Articles on the implementation of ObamaCare.
The Affordable Care Act (ACA) placed numerous requirements on insurance offered in both the individual and small group markets. This study presents data from the 174 insurers that offered qualified health plans (QHPs)—plans that satisfy the ACA requirements and are certified to be sold on exchanges—in both the individual and small group markets in 2014. QHPs in both markets are essentially the same and are governed by nearly identical regulations, making possible a better-controlled analysis of the performance of insurers participating in the two markets. Average medical claims for individual QHP enrollees were 24 percent higher than average medical claims for group QHP enrollees. Moreover, average medical claims for individual QHP enrollees were 93 percent higher than average medical claims for individual non-QHP enrollees. As a result, insurers made large losses on individual QHPs despite receiving premium income that was 45 percent higher for individual QHP enrollees than for individual non-QHP enrollees. These higher medical claims resulted in loss ratios for individual QHPs nearly 30 percentage points higher than loss ratios in other markets. Given that insurer performance selling individual QHPs worsened in 2015, these findings suggest that the ACA rules and regulations governing QHPs may be incompatible with a well-functioning insurance market even with subsidies to insurers and incentives for individuals to enroll in QHPs.
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Rather than stabilizing in 2016 as many experts predicted, the Affordable Care Act (ACA) is leading to large premium hikes and less choice and competition in the individual insurance market as plans prove unattractive to relatively young, healthy, and middle-class people. In order to achieve a better understanding of the ACA’s impact, a new Mercatus Center working paper compared insurers’ performance selling individual Qualified Health Plans (QHPs) with three other markets: the individual non-QHP market, the small group QHP market, and the small group non-QHP market.
My co-authors, Doug Badger of the Galen Institute, Ed Haislmaier of the Heritage Foundation, Seth Chandler of the University of Houston, and I make two key empirical findings. First, individual market QHP enrollees had average medical claims nearly double the average claims for individual non-QHP market enrollees in 2014. Second, individual market QHP enrollees were about 25% more expensive than enrollees in small group QHPs.
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The results of a recent poll conducted by the University of Southern California (USC) and the LA Times make it clear there is far from a consensus on the quality and affordability of healthcare in the Golden State. Less than half of those surveyed (44%) felt that healthcare in California was good or excellent, while a plurality (48%) felt that healthcare in the state was fair or poor.
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States that expanded Medicaid realized a 49.5 percent decline in the uninsurance rate, compared to a 33.8 percent decline in the uninsurance rate in non-expansion states since 2012, according to a Department of Health and Human Services report released today.
The department is touting the results of the study, which was conducted by its Office of the Assistant Secretary for Planning and Evaluation, as evidence that the roughly 20 states that have not yet expanded the program should do so.
“Today’s report is a clear reminder of the important role Medicaid expansion plays in improving access to quality, affordable care while addressing and improving overall health for millions of Americans,” HHS Secretary Sylvia Burwell said in a statement.
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With time running out for the Obama administration to prove the success of the Affordable Care Act, officials are aggressively targeting a group that could help turn things around: young people.
Federal health officials announced Tuesday they will comb tax records to find 18-34 year-olds who paid the penalty stipulated under President Barack Obama’s health act for not buying health insurance and reach out to them directly with emails to urge them to avoid even higher penalties scheduled for this year. They also plan to heavily advertise the enrollment campaign, including a promotion with trendy ride-sharing service Lyft to offer discounted rides to enrollment events.
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When the nation’s largest insurer announced its departure from a few Obamacare state exchanges last year, the law’s defenders pooh-poohed the development as a blip on the radar. Then the health insurance giant pulled out of almost all markets, forcing apologists to insist that all was well because UnitedHealth’s overall Obamacare marketshare was relatively small. Next, the company said it was closing up shop within Covered California, the massive exchange in America’s largest state. And now we get word that another enormous insurer is edging away from participation in the law — withdrawing not just from Minnesota’s Obamacare exchange, but from the state’s entire individual-based market.
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Minnesota’s largest health insurer, Blue Cross and Blue Shield of Minnesota, has decided to stop selling health plans to individuals and families in Minnesota starting next year.
The insurance carrier’s parent company, which goes by the same name, will continue to sell a much more limited offering on the individual market through its Blue Plus HMO.
The insurer explained extraordinary financial losses drove the decision.
“Based on current medical claim trends, Blue Cross is projecting a total loss of more than $500 million in the individual [health plan] segment over three years,” BCBSM said in a statement.
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ObamaCare officials are partnering with the IRS to help drive down uninsured rates among young people.
For the first time, the federal tax agency is working with the Department of Health and Human Services (HHS) to reach out directly to taxpayers who paid the required fee last year because they lacked coverage.
About 45 percent of people who paid the fee — or claimed an exemption, like financial hardship — were under 35, according to HHS.
The planned mailings will lay out options for coverage and include details about how to qualify for federal subsidies. HHS will also again partner with the ride-hailing service Lyft, which will offer discounts to customers who attend open enrollment sessions.
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Gov. Matt Bevin of Kentucky promised big changes were coming to Medicaid — and on Wednesday, he unveiled his plan. Bevin said the plan, “Kentucky Helping to Engage and Achieve Long Term Health” (or Kentucky HEALTH), will ensure the program’s long-term fiscal stability. Bevin’s predecessor, Steve Beshear, expanded Medicaid in Kentucky to adults making as much as 138 percent of the federal poverty level. Kentucky HEALTH is for that same population, plus all non-disabled adults currently covered under traditional Medicaid. The plan has two pathways: an employer premium assistance program and a high-deductible, consumer-driven health plan.
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The three key questions to ask of any Medicaid financing proposal that ends the open-ended federal reimbursement are: 1) what is the level of federal commitment? 2) how are the funds divided among the states? and 3) how are state incentives affected? Sensible Medicaid reform must accomplish two aims: reduce the unsustainable trajectory of federal and state Medicaid spending, and produce better outcomes for people most in need of public assistance. Although much more work needs to be done, the House task force proposal would take steps to accomplish both aims.
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