Third Party Resources
Posted on January 31, 2014
A new report released by PricewaterhouseCoopers (PwC) Health Research Institute found that premiums for plans offered through the Affordable Care Act’s (ACA) health insurance marketplace were comparable, if not cheaper, than premiums of plans offered by employers. The report, Health insurance premiums:comparing ACA exchange rates to the employer-based market, noted several causes for this difference. First, many plans offered through the ACA marketplace have thinner networks, which will drive down costs. Second, premium rates between the public and private sectors may equilibrate after the ACA marketplace has been established for several years.
Posted on January 28, 2014
A report recently released by The Brookings Institution stated that the Affordable Care Act (ACA) will lead to a redistribution of incomes. Specifically, the report cited that individuals with incomes in the bottom 20% of the population will see a 6% increase due to the availability of subsidies and Medicaid expansion, while individuals in higher income brackets may see a slight reduction in their incomes based upon higher taxes and shifts in the insurance market. Of note, the authors of the report include “government and employer contributions to health insurance” in their determinations for income.
Posted on January 21, 2014
The RAND Corporation released a study analyzing three proposals to address health insurance plan cancellations under the Affordable Care Act (ACA). To ameliorate this issue, the administration initiated a transitional policy, which permitted individuals to remain on health insurance plans that did not meet the coverage requirements of the ACA. Many lawmakers, however, disagreed with this approach. Ultimately, RAND found that each proposal would “slightly to moderately” impact premiums, enrollment, and federal spending associated with the ACA. Moreover, RAND concluded that none of the options studied would result in a death spiral or collapse of the private insurance market.
Posted on January 14, 2014
Irrespective of their increased efforts, a new study released today indicates that community health centers operating in states less receptive to the Affordable Care Act (ACA) are having difficulty performing outreach and enrolling uninsured individuals. The study, performed by the Geiger Gibson Program within The George Washington University School of Public Health and Health Services and RCHN Community Health Foundation, is the first to assess how state restrictions are impacting enrollment and coverage under the ACA. A press release describing key findings about the study may be accessed here.
Posted on January 2, 2014
A new brief released from healthinfolaw.org, a partnership between The George Washington University Department of Health Policy and the Robert Wood Johnson Foundation, discusses the certification and accreditation standards for qualified health plans (QHP) to be offered on the Affordable Care Act’s (ACA) health insurance marketplaces. The article specifically discusses the impact of disclosing information on health insurance policies, practices, costs, and quality on public availability of data on health plan performance.
Posted on December 30, 2013
As a wrap-up to 2013, The Commonwealth Fund has published a slew of studies and reports concerning the implementation of the Affordable Care Act (ACA). Several of these publications are highlighted below.
The first publication, Realizing Health Reform’s Potential: How Are State Insurance Marketplaces Shaping Health Plan Design?, analyzes how state-based marketplaces (SBM) and state-partnership marketplaces (SPM) utilized their plan certification capabilities to enhance or alter the requirements for plans to participate in the marketplaces. The report examines the following certification areas: inclusion of essential community providers, benefit substitution, and provider networks. The second publication, What’s Behind Health Insurance Rate Increases? An Examination of What Insurers Reported to the Federal Government in 2012–2013, found that increases in healthcare rates from mid-2012 to mid-2013 can predominantly be attributed to medical trends, and a slight increase resulted from rate increases associated with the ACA. The third publication, Realizing Health Reform’s Potential: What States Are Doing to Simplify Health Plan Choice in the Insurance Marketplaces, discusses several policies employed by SBM to help simplify plan choices for consumers. Several of these policies include: incorporating meaningful difference standards (where a plan cannot be offered if it is too similar to one already in existence on the marketplace), limiting the number of plans or benefit designs an insurer may offer in the marketplace, and requiring standardized benefit designs.
Posted on December 16, 2013
A report issued by McKinsey & Company this month discusses changes in insurance network configurations resulting from the Affordable Care Act (ACA). The report, Hospital networks: Configurations on the exchanges and their impact on premiums, analyzed over 20 cities in both federally-facilitated and state-based marketplaces. McKinsey found that nearly 60% of insurance plans sold on ACA Marketplaces cover fewer hospitals than current insurance plans. Moreover, ACA insurance plans with larger hospital networks charge higher premiums, with the more comprehensive plans costing 26% more than plans offering limited network coverage.
Posted on December 13, 2013
A new report from the Georgetown University Health Policy Institute Center for Children and Families discusses some of the issues with premium administration for public and subsidized insurance programs from the perspective of low-income individuals and families. The report, Handle with Care: How Premiums Are Administered in Medicaid, CHIP and the Marketplace Matters, describes how the absence of policy alignment between Medicaid, the Children’s Health Insurance Program (CHIP), and insurance subsidies from the Affordable Care Act (ACA) can be very detrimental to low-income individuals enrolling in and maintaining coverage. Some of the specific policies addressed by the brief include payment and collection options, grace periods, and cancellation rules.
Posted on November 22, 2013
The Robert Wood Johnson Foundation (RWJF), in conjunction with Georgetown University’s Center on Health Insurance Reform, recently published their Navigator Review Guide. Navigators are trained to help individuals understand their coverage options under the Affordable Care Act (ACA) and help them select plans most appropriate for their needs. The Navigator Resource Guide is divided into three sections:
- Enrollment issues for individuals without coverage options from an employer;
- Enrollment issues for individuals with coverage options from an employer, but who may want to learn more about additional options under the ACA; and
- Enrollment issues for small employers.
The 102 page document is designed to provide additional information and supplement the training for navigators working with private insurance under the ACA.
Posted on November 5, 2013
An analysis performed by the Kaiser Family Foundation found that nearly 6 in 10 Americans eligible to participate in the Affordable Care Act’s (ACA) health insurance marketplaces, which equates to 17 million individuals, will qualify for insurance subsidies. To receive a subsidy through the ACA, individuals must earn between 100-400% of the federal poverty line. Most of the individuals qualifying for subsidies reside in Texas, California, and Florida. The analysis was based on population and economic data collected by the Census Bureau for 2012 and 3013, stated that.