17.07.2018 10.34 CDT

At the core of the Administration’s actions to dismantle the ACA are actions that pull lives out of the risk pool; undermining the integrity of the ACA’s risk pools will undermine the stability of health insurance markets. This instability may prove to be yet another set of ACA-related headaches for employers.

Risk Pooling, Risk Shifting and Risky (Health Insurance) Business

Risk Pooling, Risk Shifting and Risky (Health Insurance) Business

It is difficult to measure the specific effects, of each of these actions, on health insurance markets. However, there is increasing evidence that the cumulative effects of these actions are reshaping health insurance markets in the United States.

Over the past year the Administration has taken a number of steps that serve to undermine the ACA by facilitating the movement of covered lives away from plans covered by the ACA - by increasing premiums, by discouraging carrier participation in ACA exchanges and by reducing behavioral barriers to dropping individual coverage. These actions represent traps for employers caught in the middle of this slow-motion ACA repeal.

04.11.2017 12.57 CDT

The Centers for Medicare & Medicaid Services (“CMS”) has issued new proposed regulations regarding the operation of health insurance exchanges under the Affordable Care Act (“ACA”). These proposed regulations will provide increased authority to states and insurance companies.

The (Ongoing) Saga of ACA: New Proposed Regulations

The (Ongoing) Saga of ACA: New Proposed Regulations

Proposed regulations will transfer control over key decisions from the federal government to individual states and insurance companies.

Proposed regulations will transfer control over key decisions from the federal government to individual states and insurance companies. The proposed regulations do not, directly, make significant changes to the health insurance coverages offered under ACA. However, they set the stage for such changes to occur in coming years.

08.10.2017 11.11 CDT

Employers are caught in the middle of the ongoing stalemate over the future of the ACA. Unfortunately, being caught in the middle could prove to be costly in a variety of ways.

Healthcare Wars: Employers Caught in the Middle

Healthcare Wars: Employers Caught in the Middle

As the political battles over the possible repeal, replacement or repair of the Affordable Care Act (ACA) drag on, employers are likely to get caught in the middle.

As the political battles over the possible repeal, replacement or repair of the Affordable Care Act (ACA) drag on, employers must come to grips with an unpleasant reality: they are likely to get the worst of all worlds for the foreseeable future.

05.03.2017 03.25 CST

People on Medicare should pay attention to the ongoing debate over a TrumpRyanCare proposal - your prescription drug costs could be affected.

ACA Repeal and Medicare Beneficiaries

ACA Repeal and Medicare Beneficiaries

People who have prescription drug coverage under Medicare may, once again, fall into the "donut hole" if Obamacare is repealed.

Efforts to replace and repeal the Affordable Care Act will have the greatest effect on those under 65 - but may also have a significant impact of people covered by Medicare. Specifically, if the AC is repealed your cost of prescription drugs may go up. Here how Medicare beneficiaries may be impacted by an ACA repeal.

02.03.2017 02.35 CST

Those promoting Trump/RyanCare will focus their message on accessibility rather than affordability. To the extent they discuss affordability, they will focus on the aspirational goal of making health care more affordable in the long term.

Access to Healthcare Under TrumpRyanCare

Access to Healthcare Under TrumpRyanCare

Those who rely on financial support under ACA are likely to find themselves entering new terrain.

The Affordable Care Act (ACA) sought to provide increased access to health insurance with two different sets of provisions – those impacting “market” access (“If I apply for a policy, can I get one?”) and others focused on “financial” access (“Can I afford a policy?”). This blog post will describe how Trump/RyanCare is likely to treat the market access provisions of ACA differently than the financial access provisions - and how different groups will be affected.