August 31, 2017

JUST A TWEAK:

The ACA markets are a narrow problem. They should be treated that way. (Drew Altman, 8/31/17,  Kaiser Family Foundation)

[T]he non-group market is actually fairly small, covering about 18 million people, with about 10 million of them in the ACA marketplaces which have received so much attention. [...]

For context: In fact, the rest of the health system where most Americans get their coverage looks very different from the non-group market. As the chart shows:

Average premiums in the employer insurance market, where 151 million Americans get their health coverage, rose by an average of just 3% last year. And we're expecting continued moderation this year.

Likewise, per capita spending for Medicaid is projected to grow a modest 3% in 2017, with per capita Medicare spending growing by just 2 percent.

The back story: Insurers and regulators have been struggling with a unique set of issues in the non-group market, most especially a sicker than expected risk pool and the uncertainty surrounding Trump administration policies. The most important areas of uncertainty have been whether the administration will continue to pay out the $7 billion in cost sharing subsidies and enforce the individual mandate.

But even before the ACA, the non-group market was also the weak link of the insurance system, with sick people priced out or excluded from coverage altogether.

What to watch: Some think a deal on stabilizing the non-group market could be as narrow as an agreement to appropriate the $7 billion in federal cost sharing subsidies in exchange for greater flexibility for states under the ACA. 

Posted by at August 31, 2017 5:29 AM

  

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