health insurance exchanges

More than 8 million U.S. children depend on the Children’s Health Insurance Program for access to timely medical care. The program is authorized through 2019, but its federal funding expires in September and it’s unclear what Congress will do. That uncertainty stresses all the systems and families that depend on CHIP, but it may be especially risky for the 2 million chronically ill children who get care through the program, which was originally designed for families falling in the gap between market affordability and Medicaid eligibility. In a study published this month in Health Affairs,…
There was always an assumption that the Affordable Care Act would need time to find its sea legs. That’s why it included measures to shield insurers from the potential profit losses that inherently come with offering millions more people better health coverage at more reasonable prices. Insurers operate on profit margins and the ACA took that into account, for better or for worse. But it’s still been a rocky road for insurers. (Insert argument here for single-payer health care, but that’s a different story.) On the patient side, with 20 million more Americans insured and growing accounts of…
If you look at the numbers, there’s no doubt that the Affordable Care Act is making a positive difference. In fact, just last month, the U.S. Census Bureau reported that the nation’s uninsured rate had hit a record low. At the same time, the health reform law wasn’t intended as a silver bullet and a number of problems remain. One of those problems is known as “churning.” “Churning” describes changes in a person’s insurance coverage over time and it’s an issue that can have a significant impact on a patient’s continuity of care and health status. Of course, changes in insurance coverage are…
More good news from the Affordable Care Act: Since it became the law of the land, uninsurance disparities between white, black and Hispanic residents have narrowed significantly. In a study published this month in the journal Health Affairs, researchers found that by the fourth quarter of 2014, the uninsurance rate for Hispanic adults had fallen to 31.8 percent from about 40 percent in the third quarter of 2013. During the same time period, uninsurance among black adults declined from 25.5 percent to 17.2 percent, while uninsurance among white adults fell from 14.8 percent to 10.5 percent.…
“Established by the state.” Those are the four words at the center of an upcoming Supreme Court case that could strip affordable health insurance coverage from millions of working families and result in billions of dollars in uncompensated care costs. The case is known as King v. Burwell and at its core is the question of whether residents who live in states with federally administered health insurance marketplaces, versus state-run marketplaces, are eligible to receive insurance subsidies. The plaintiffs in the case claim that those four little words in one section of the entire Affordable…
With so much pressure on the Affordable Care Act to immediately live up to high expectations, and with opponents who seem gleeful at the news that Americans are having a hard time signing up for affordable health care, it’s reassuring to read that the health reform law can readily take a few blows and keep moving forward. In a December analysis released by the Urban Institute, authors Linda Blumberg and John Holahan write that the “Affordable Care Act is unlikely to suffer long-term damage even if the marketplaces experience low enrollment and some adverse selection in the first year.” (…
The extent to which the Affordable Care Act succeeds in making affordable health insurance more widely available depends to a great degree on the success of the state-based health insurance exchanges that are currently being developed. A piece by Ewout van Ginneken and Katherine Schwartz in the latest New England Journal of Medicine offers some advice and cautions about the exchanges, based on the experiences of the Netherlands and Switzerland. Both those countries rely extensively on private insurers plus substantial government involvement. Risk adjustment is one key to exchanges' success.…