Entries by David Anderson

Delaware and affordability

Yesterday, we briefly talked about Delaware receiving approval for a 1332 reinsurance waiver.  This waiver will reduce non-subsidized premiums.  It will make insurance for folks earning above 400% FPL more affordable.  State regulators expect a 20% decline in premiums.  Some of that decline is from the state funding and some of it is from reduced […]

Flavors of public ACA reinsurance

Delaware just had their ACA Section 1332 reinsurance waiver approved by the Center for Medicare and Medicaid Services (CMS). This plan is one of two flavors of public re-insurance for the ACA market. This flavor is the external money flavor. In it, an external source of state based money is added to the pool of […]

Partisanship, policy and adverse selection

Samual Trachtman’s fascinating paper** on the feedback loop between political polarization and ACA premiums just got released by the Journal of Health Politics, Policy and Law (JHPPL). The headline finding is fascinating on multiple levels: Insurers have increased marketplace premiums at higher rates in areas with more Republican voters. In the preferred model specification, a […]

Social and health spending

The big problem in US healthcare spending is that we don’t spend enough on social services and as social services can act as an upstream substitute of expensive medical services. This is a core assumption of the social determinants of health argument. A new article in Health Affairs by Irene Papanicolas and others explodes this […]