In a stunning rebuke to the political establishment, Donald Trump will now set the healthcare agenda. Although certainly not the sole driver for victory, the ill-timed, eye-popping health insurance cost increases on the exchanges slated for 2017 did not help the Democrats. I bet the Democrats wished they followed this blog since to me, the timing of… [Read More]
Presidential Healthcare Politics
The reason we haven’t heard much about healthcare during this highly charged election year is that the candidates aren’t too far apart. Clinton is supportive of continuing the Obama ACA legacy with small adjustments, and Trump, although asserting repeal and replace, seems to be taking a similar approach: building on the changes made to healthcare under… [Read More]
Employers Outsmart the Government
Last week, the U.S. Census released new data on the prevalence of employers offering health coverage and the employee take-up rate of the coverage being offered. The data is particularly relevant as it is the largest data set in which we can observe employers’ behavior in 2015, the first year employers were bound by the ACA… [Read More]
An Update in Healthcare and Politics
November 8th, 2016 is rapidly approaching, and it is pretty clear that Hillary Clinton will be facing Donald Trump in the presidential election. What does this mean for healthcare? First, let us talk about the landscape. The setup of healthcare exchanges under the Affordable Care Act, the underpinning of healthcare as we now know it, is… [Read More]
Sorry, Did You Say Voluntary?
A few weeks back, the U.S. Equal Employment Opportunity Commission (EEOC) issued final rules regarding how corporate wellness programs can be designed within the framework of existing anti-discrimination laws, namely the Americans with Disabilities Act (ADA) and the Genetic Information Non-discrimination Act (GINA). The rules should serve as a roadmap on how to structure incentives… [Read More]
Be on the Lookout for Marketplace Notices
CMS has released a sample of the notice that the Federally-Facilitated Marketplaces (FFM) will send an employer when one of their employees accesses marketplace coverage and receives a tax credit. These notices will be sent out to employers throughout 2016 with plans for the first notices to be sent out in the coming weeks. Employers should… [Read More]
Examining Multi-Tiered Networks to Minimize Premiums and Foster Consumerism
As health insurance premiums, copays and deductibles become unbearable, we’re often faced with clients who feel completely out of options during renewal conversations. They don’t want to switch carriers, but are out of levers to pull in order to control costs. Now we’re seeing carriers step in with an interesting solution: multi-tiered networks that align… [Read More]
Is Government-Provided Healthcare Better?
I recently returned from a cultural excursion to Havana, Cuba. As a healthcare geek, of course I wanted to know about accessing care in a communist country. First, I must say that I was surprised to find that the country did not live up to the third world impressions which many people may expect –… [Read More]
More Bad News for the Individual Exchanges
In what came as no surprise to the insurance world, Aetna announced it is losing money in its individual exchange business. This comes on the heels of both UnitedHealthcare and Anthem Blue Cross announcing they had lost money in this segment. As we have chronicled in the past, the exchanges are enrolling fewer people than… [Read More]
As Enforcement Increases, So Will Dissatisfaction with the Affordable Care Act
The Affordable Care Act offers generous subsidies to applicants whose income is less than 400% of the federal poverty level. There are a few ways the subsidy can be modified: if an individual’s income varies from what was originally reported on the application or if they are in some manner disqualified from receiving a subsidy…. [Read More]
