SPOTTED: Melissa McCarthy scoots around NYC on a White House podium (VIDEO) https://t.co/e6Z7JDL1mw pic.twitter.com/ZDAhriBQLA — Talking Points Memo (@TPM) May 12, 2017 There are three important things to come of this. 1) I am staying up past my bed time 2) SNL is aiming for monster ratings 3) We’ll see an exacerbation of the rolling …
Donuts and AHCA plan design
Insurers can design plans under the AHCA and MacArthur constraints that will be attractive to most healthy people that they can underwrite. They will offer plans that are priced at the subsidy level in two basic configurations. A third design will be offered that is a risk attraction magnet. But let’s talk donuts first! Andrew …
CSR and Certainty
Cost Sharing Reduction (CSR) subsidies are the 2017 Sword of Damocles. Insurers have to provide an actuarial value bump to low income on-Exchange buyers but they don’t know if the Federal government will pay for the bump. Their current contracts with the Center for Medicare and Medicaid Services (CMS) allows carriers to withdraw from the …
Managing the information fire hose
How do we manage the information fire hose when critical public news breaks in an area with significant technical jargon, precedents and folk ways breaks through the barrier of interesting to vital. How do we, people who want to be reasonably well informed, differentiate between the spectrum between expertise to bullshit to active noisemaking to …
CSR assumptions and impacts
Yesterday’s letter from Blue Cross and Blue Shield of Tennessee illustrates the strategic dilemma insurers face as they have to set prices for next year. What should they assume on Trump administration monkey wrenching? Given the potential negative effects of federal legislative and/or regulatory changes, we believe it will be necessary to price-in those downside …
A prediction for East Tennessee
News: Tennessee’s empty shelf problem appears to be fixed! Blue Cross of TN will sell coverage in Knoxville area. — Sarah Kliff (@sarahkliff) May 9, 2017 My mental model of bare counties being covered by other in-state insurers that are looking to maximize the revenue from a local near monopoly is being tested in Iowa. …
HHI hacking argument in Massachusetts
The New England Journal of Medicine has a great piece on the arguments of the Partners Effect in the Eastern Massachusetts healthcare and hospital market. It is framed as an explainer as to why Lahey Clinic and Beth-Isreal-Deaconess would want to merge as a matter of public interest instead of internal gains seeking: The system …