News reports indicate that consumers may see some welcome changes when they enroll or re-enroll in a health insurance plan on HealthCare.gov on November 1. They should expect to see an upgraded web site with new tools to help them window shop and choose the best plans for them.
While the Affordable Care Act has achieved a second victory before the Supreme Court and produced significant coverage gains, it might also have produced a less positive outcome: in an NBER working paper, Penn LDI colleagues Mark Pauly, Adam Leive and Scott Harrington found that a large portion of non-poor (measured by income above 138% of the poverty level) who gained coverage now have a higher financial burden and lower welfare (well-being) than when they were uninsured.
In June, we presented national data from one of the first attempts to measure the size of provider networks in plans sold on the health
insurance marketplaces. We used simple “T-shirt” sizes to categorize networks in a way that could help consumers quickly grasp the
choices they were making. In this Data Brief, we present network sizes summarized up to the level of the state and the rating area.
This analysis should help regulators and consumers assess and understand the trade-off between premiums and network size as we
enter the next open enrollment period.
In June, we described the first attempt to measure, in a consumer-friendly way, the breadth of physician networks offered by all silver plans on the 2014 health insurance marketplaces. We estimated network size based on the fraction of office-based physicians participating in the network within relevant rating areas in the state. We categorized networks using "T-shirt" sizes: x-small (less than 10%), small (10%-25%), medium (25%-40%), large (40%-60%), and x-large (more than 60%). We found that nationally, 41% of all networks were either “small” or “x-small”.
In the beginning (Web Site 1.0), we measured the success of health insurance marketplace sites by whether they worked. Last year (Web Site 2.0), technical glitches were resolved, and we can start to measure success by whether the sites help people make the best decisions in choosing a health plan.
cross-posted with US News
Health insurers are merging everywhere you turn in the newly reformed and more heavily regulated health insurance system. Anthem announced last week it will buy insurance giant Cigna for over $54 billion, acquiring more than 53 million new patients. And Aetna, earlier this month, announced its agreement to buy Humana, the nation’s fifth-largest health insurer.
cross-posted with the Field Clinic
In recent weeks, two sets of already huge health insurers—Aetna and Humana, Cigna and Anthem—have announced plans to combine. And more mergers may be in the works. Should the rest of us fear being trampled when these behemoths connect? The answer to that question, as with almost all questions in health economics, is “it all depends.”
Effects of the ACA’s 3Rs (Reinsurance, Risk Adjustment, and Risk Corridors) on the Bottom Line (Part II)
Yesterday, I looked at the aggregate effects of some of the ACA’s premium stabilization programs (reinsurance, risk adjustment, and risk corridors, the 3Rs). Today, I illustrate the potential effects of the 3Rs on insurers’ reported revenues, costs, and underwriting profits (losses).
Effects of the ACA’s 3Rs (Reinsurance, Risk Adjustment, and Risk Corridors) on the Bottom Line (Part I)
We now have better information on how the “3Rs”—the ACA’s mechanisms designed to help stabilize premiums and protect insurers against large losses in the first years of health care reform—affected insurers’ bottom lines in 2014. In this first of two posts, I review the information reported by CMS for two of the 3Rs: reinsurance and risk adjustment.
The Affordable Care Act (ACA) mandates that private health insurance plans cover all FDA-approved prescription contraceptives with no cost-sharing.
The Affordable Care Act (ACA) has prompted health plans to increase their use of “narrow networks” of providers as a cost containment strategy. The Leonard Davis Institute of Health Economics (LDI) has assembled the first integrated dataset of physician networks for the plans offered on the ACA marketplace. This data brief uses this new resource to describe the breadth of the physician networks in plans sold on the state and federal marketplaces.
There’s been a lot of talk about "narrow" networks in ACA plans, which trade off limited provider coverage for lower premiums. Using a new integrated dataset of physician networks in plans on the federal and state marketplaces, our latest LDI/RWJF Data Brief describes the breadth of physician networks across all silver plans sold in 2014.