…businesses, with a projected 48 million people under age 65 living in families with a COVID-19-related job loss, and over 10 million of these individuals are projected to lose their health coverage at the same time. While the White House and Congress negotiate a relief package to mitigate these negative economic effects, the Biden administration is likely to take immediate…
…medical loss ratio (MLR) formula. This guidance means that policyholders will receive an estimated 2.4 percent ($298 million) of the risk corridor payout in the form of MLR rebates. At the same time, 2020 has been a highly profitable year for many health insurers, due to depressed utilization of health care services during the COVID-19 pandemic. In a recent “Expert…
…to face the loss of employment, income, and/or their source of health insurance. There are a number of policy changes related to the pandemic that can impact enrollment and affordability on the marketplace. Some states that run their own marketplace may have established additional special enrollment periods due to the COVID-19 pandemic, so check with your state marketplace to see…
…do not stop at private health insurance. The expansion of Medicaid, which provides free health coverage for low income people expanded coverage to 12 million low income adults. Cuts to this program would send these individuals back to the individual market where they would almost certainly not be able to afford the premiums. As many as 3 million children who…
…the period with an estimated 243,000 more children living without health coverage. Florida has the next biggest loss, adding about 55,000 children to the uninsured count over the three-year period. As a consequence, 41 percent of children’s coverage losses during the Trump Administration occurred in Texas and Florida. The only state that bucked national trends and significantly reduced its number…
…that could overturn the ACA, and rising uninsured rates are insurers flocking back to the individual marketplace? A Sicker-than-expected Risk Pool, Policy Uncertainty Drove Insurer Exits in 2017 By 2017, many insurers had experienced significant losses in the individual market. Nationwide, insurers selling in the individual market lost $2.5 billion in 2014 alone. The following year was little better. Competitive…
…health plans. Nothing about how they will stop the projected 82 percent increase in uncompensated care costs for providers. In short, the Trump administration has no plan, or even a semblance of a plan. The only thing they appear to have is the cynical belief that, unlike the lady from the Wendy’s ad, most Americans won’t check under the bun….
…pushed some into poverty. Medical debt: a symptom of a broken health care system Unpaid medical bills can either be a product of lack of health insurance coverage or having health insurance coverage that does not adequately protect from financial risk. Given the job losses we have seen during this pandemic, an estimated 3.5 million people will join the ranks…
…in the uninsured rate, with more participants reporting coverage after a job loss (77.6 percent, up from 76.2 percent before job loss) than in the pre-ACA period, with Medicaid and marketplace coverage almost fully offsetting loss of employer-based coverage. There was a 6.0 percentage point decrease in net coverage reduction among participants following a job loss in the post-ACA period…
On August 14, 2020, the Court of Appeals for the Federal Circuit affirmed a lower court ruling that the federal government is liable to insurers selling marketplace health plans for the loss of cost-sharing reduction (CSR) reimbursements mandated under the Affordable Care Act (ACA). However, the court determined that the federal government could reduce the damages it owes to insurers…
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