Entries by David Anderson

IDNs, HHI and switching costs

Warning — this is going to be a nerdy post even by my standards —- Last week at the National Health Policy Conference, I attended the most depressingly enlightening session on the schedule. It was an examination of the concentration of both insurers and providers in the health care industry. There are a dozen powerful […]

Wellmark and Iowa’s market questions

Wellmark is Iowa’s largest insurer.  They control the vast majority of the underwritten individual market in Iowa as well as a significant chunk of the employer sponsored insurance market. They left the Iowa ACA market in 2018 after they lost a boat load of money in 2016 and 2017.  They also were a major intellectual […]

Funding CSR and getting something back

Axios’s Caitlyn Owen’s reported recently that Senator Murray (D-WA) is still trying to get Alexander-Murray passed with modifications. I’ve been on-board with three of the four segments. I have not thought that Cost Sharing Reduction (CSR) subsidies should be appropriated as Silver Loading combined with either Silver Switch or state 1332 waivers could improve the […]

HSA and market volalitity

Health Savings Accounts (HSA) can be invested in the stock market. Over a long enough time horizon, stocks have better rates of return than other investment classes as they have more risk. The idea is that in most years, most people barely touch the medical system so savings can be built up during good years […]

What insurers want CSR funded?

Earlier this week, the Hill reported that the Blue Cross and Blue Shield Association wanted Congress to appropriate funding for Cost Sharing Reduction (CSR) subsidies: A leading health insurance group said Monday there is an “urgent” need for Congress to act to stabilize ObamaCare markets after the repeal of the individual mandate in December. “There’s […]

Network thoughts from NHPC

I was at the Academy Health National Health Policy Conference this week and it was wonderful. I learned a lot, I nerded out a lot, I saw a bunch of people that I mainly see on Twitter. I also am in the middle of a really good rethink on network choice structures. Katherine Ho of […]