…that the loss ratios (the percentage of premium revenues spent on medical claims) of individual market insurers dropped to an average of 70 percent. Their average per member/per month (PMPM) margins increased to $166.82 (compared to an average PMPM loss of $9.21 in 2015). As a result, insurers expect to owe consumers $800 million in medical loss ratio rebates for…
…governors’ and legislatures’ control would be undermined; insurers would compete on an uneven playing field, risking insolvency and job loss for local carriers and brokers; and consumers would be “confused and [] angry” by the influx of low-quality coverage. States noted that this is not the right solution for reducing healthcare costs, since it would threaten the stability of local…
…the Medicaid expansion, which extended coverage to 465,000 Louisianans, as well as federal funding for premium subsides for private coverage (the ACA’s premium tax credits). Few, if any, states have the financial resources to offset the lost dollars on which these programs depend; for Louisiana alone, a win for the plaintiffs means a loss for the state of $3.6 billion…
…can exacerbate health conditions and inhibit the prevention of others. Groups have varied, but supportive, views on silver loading Five of the seven groups in this analysis responded to the agency’s request for comment on the practice of silver loading, in which insurers raise the price of premiums for silver-level plans on the marketplace to compensate for the loss of…
…The ACA’s marketplaces were created to give consumers an unbiased one-stop shop for quality health coverage. When consumers go to HealthCare.gov, or an equivalent state-run enrollment platform, their personal information is kept private, they will be screened for multiple health insurance programs, and will have access to all available plans in their rating area. Although the idea behind direct enrollment…
…estimated 133 million – depend on it to protect them from discrimination due to a pre-existing condition. Further, with health care now representing 18 percent of our economic output, invalidating the law will result in an estimated 1.2 million people losing their jobs, with billions in financial losses for hospitals and other providers. Most legal experts – including conservative experts…
…to be considered a qualified health plan. Before you, many insurance plans left out important and costly health services like mental health treatment, maternity care, and prescription drug coverage. This left consumers on the hook for high medical bills for health care services that are often unavoidable. You don’t discriminate You’ve stopped major medical insurance plans from charging higher premiums…
…all urged HHS to maintain the existing renewal process. Molina explained that automatic renewals promote continuity of care, are “standard practice” in most insurance markets (e.g., property and casualty), and “don’t deter consumers from actively shopping for coverage…rather, they provide an important backstop against loss of coverage.” To encourage active shopping, Molina recommended that HHS instead invest more in outreach…
…narrowly define the types of classes employers could use to differentiate among employees. For example, ACS-CAN noted that cancer patients often must reduce their hours worked due to treatment and expressed concern that the proposal could result in status shifts triggering the loss of a more generous group plan with greater provider choice. ADA recommended employers only be allowed to…
…cost-sharing plans. Of note, the court decisions suggest that the government continues to owe these CSR payments even though most insurers were able to mitigate their losses by increasing plan premiums in 2018 and beyond. In her latest article for the State Health & Value Strategies Expert Perspectives blog, CHIR’s Sabrina Corlette shares insights on the impact of this litigation…
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