Medicaid HMOs: Growth Prospects Undervalued
We believe that growth prospects for the commercial HMOs (e.g. CI, AET, WLP, UNH) are substantially weaker than growth prospects for the Medicaid HMOs (e.g. MGLN, WCG, CNC, MOH), but…
ACA Enrollment Round-Up – How Many Have Paid Premiums; How Many Were Already Insured Last Year; How Their Health Compares to Employer-Sponsored Beneficiaries’
7.5 million persons selecting a plan … On Thursday the Administration announced a revised enrollment estimate of 7.5 million persons for the Affordable Care Act’s (ACA) health insurance exchanges (HIEs).…
ACA Enrollment and Adverse Selection Pressures – An Update
The age-mix of health insurance exchange (HIE) enrollees (Exhibit 1, green columns) skews older than the age-mix we believe is necessary (Exhibit 1, grey columns) to avoid adverse selection, i.e.…
Your (HIE-based) Plan Doesn’t Cover That: A Comparison of Drug Formularies On and Off the Health Insurance Exchanges
Summary and Conclusions The prescription drug formularies of health plans sold on the Affordable Care Act’s (ACA’s) public health insurance exchanges (HIEs) are significantly more restrictive than the drug formularies…
Adverse Selection on the HIEs – It’s Not (Just) About the Federal Website
Health insurance exchange (HIE) enrollment levels through December 28 remain quite low. States operating their own exchanges enrolled 1.0M persons, equivalent to 7.4% of these states’ adjusted uninsured populations (Exhibit…
Drug Benefit Chicken: An Analysis of Benefit Designs on the Health Insurance Exchanges
Summary To get a sense of what drug coverage will look like across plans offered on the health insurance exchanges (HIEs), we analyzed the drug benefits of all Silver[1] plans…
Why Adverse Selection is Likely on the HIEs: A Simple Model of Enrollment Behavior
What enrollment patterns are required for premiums to meet or exceed claims paid on the health insurance exchanges (HIEs), and can we reasonably expect these patterns to emerge? We showed…
Higher Premiums – and Higher Deductibles: An Analysis of Health Plans on Offer in 2014
Summary To better understand how the Affordable Care Act (ACA) may have affected price / value relationships in the market for individually purchased coverage, we’ve compared premiums (by age), deductibles,…
ACA: Web Problems and Political Drama are Temporary. Ambivalence of the Uninsured is Permanent
Summary and Conclusions Despite the ACA’s razor-thin margin of passage and ideologically narrow base of support, more Americans want to see the Act implemented than to see it dismantled, or…
A Simple Yardstick for HIE Enrollment: CBO’s Revised Estimate Looks Like an Outer Bound
Price : Quantity relationships in the employer sponsored (ESI) market To estimate price elasticity of demand for health insurance in the employer sponsored (ESI) market, we define the price of…