Entries by David Anderson

Pricing matters

At the Health Affairs Blog, I looked at the on-Exchange enrollment changes in 2018 stratified by the type of exchange and the state strategy for dealing with the termination of Cost Sharing Reduction (CSR) subsidies. This is the money exhibit:   Unsurprisingly, to me at least, pricing matters. Silver Loading, the CSR strategy that placed […]

Plan domination and the Gold Gap Strategy

I’ve been a major proponent of states Silver Loading CSR costs onto only their Silver plans so that premium tax credits would increase faster than the overall rate of claims cost increases. This makes the subsidized premium of Platinum, Gold and Bronze plans lower than they otherwise would have been. There is a major concern […]

Iowa’s new monopoly

Iowa’s governor signed into law a plan that will intentionally break the ACA market in Iowa When you step back, Iowa's plan to let the Farm Bureau sell unregulated insurance is pretty wild. Although it looks like health insurance, the Farm Bureau's plan will not be called health insurance. Therefore, it won't be regulated by […]

Utah’s partial expansion request

Utah’s governor just signed a bill that authorizes a 1115 Medicaid demonstration waiver. The waiver combines work requirements with a request. This is interesting on several levesl. KUER reports: The new law would ask the federal government to allow Utah to widen it’s low-income health insurance program. Right now, a single adult with Medicaid coverage […]

Quality in networks

Covered California is the California exchange entity. It is very different than any other exchange in the country as it is a very active buyer and manager of the choices it allows to be sold on the individual market. This has allowed it to be the leading Silver Gapper and Silver Loader in the country […]

Evaluating Buy-in proposals

Last week, Emma Sandoe and I wrote in the Health Affairs blog an outline on how to think about evaluating Medicaid buy-in proposals.  We thought that as the primary season is opening up and the chaos in the individual market, that more states will start thinking about Medicaid buy-in options for the individual market.  From […]