Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Health Insurance' Category

How did the Affordable Care Act affect the U.S. labor supply?

The Affordable Care Act (ACA) aimed to increase health insurance coverage largely through two pathways: (i) raising the income limits for individuals to qualify for Medicaid, (ii) creating new health insurance exchanges and health insurance subsidies to encourage the purchase of private health insurance among individuals that were not eligible for Medicaid.  Other provisions, such […]

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What happens to CHIP?

The Children’s Health Insurance Program (CHIP) is a federal program that provides matching funds to states in order for them to provide health insurance to children.  The program was designed to cover uninsured children in families with incomes that are modest but too high to qualify for Medicaid. Currently, however, the program is in jeopardy.  In fact, federal funding for […]

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The Big Five

UnitedHealthcare, Anthem, Aetna, Cigna and Humana are the five largest health insurers in America. To learn more about them, check out a recent paper by Schoen and Collins (2017) in Health Affairs. The five largest US commercial health insurance companies together enroll 125 million members, or 43 percent of the country’s insured population…In 2016 Medicare and Medicaid […]

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Health insurance expansion and physician supply

When new bills pass in Congress or state legislatures that expand health insurance coverage, most researcher look at the demand side effect.  How does the insurance expansion affect the number uninsured?  How does it affect access to care?  How does it affect out of pocket cost? What is less frequently studied is the supply side […]

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Progress on Obamacare Sign-ups

According to the N.Y. Times: Despite the Trump administration’s efforts to scale back the health law, about 300,000 more people have signed up for health insurance in the Affordable Care Act marketplaces in the first weeks of this enrollment period than last year. This is about a 25% increase from last year at this time.  However, […]

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Why shopping for health insurance is hard

The premise is simple.  Create markets, let consumers choose the products that fit them best, and the competition will lead to higher quality and lower prices.  That is the premise behind the Affordable Care Act’s health insurance exchanges.  A necessary condition for this to work, however, is that patients have visibility into the quality and […]

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Are PBM exclusion lists value-based?

Value-based insurance design (VBID) is a simple concept.  In short, interventions that provide high-value should be covered with little cost sharing; treatments with low-value should be covered with higher rates of cost sharing or in some cases perhaps not even covered at all. A paper by Cohen et al. (2017) aims to see how far […]

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Why don’t we rely exclusively on CEA estimates to make drug coverage determinations?

Cost effectiveness analyses (CEA) typically analyses the value of a new treatment relative to its cost.  If the value of the additional health benefits outweigh the additional cost, then they should be covered; if the additional cost outweighs the additional benefit, then it should not be covered, right? There are a few issues with this […]

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Trump tax bill keeps the individual mandate

The Trump tax bill–potentially known as the “the Tax Cuts and Jobs Act“– includes provisions such as increasing the standard deduction and reducing the number of tax brackets from 7 to 4.  Additionally, a number of deductions are removed–such as capping local and state property tax deductions at $10,000 and only allowing mortgage interest deductions for […]

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Do HDHPs save money?

This is the question that Zhang et al. (2017) attempt to answer using data form people who switched to a high-deductible health plan (HDHP) compared to those who stayed in the same plan.  They found: After enrollment in HDHPs, 28 percent of enrollees changed physicians for office visits (compared to 19 percent in the Traditional […]

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