Affordable Care Act

CMS: Idaho Association Health Plan Expansion Violates ACA

by Thomas Beaton

CMS Administrator Seema Verma informed Idaho governor C.L. “Butch” Otter (R-ID) and state insurance officials that efforts to launch an expansion of association health plan (AHPs) sales...

BCBS Earned Positive ACA Health Plan Revenues in Uncertain Market

by Thomas Beaton

BlueCross BlueShield of North Carolina (BCBS of NC) earned positive ACA health plan revenues after years of financial losses, citing low medical claims and more available consumers after other payers...

Idaho’s Expansion of Association Health Plans Risks ACA Market

by Thomas Beaton

The Academy of Actuaries warned insurance officials and government leaders in Idaho that the decision to expand the sale of association health plans (AHP) will destabilize ACA individual health plan...

Uninsured Adults Apprehensive About Health Insurance Costs

by Thomas Beaton

About 71 percent of uninsured adults aware of open enrollment periods did not enroll in state or federally-based health plans because of apprehension to rising health insurance costs and waning...

Reinsurance, CSR Reinstatement May Stabilize Individual Premiums

by Thomas Beaton

AHIP supports a number of policy solutions that could reverse Trump Administration actions that have resulted in higher premiums and unstable markets. In a new policy brief, the payer advocacy group...

CMS Proposes 9-Month Extension of Short-Term Health Plans

by Thomas Beaton

CMS is proposing that consumers should be allowed to stay on short-term health plans, including association health plans, for twelve months at a time, despite the fact that these plans are generally...

Idaho Prepares to Offer Association Health Plans to Consumers

by Thomas Beaton

Idaho will allow payers to offer association health plans (AHPs) that are not required to meet all of the consumer protections or benefits criteria included in the Affordable Care Act.   Governor...

2019 HHS Budget Aims for ACA Repeal, Public Payer Savings

by Thomas Beaton

The newly proposed HHS Budget for fiscal year (FY) 2019 says a repeal and replace of the Affordable Care Act (ACA) would save the government trillions, while restructuring Medicare and Medicaid could...

Academy of Actuaries Reaffirms Association Health Plan Risks

by Thomas Beaton

The American Academy of Actuaries released a statement reaffirming its concerns with expanding association health plan (AHPs) availability in light of perceived risks to the individual insurance...

ACA Implementation Led to Varied Out-of-Pocket, Premium Spending

by Thomas Beaton

Affordable Care Act (ACA) implementation led to an 11.9-percent decrease in out-of-pocket spending but also a 12.1-percent increase in premium spending totals, according to a study published in JAMA...

Proposed Rule Details Association Health Plan Expansion Guidelines

by Thomas Beaton

The Department of Labor (DoL) released a proposed rule that allows small businesses and employee groups to purchase association health plans (AHPs) in lieu of employer-sponsored or individual health...

Healthcare Insurance Market Profits May Hold Steady in 2018

by Thomas Beaton

Certain segments of the healthcare insurance market, including employer-sponsored insurance and Medicare Advantage (MA), will help to stabilize payer profitability in 2018, predicts a report by A.M....

Affordable Care Act Changes May Bring a Rocky 2018 for Payers

by Thomas Beaton

2017 was a turbulent year for the Affordable Care Act.  Legislative battles in Congress, fluctuating support from healthcare stakeholders, and threats of repeal have left many payers facing an...

2018 ACA Open Enrollment Totaled 8.82M Beneficiaries in Last Week

by Thomas Beaton

Approximately 8.82 million beneficiaries enrolled in a health plan during the seven week 2018 ACA open enrollment period, which experienced surges in health plan purchasing activity during the...

Federal Tax Bill, Individual Mandate Repeal Passes House and Senate

by Thomas Beaton

GOP lawmakers in both the House and Senate passed a federal tax bill that includes a repeal of the ACA’s individual mandate to purchase health insurance.  The bill now heads back to the...

AHIP, BCBS: Association Health Plan Expansion Presents Concerns

by Thomas Beaton

An October executive order that expands the availability of short-term association health plans (AHPs) could present significant challenges for state governments and consumers, asserted AHIP, BCBS, and...

ACA Cost Concerns Offer Payers a Member Engagement Opportunity

by Thomas Beaton

Consumers purchasing health insurance through the ACA exchanges are likely to actively seek out lower-cost options when enrolling or re-enrolling in individual health plans, says new data from GAO,...

Individual Mandate Repeal Would Lead to Payer Financial Losses

by Thomas Beaton

A repeal of the individual mandate, as included in the current GOP Senate tax reform plan, would result in financial losses for payers that could not be offset by cost-sharing reduction payments, the...

Prescription Drug Spending Cuts Require Payer Policy Changes

by Thomas Beaton

The US’s current prescription drug policies require updates that cut prescription drug spending while increasing competition in the market, a new report from the National Academies of Sciences,...

Senate Passes Tax Bill, Individual Mandate Repeal in 51-49 Vote

by Thomas Beaton

The US Senate voted 51-49 to reform national tax policy and simultaneously repeal the Affordable Care Act’s individual mandate, major news outlets reported at the end of last week. GOP senators...