオバマ 医 療 保 険 改 革 長 谷 川 千 春 Employer- Sponsored Health Insurance I 65 16
2 fringe benefit FEHB Federal Employees Health Benefits States Employee Health Benefits Medicare 1965 TitleX VIII of the Social Security Act A Medicare social security tax Medicaid A
3 Summer 2010 No Tricare/CHAMPVA Tricare/CHAMPVA Tricare/CHAMPVA Tricare/CHAMPVA TRICARE CHAMPUS CHAMPVA the Civilian Health and Medical Program for the Department of Veterans Affairs Fronstin 2003,
4 GDP YY U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (2010) 1 GDP III GDP GDP GDP
5 Summer 2010 No $149.0 $274.6 $359.0 $454.7 $497.6 $551.1 $603.7 $645.9 $690.0 $727.5 $ U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (2008) II HI Trust Fund Workers Compensation and Temporary Disability Insurance
6 Cowan et al (1996); U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (2008) General Motors GM GM 1980 GM GM GM GM GDP
7 Summer 2010 No U.S. Bureau of Labor Statistics ( ), Current Employment Statistics Survey 3 ( ) GM GM GM Wal Mart WM
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9 Summer 2010 No. 171 Fronstin (2003, 2009) 4( ) /
10 25 Fronstin 2003, ( ) Fronstin (2009)
11 Summer 2010 No IV Energy & Commerce; Ways & Means; Education & Labor Affordable Health Care for America Act (H.R. 3962) Fi nance; Health, Education, Labor and Pen sions Patient Pro tection and Affordable Care Act (H.R. 3590) Exchange
12 Exchange H.R. 3962) H.R. 3590) filing threshold % 750 ( 2250 ) 2 qualified health benefits plan) 5 Exchange Exchange 8 Exchange ) Commissioner) Health and Human Services) 2015 Exchange Exchange SHOP exchange) Exchange Exchange Exchange 72.5 ) 65 ) 27
13 Summer 2010 No % Exchange 12% (2014 Commissioner 400% Exchange 9.8% 6 ( Exchange ) FPL FPL150 FPL133 3 FPL FPL400 2 FPL FPL FPL FPL FPL FPL ) FPL FPL FPL FPL Exchange Exchange HHS 20 HSA) FPL FPL FPL ) FPL FPL FPL FPL150% FPL133% Congressional Research Service (2009); Congressional Research Service (2010); H. R an ACT ( gov/fdsys/pkg/bills-111hr3962eh/pdf/bills-111hr3962eh.pdf); H.R AMENDMENTS ( fdsys/pkg/bills-111hr3590eas/pdf/bills-111hr3590eas.pdf); Kaiser Family Foundation (2010) 28
14 filing threshold Exchange Exchange Health Insurance Exchange Exchange Health Choices Com missionercommissioner Exchange Commissioner Commonwealth Health Insurance Connector Authority (Connector) Con nector 25 Exchange 29
15 Summer 2010 No. 171 Exchange 4 FPL400 FPL400 Exchange Exchange 2 2 FPL FPL FPL FPL FPL FPL Exchange
16 State Children s Health Insurance Program: SCHIP2009 Children's Health Insurance Program CHIP 3 Fronstin 2003, U.S. Census Bureau (2009). 5 U.S. Census Bureau (2009). 6 EBRI Notes, March O Brien (2003). 8 American Demographics, May General Motors Corporation (2004). 10 General Motors Corporation (2006) UAW UAW General Motors Corporation 2006, Annual Report GM 2010a 2 13 Wal-Mart State by State Information. 14 Wal-Mart 2010a) Wal-Mart (2007); Washington Post, January 11, Fronstin (2009) 18 U.S. Department of Health and Human Services FPL100 Federal Register, Vol. 74, No. 14, January 23, a a 4 21 White House (2009). 22 Congressional Research Service (2009); Congres sional Research Service (2010); H. R an ACT ( p d f / B I L L S h r E H. p d f ) ; H. R AMENDMENTS( BILLS-111hr3590EAS/pdf/BILLS-111hr3590EAS.pdf); Kaiser Family Foundation (2010) b 24 financial hardship 25Connector 2010b 31
17 Summer 2010 No White House, THE PRESIDENT S PROPOSAL, February 22, Congressional Research Service (2009), Private Health Insurance Provisions of H.R.3962, CRS Report, R Congressional Research Service (2010), A Comparative Analysis of Private Health Insurance Provisions of H.R and Senate-Passed H.R. 3590, CRS Report, R Cowan, C.A., B.R. Braden, P.A. McDonnell and L. Sivarajan (1996), Business, households, and government: health spending, 1994, Health Care Financing Review, 17(4), pp Fronstin, P. (2003), Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2003 Current Population Survey, EBRI Issue Brief, 264. Fronstin, P. (2009), Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2009 Current Population Survey, EBRI Issue Brief, 334. General Motors Corporation ( ), General Motors Corporation Annual Report. Kaiser Family Foundation (2010), Side-by-Side Comparison of Major Health Care Reform Proposals, Focus on Health Reform, updated January 13. O Brien, E. (2003), Employers Benefits from Workers Health Insurance, Milbank Quarterly, 81(1). U.S. Bureau of Labor Statistics ( ), Current Employment Statistics Survey. U.S. Census Bureau (2009), Income, Poverty, and Health Insurance Coverage in the United States: U.S. Department of Health and Human Services, Center for Medicare & Medicaid Services (2008), Sponsors of Health Care Costs: Businesses, Households, and Governments, U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (2010), National Health Expenditure Data. Wal-Mart (2007), Open Enrollment Survey Report. White House (2009), The OBAMA Plan Stability & Security for All Americans a 2010b
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