Entries by David Anderson

Meaningful difference, APTC Hacking and optimization problems

The loose meaningful difference regulation produces some desirable, from Center for Medicare/Medicaid Services (CMS) point of view, outcomes. The biggest positive outcome from CMS’s point of view and the point of view of PPACA supporters is a good Congressional Budget Office (CBO) score. The subsidies are based on the price of the second lowest Silver. […]

You be the referee

As the fall season heats up, just a couple of scenarios to think through:   Scenario A:   What do you do? Scenario A-1 — what happens if the keeper smothers the ball one bounce before it is in the net? Scenario A-2 — what happens if the keeper actually gets his hands on the […]

And Kentucky just got worse

Kentucky released their revised Medicaid waiver application earlier this week.  We had looked at their draft application a few months ago.   The base story in their draft application was that people on Legacy Medicaid would barely be touched by the institution of road blocks, bureaucratic barriers, confusion and add-on requirements.  The Medicaid expansion population that […]

APTC Hacks – buggering the competitors

On the whole I want as many insurers and states to engage in a Silver Gap strategies.  However there are situations where it can be used offensively to bugger and beggar competitors.  Let’s walk though an example. The scenario needs one insurer that actually wants to cover people in a county.  It also needs an […]