Those greedy insurance companies?

Health insurance companies are not spending as much money as expected. While COVID-19-related costs are up, the cost savings from people foregoing or delaying elective care has more than offset the COVID costs. Health insurers are refunding much of that savings to their enrollees. However, this is due to a provision of the ACA that…

The problem with step therapy

Step therapy is good in theory, but often not in practice.  In step therapy, patients are required to try one drug first–typically a low cost and/or high-value treatment–before moving on to more expensive alternatives.  In theory, this is a great idea.  The first drug patients should try should be the highest value one. In practice, however,…

Is Obamacare working?

The answer is yes and no. According to a study Holahan, Karpman, and Zuckerman (2016), the health insurance exchange plans are good at insuring individuals against financial losses, but not everyone is happy with the care they are receiving. Low- and moderate-income adults with Marketplace coverage are no more likely to report problems paying medical…

Covered California and Adverse Selection

The Affordable Care Act requires all individuals to be offered the same premium regardless of health status. Although there are some ratings bands based on age and smoking status, most people who purchase insurance on health insurance exchanges receive the same premium for any given insurance product from any given insurance company. The insurance products…