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No doubt it will take some time to sort out how elements of the debt deal (formally "The Budget Control Act of 2011") will all work. Delving into the details of how it affects subsidies in the Affordable Care Act (ACA) to make insurance more affordable helps to illustrate how complex this business can be. Let's start with a short primer on the ACA subsidies. Starting in 2014 people buying insurance on their own in…
There seems to be growing interest in the question of how many employers will keep offering coverage to their full-time employees once the Affordable Care Act (ACA) is fully implemented in 2014, or instead will choose to stop offering coverage and pay a penalty. While there is some good analysis and plenty of conjecture, it is impossible to predict with any certainty how employers will react at this moment because some of the key rules…
There's been quite a bit of focus lately insofar as these issues go, anyway on health insurance agents and brokers (sometimes known in the industry as "producers"). They are pushing legislation that has been introduced in Congress and is now being studied by the National Association of Insurance Commissioners that would exempt agent and broker commissions for health insurance from minimum medical loss ratio (MLR) thresholds established in the health reform law. (The MLR is…
I usually don’t make predictions, unless they are backed up by the kind of statistical modeling we often produce. But here are three predictions I am confident about that form the basis of this latest column. GROUP HEALTH INSURANCE PREMIUMS WILL CONTINUE TO RISE AT HISTORICALLY MODERATE LEVELS, AT LEAST FOR THE NEXT FEW YEARS. One reason for this is the lingering effect of the recession. Employers will have little trouble attracting workers in the…
Conservatives obviously don't like what they call "Obamacare" because they think it expands the role of government too much and spends too much money. But ironically, the Affordable Care Act (ACA) actually promotes -- though not explicitly -- something that has been a fundamental objective of conservatives in health care for years: high-deductible health plans with more "skin in the game." In a new study we just released, we commissioned three different actuarial consulting firms…
The Patient Protection and Affordable Care Act (PPACA) establishes four levels of coverage based on the concept of "actuarial value," which represents the share of health care expenses the plan covers for a typical group of enrollees. As plans increase in actuarial value – bronze, silver, gold, and platinum – they would cover a greater share of enrollees' medical expenses overall, though the details could vary across plans. The levels of coverage provided for in…
The Patient Protection and Affordable Care Act calls for the creation of Health Insurance Exchanges in all states by January 1, 2014. The exchanges are a critical element of the health reform law, aimed at helping individuals and families shop for and purchase health insurance on their own with additional assistance for lower-income individuals and families. The Congressional Budget Office has estimated that approximately 24 million people will purchase coverage through the state health exchanges…
A major goal of the Patient Protection and Affordable Care Act (ACA) is to significantly expand coverage and reduce the number of uninsured. Beginning in 2014, the ACA will establish a new continuum of coverage that will provide assistance to individuals with incomes up to 400% of poverty through a broad expansion in Medicaid and by making premium tax credits available to eligible individuals to purchase coverage through new Health Insurance Exchanges. The law standardizes…
The major coverage provisions in the Affordable Care Act (ACA) go into effect in January 2014 with an expansion of Medicaid eligibility to nearly all individuals under 138% of poverty and new subsidies for individuals with incomes between 138% and 400% of poverty to purchase coverage in newly established Health Insurance Exchanges. The ACA envisions a streamlined and simplified application process with seamless transitions between coverage in the Exchange and Medicaid. Using a web portal,…
The Patient Protection and Affordable Care Act creates a new federal role to examine “unreasonable increases” in the premiums charged for certain individual and small group health plans. Under the health reform law, the U.S. Department of Health and Human Services (HHS) will work with state insurance departments to conduct an annual review of unreasonable rate increases, and insurers must provide justification for such increases to HHS and to the public via their websites. The…
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