This brief examines four options to promote the sale of health plan options in the individual or non-group market that are not subject to Affordable Care Act (ACA) requirements for other major medical health plans. It reviews the trade-offs involved if such loosely regulated markets take root as an alternative to the ACA-regulated market, particularly as the repeal of the individual mandate penalty takes effect next year.
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Democrats are expected to turn the tables and attack Republicans for rising premiums and sabotaging the Affordable Care Act. In his Axios column, Drew Altman discusses a balancing act they face which has not received attention: score political points, but run the risk of a new debate scaring the broader public and undermining the ACA by focusing on its continuing problems.
Digging Into the Data: What Can We Learn from the State Evaluation of Healthy Indiana (HIP 2.0) Premiums
Indiana initially implemented the ACA’s Medicaid expansion through a Section 1115 waiver in February 2015. Indiana’s waiver included important changes from federal law regarding enrollment and premiums. The initial waiver expired, and Indiana received approval for a waiver extension in February, 2018 which continues most components of HIP 2.0 and adds some new provisions related to enrollment and premiums. This brief looks at available data from the state’s evaluation of premiums prepared by The Lewin Group (as well as other reporting to CMS) to highlight what is known about the impact of these policies to date. We review these data to identify potential implications for changes in the recent Indiana renewal and for other states considering similar provisions.
The Financial Burden of Health Care Spending: Larger for Medicare Households than for Non-Medicare Households
Medicare offers health and financial protection to nearly 60 million adults ages 65 and over and younger people with disabilities. However, the high cost of premiums, cost-sharing requirements, and gaps in the Medicare benefit package can result in beneficiaries devoting a substantial share of their total household spending to health care costs.This analysis compares health-related expenses as a share of total household spending for Medicare and non-Medicare households, using the 2016 Consumer Expenditure Survey. We estimate how much Medicare and non-Medicare households spent on health care, including premiums, compared to other household spending (e.g., housing, transportation, and food).
Maps illustrate how premiums in Affordable Care Act (ACA) marketplaces changed for 2018 by looking at the change in the lowest-cost bronze, silver and gold plans by county; counties where an individual’s tax credit covers the full premium of the lowest-cost bronze plan; and counties where the unsubsidized premium for the lowest-cost gold plan has a lower or comparable premium to the lowest-cost silver plan in 2018.
As Open Enrollment for 2018 coverage gets underway, consumers who have health coverage through the Affordable Care Act (ACA) Marketplace are again receiving renewal notices from their health insurers. Though the insurer renewal notices this year are based on the same model notice required in the past, this year for many consumers, it may be causing significant – and misleading – sticker shock. That is because renewal notices sent by insurers are required to inform consumers what their 2018 monthly premium will be, assuming they receive the same amount of advanced premium tax credit (APTC) next year that they did in 2017. Insurer renewal notices have been required to present information this way since 2014.
Prescription drugs play an important role in medical care for 59 million seniors and people with disabilities, and account for $1 out of every $6 in Medicare spending. This series of charts presents and explains basic facts about prescription drug spending specifically within the context of Medicare. These 10 charts include information on current and projected Medicare prescription drug spending, out-of-pocket prescription drug costs for beneficiaries, and public opinion on prescription drug-related policy options.
How Many of the Uninsured Can Purchase a Marketplace Plan for Less Than Their Shared Responsibility Penalty?
For people who are uninsured and eligible for Affordable Care Act (ACA) marketplace plans, the analysis compares the cost of a premium for the lowest-cost bronze plan with the estimated individual mandate tax penalty for 2018. It finds that more than half (54% or 5.9 million) of the 10.7 million people could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.
This brief describes health insurance subsidies available through the Affordable Care Act’s marketplaces, including premium subsidies that would be provided in the form of tax credits, as well as other subsidies that would lower cost sharing to eligible Americans. It provides details on who is eligible for the assistance, the maximum repayment limits for the credits, and out-of-pocket spending limits.