…in their high-risk pools in order to limit losses. And all of them experienced losses, even though they received billions in government subsidies. In 2011, net losses for the 35 state high-risk pools were over $1.2 billion. There is no question that high-risk pools provided a source of coverage to a set of very vulnerable, high-need people in the days…
…2022. The enhancements are now set to expire after 2025. It has been widely reported that expiration jeopardizes health coverage for millions of Americans. But there has been less discussion of when the enhancements must be extended to avert these losses. Given that Congress commonly extends tax rules just before or even after expiration, observers may believe that extending the enhancements to 2026 and beyond…
By, Sheela Ranganathan and Maanasa Kona Amidst the growing interest among policymakers to protect patients from medical debt and its negative downstream effects, in April 2023, the three credit reporting agencies (CRAs)—Equifax, Experian, and TransUnion—voluntarily agreed to stop reporting any medical debt under $500. This April, the Consumer Financial Protection Bureau (CFPB) found that, despite these changes, 15 million Americans still have…
…increase in unemployment. Unemployment then leads to reductions in collected federal income tax: for every one percent rise in healthcare prices there is 0.4 percent decline in tax revenue. Hospital mergers are a primary driver of healthcare costs, and have severe implications for insurance premiums, job and wage losses, and federal tax revenue. One anticompetitive hospital merger – defined by…
…by 2034. The agency identifies several factors driving the increase in our uninsured rate, in particular: The Medicaid “Unwind”: States resumed eligibility redeterminations for Medicaid and the Children’s Health Insurance Program (CHIP) in 2023, after pandemic-related continuous coverage requirements expired. Between 2023 and 2024, the CBO projects that this will result in a loss of 13 million people from Medicaid and CHIP,…
…example, Virginia now requires hospitals to comply with the federal hospital price transparency rules, and Indiana requires hospitals to continue complying with federal hospital price transparency rules even if the federal rules get repealed or the federal government stops enforcing them. Minnesota requires not just hospitals but also other providers such as outpatient surgical centers, large imaging and laboratory service providers, and large dental service providers…
…eligibility after one year of failing to reconcile APTC—a year in advance of APTC loss. While most commenters supported the proposal, some expressed concern about SBMs’ capacity to send notices of FTR status that comply with federal tax privacy laws. Some requested additional guidance about the content of notices and technical assistance to develop notices and support enrollees. Others expressed…
…87 percent applied actuarial value of a Marketplace plans. In another example, a Texas consumer who believed he was enrolled in a comprehensive insurance policy received a $67,000 hospital bill after a heart attack. In fact, he had a fixed indemnity policy that provided a cash benefit of less than $200 per day of hospitalization. According to NAIC data, the medical loss…
…coverage is the underlying and rising cost of care. Unfortunately, experience suggests that expanding HSAs will not tackle this problem or meaningfully expand coverage. The loss of federal revenue associated with HSAs’ regressive tax cuts could thwart policies that expand health care access for people with the greatest need—those who are currently least likely to have access to affordable coverage…
…be charged) and bars health care providers from collecting more than the insurer-contracted facility fee rate when consumers have not met their deductible. More narrowly, health care providers in Colorado will be prohibited from balance billing consumers for facility fee charges for preventive services provided in an outpatient setting beginning July 1, 2024. 5. Prohibitions on Outpatient Facility Fees: Stopping…
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