Start with Pharmacy to Reduce Healthcare Costs

Medical golden capsule full of coins isolated on white background

I was at dinner the other night discussing President Trump’s lashing out at insurance carriers and issuing an executive order to suspend federal funding for exchange cost-sharing subsidies (which last week I said was misguided). And my friend, a former insurance company executive, pointed out that since the Affordable Care Act’s passage, healthcare company profits and… [Read More]

Can We Stop the Obamacare Meltdown?


Desperation seems to be setting in as President Obama’s signature legislation crashes and burns. I watched a CBS News feature on Tuesday morning highlighting a 56% increase in the Tennessee market as Blue Cross Blue Shield’s market exit leaves only one insurer in that market. The same is true in Arizona with increases over 100%…. [Read More]

McKinsey Study Is the Latest Evidence That Obamacare Is Not Working


After years of politically biased pontification, likely created by the effects of the ACA, the last few weeks have been littered with actual data-driven evidence on performance. And the news has not been good – that is, depending on your definition of success. Some industry experts seem to have very mixed measures of success that… [Read More]

State Healthcare Innovation Possible With 1332 Waivers

health policy

States are allowed to tiptoe to the healthcare edge with Section 1332 State Innovation Waivers. Under this provision, waivers from the exchange regulations are available. In evaluating the application, HHS has developed guidelines which compare costs and benefits under the waiver program to the exchange system. The evaluation of comparability gives special consideration to the… [Read More]

It’s Time to Get Real About Medical Insurance Costs

healthcare cost medical insurance

Intuit, the tax preparation software company, has said that three-fourths of filers who might be subject to the individual mandate were able to find an exemption in 2015.  It’s no surprise with the liberal policies put in place by regulators that this watered down threat provides little leverage to bring the healthiest Americans into the… [Read More]

Why Is UnitedHealthcare Leaving the Exchanges?

healthcare exchange

UnitedHealthcare’s announcement that it would not participate in the state-based or federal healthcare exchanges wasn’t a big surprise. The cards are stacked against healthcare companies. But first, a little history: The Affordable Care Act erased the actuarial tables on individual health insurance. There were too many unknowns to establish credible pricing. Yet, the national insurers… [Read More]

Healthcare Cost Pressures are Starting to Build

healthcare cost 4

Elected officials are starting to hear static about affordability (or lack thereof) of exchange plans. ACA cost-sharing is simply too high to provide meaningful protection for many middle to low income Americans. CMS put out a new marketing piece entitled: “Five Facts about Deductibles” to deflect the negative impression of deductibles which states: “Here are… [Read More]

Healthcare Is In Even More of a Crisis Under ACA

healthcare us government aca

As healthcare is restructured, the key constituencies are fortifying their positions and as can be expected, taking advantage of the renegotiation, market gyrations and general confusion. Fraud (intentional or otherwise) is rampant and uncontrolled. During a recent congressional hearing on the website, a GAO official testified about efforts to test by enrolling 18 completely… [Read More]