Individual insurance market performance in early 2019: The Henry J. Kaiser Family Foundation

“The early years of the Affordable Care Act (ACA) exchanges and broader ACA-compliant individual market were marked by volatility. Markets in some parts of the country have remained fragile, with little competition, an insufficient number of healthy enrollees to balance those who are sick, and high premiums as a result,” Rachel Fehr, Cynthia Cox and […]

Behind the scenes at a health insurer: How the money is made, or why the Medical Loss Ratio matters

Behind the scenes at a health insurer: How the money is made, or why the Medical Loss Ratio matters

A contributor to one of my online communities, Scott Haas, wrote this to the group the other day in the context of what happens behind the scenes in health insurance. His note primarily concerns the Medical Loss Ratio formula and the way it was changed by the Affordable Care Act — and the role of […]

Claims denials and appeals in ACA marketplace plans: Kaiser Family Foundation

Claims denials and appeals in ACA marketplace plans: Kaiser Family Foundation

“In this report, we analyze transparency data released by the Centers for Medicare and Medicaid Services (CMS) to examine claims denials and appeals among issuers offering individual market coverage on healthcare.gov from 2015-2017,” Karen Pollitz, Cynthia Cox and Rachel Fehr write for the Kaiser Family Foundation, in a startling analysis of federal data that reveals […]

What to know before you buy short-term health insurance: The New York Times

Filed Under: Costs, Health plans, Patients

What to know before you buy short-term health insurance: The New York Times

“The Trump administration has just completed rules that will allow people to shop for a new kind of health insurance,” Margot Sanger-Katz writes over at The New York Times. “So-called short-term plans will be offered for relatively long periods — just under a year at a time, with renewals for up to 36 months — […]

Obamacare is proving hard to kill: The New York Times

Obamacare is proving hard to kill: The New York Times

“As health insurers across the country begin filing their proposed rates for 2019, one thing is clear: The market created by the Affordable Care Act shows no signs of imminent collapse in spite of the continuing threats by Republicans to destroy it,” Reed Abelson writes over at The New York Times. “In fact, while President […]

Those who don’t qualify for government aid aren’t buying Obamacare plans: The Washington Post

Those who don’t qualify for government aid aren’t buying Obamacare plans: The Washington Post

“There’s an ever-growing chasm between the number of Americans who receive government subsidies — meant to offset the cost of buying health insurance on the individual marketplaces — and those who don’t under the 2010 law known as Obamacare,” Colby Itkowitz writes over at The Washington Post.  “Fresh enrollment data released Monday by the Centers for Medicare […]

A past pre-existing condition shouldn’t mean my son is denied insurance: Stat News

A past pre-existing condition shouldn’t mean my son is denied insurance: Stat News

“When our second child, Zade, arrived in 2004, my wife and I thought we knew most of the hazards facing babies,” Doug Hirsch writes over at Stat News. “Until the night in the fast food restaurant when Zade died. At least that’s what it seemed like. I had taken him to the bathroom to change […]

The sky-high pay of health care CEOs: Axios

The sky-high pay of health care CEOs: Axios

“The CEOs of 70 of the largest U.S. health care companies cumulatively have earned $9.8 billion in the seven years since the Affordable Care Act was passed, and their earnings have grown faster than most Americans’ during that time, according to an Axios analysis of federal financial documents,” Bob Herman writes over at Axios, in […]

The only health insurance enrollment guide you’ll need

The only health insurance enrollment guide you’ll need

This post originally appeared on Forbes, where I am a contributor. It’s open enrollment season for health insurance. And this year there’s much more confusion than in past years, given the events in Washington. Don’t worry: I’ll break it all down for you in this, the only guide to buying health insurance you’ll need this year, […]

Buying health insurance: An invaluable resource from Charles Gaba at acasignups.net

Buying health insurance: An invaluable resource from Charles Gaba at acasignups.net

An excellent source for how to think about buying health insurance if you’re not employer- or government-covered is this one, from Charles Gaba, a Web developer who has meticulously kept track of the Affordable Care Act for several years now. The effects of the events in Washington on different people with different income levels and […]