Individual Health Insurance Market

2022 Marketplace Rate Filings Show Few Pandemic-Related Increases

by Victoria Bailey

Based on 75 individual marketplace rate filings, the coronavirus pandemic is not expected to meaningfully affect healthcare spending in 2022, a Peterson-Kaiser Family Foundation (KFF) Health System...

Public Option with ACA Subsidies Lowers Gains in Federal Spending

by Kelsey Waddill

As policymakers consider using Affordable Care Act subsidies to reduce the Medicaid gap and extend healthcare coverage to all Americans with incomes below the federal poverty line, they could implement...

CMS 2022 Payment Parameters Look to Boost Access to ACA Coverage

by Kelsey Waddill

In its latest proposed update to the 2022 Payment Parameters, CMS has suggested steps to expanding access to coverage through the Affordable Care Act marketplace, steps which would impact the Navigator...

Nevada Set to Become Second State with Public Option Health Plan

by Kelsey Waddill

The state of Nevada could become the second state to embrace a public option health plan, if the governor signs SB420. “Section 10 requires the Public Option to be available through the Exchange...

CMS Raises Awareness of ACA Marketplace Coverage for Gig Workers

by Victoria Bailey

The Centers for Medicare and Medicaid Services (CMS) is asking online platform companies to bring awareness to their gig workers’ ability to obtain Affordable Care Act marketplace coverage during...

ACHP Urges Policymakers to Solidify Affordable Care Act Changes

by Victoria Bailey

The Alliance of Community Health Plans (ACHP) released recommended steps to build on the success of the Affordable Care Act (ACA) and enhance and expand coverage in the...

How Extending ACA Premium Tax Credits May Fix the Family Glitch

by Kelsey Waddill

By making all family members eligible for marketplace premium tax credits with the exception of those who have access to affordable coverage individual health insurance marketplace premiums may decline...

Gross Margins, MLRs May Confirm Payer Profitability in 2020

by Kelsey Waddill

Gross margins and medical loss ratios from 2020 may confirm that payer profitability increased during the coronavirus pandemic, according to a brief from Kaiser Family Foundation. The researchers...

Uninsurance May Drop 14% If ACA Subsidy Increases Are Solidified

by Kelsey Waddill

If Congress made permanent the American Rescue Plan’s Affordable Care Act subsidy increases, then uninsurance might drop, marketplace enrollment could rise, and non-group premiums could decline...

Rectifying the ACA Family Glitch Could Drive ACA Premiums Down

by Kelsey Waddill

Approximately 5.1 million individuals are caught in the Affordable Care Act’s “family glitch,” according to a recent Kaiser Family Foundation (KFF) analysis. Under the Affordable...

How to Compare Impacts of Capped Provider Payment, Public Option

by Kelsey Waddill

While both public option and capped provider payment rates have the potential to produce savings, the solutions differ in how they would impact insurer marketplaces, a recent analysis from the Urban...

How Expanding ACA Premium Tax Credits Could Effect ESI Coverage

by Kelsey Waddill

Opponents of expanding the Affordable Care Act’s premium tax credit policy have argued that doing so would have a negative effect on employer-sponsored insurance, but recent research from the...

Aetna to Re-Enter ACA Individual Health Insurance Marketplace

by Kelsey Waddill

Aetna will be returning to the Affordable Care Act's individual health insurance marketplace, CVS Health announced in its 2020 fourth-quarter earnings results. “As the ACA has evolved...

Payers Expect Enrollment to Offset Normalized Healthcare Spending

by Kelsey Waddill

As major payers like Centene and Cigna emerge from an atypical year, they are predicting in their fourth quarter 2020 earnings reports that revenues will increase in 2021, despite utilization and...

Anthem Earnings Call Projects COVID-19 Vaccine Impact, ACA Growth

by Kelsey Waddill

Coronavirus vaccine distribution and the new administration may have an impact on payers’ costs and marketplace growth in 2021, Anthem’s fourth quarter of 2020 earnings call...

Nevada Explores Potential State Public Option Models, Impacts

by Kelsey Waddill

Nevada’s state senate might consider a public option based on an existing public program or a model that creates a new Silver or Gold public option plan on the Affordable Care Act...

Payer Gross Margins, Medical Loss Ratios Point to a Profitable 2020

by Kelsey Waddill

Although utilization has started to return to normal levels, payers have continued making a profit during the third quarter of 2020, a Kaiser Family Foundation brief discovered. “In this brief,...

CMS Proposes Reduced Exchange User Fees To Lower ACA Premiums

by Kelsey Waddill

CMS has proposed diminishing federal exchange fees in order to lower Affordable Care Act premiums on the federal exchange platform. This proposal comes as part of the 2022 payment...

ACA Marketplaces Gain Payers in 2021, Rural Areas Still Struggle

by Kelsey Waddill

Over three-quarters of Affordable Care Act marketplace enrollees will have three or more payer options in 2021, a Kaiser Family Foundation (KFF) report found. That represents an 11 percent increase...

Market Concentration Escalated in Small Group, Individual Markets

by Kelsey Waddill

The Government Accountability Office (GAO) has released a report finding high market concentration across the payer industry and that having increased health plan options does not necessarily reduce...