Entries by David Anderson

Commercial plans are expensive vs. Medicaid

A few weeks ago as the Senate introduced the BCRA, I made a note on the cost equivalence of using the baseline 58% Actuarial Value (AV) subsidy funds for Medicaid. Medicaid pays providers a lot less than most commercial plans in most states. The AV difference is meaningful and significant. The cost effectiveness is the […]

Block grants and breathing

Block grants offer a fixed sum of money that may be indexed to a predetermined growth rate. They provide the granting entity with a predictable cash outflow. They don’t offer flexibility to accommodate changes in subgroup patient mixture or new technologies that are more effective and more costly than current best choice treatments. Cystic Fibrosis […]

Stable sub-optimal equilibriums

Iowa has Exchange problems. It has a single insurer, Medica, planning to be on-Exchange in 2018. Its prices are comparatively high which is mainly a problem off-Exchange. There are real problems in Iowa. Yet Iowa is in a stable, sub-optimal equilibrium of a single carrier taking on all actuarial risk without taking on strategic competition […]

The old days pre-ACA

The Cruz and Trump plan is to restore the insurance industry to the pre-ACA status quo: WOW: @SecPriceMD admits Senate bill would basically permit insurers to operate like they did before ACA: deny coverage, price folks out pic.twitter.com/GCPaFKO3wB — igorvolsky (@igorvolsky) July 16, 2017 And what does that look like? Here is a brochure targeted […]