We investigate the effect of the Risk Corridors (RC) program on premiums and insurer participation in the Affordable Care Act (ACA)’s Health Insurance Marketplaces. The RC program, which was defunded ahead of coverage year 2016, and ended in 2017, is a risk sharing mechanism: it makes payments to insurers whose costs are high relative to their revenue, and collects payments from insurers whose costs are relatively low. We show theoretically that the RC program creates strong incentives to lower premiums for some insurers. Empirically, we find that insurers who claimed RC payments in 2015, before defunding, had greater premium increases in 2017, after the program ended. Insurance markets in which more insurers made RC claims experienced larger premium increases after the program ended, reflecting equilibrium effects. We do not find any evidence that insurers with larger RC claims in 2015 were less likely to participate in the ACA Marketplaces in 2016 and 2017. Overall we find that the end of the RC program significantly contributed to premium growth.
Workers would be allowed to band together to buy health insurance under a proposed rule released Thursday by the Department of Labor.
The proposed rule was issued in response to an executive order by President Trump, which would allow associations of workers to purchase cheaper health insurance that’s not subject to the same rules as plans under ObamaCare.
This analysis includes the impact of the repeal of the individual mandate penalty.
As has been widely reported, both houses of Congress have now voted to repeal the Affordable Care Act’s (ACA) individual shared responsibility penalty, effective for 2019, as part of the 2017 tax reconciliation act. This post discusses first what the repeal does and does not do. Second it discusses the repeal’s possible effects.
As we have long insisted, America’s health care system consists of the worst of both worlds. It amounts to socialism for the beneficiaries, which generates uncontainable demand via third-party paid, cost-averaged pricing; and crony capitalism for the providers, where delivery system cartels of doctors, hospitals, nursing homes, pharma suppliers, medical device makers etc. have implanted themselves deep on K-street and have thereby rigged reimbursement systems for maximum private revenue gain (and minimum system efficiency and competitive discipline).
Pharma & Healthcare #BeltwayBrief DEC 13, 2017 @ 08:01 AM 1,011 The Little Black Book of Billionaire Secrets Under New Bill, Medical Device Tax Might Vanish, But Only TemporarilyDecember 14, 2017
A controversial tax on medical device sales under the Affordable Care Act could be suspended again rather than disappear permanently under new legislation emerging in the Republican-led Congress.
The 2.3% tax on medical device sales that is part of the ACA has already been on a temporary hiatus since the beginning of 2016. That suspension is scheduled to expire at the end of the month.
But new legislation emerging in the U.S. House of Representatives would put the medical device tax on another hiatus. Reps Erik Paulsen (R-Minnesota) and Jackie Walorski (R-Indiana) said the proposed legislation would suspend the medical device tax for another five years under a new bill introduced Tuesday.
In this study, we analyze the regulation of markets for the provision of services whose costs are subsidized for paternalistic reasons. We model the choice of a benevolent regulator who wants to maximize consumer welfare in a setting where quality cannot be verified and the good provided is fully subsidized. The choice is thus made between two types of providers (profit maximizers and altruistic providers) and two frameworks (monopoly franchise and quality competition). Our analysis shows that in this environment the performance of mixed markets is always dominated by pure forms. Moreover, although making efficient providers compete for the market minimizes cost, the choice of quality competition with altruistic providers may be preferable from a welfare point of view whenever service quality is relevant and the productivity differential is not substantial.
Editor’s note: the U.S. health system is a “mixed markets” approach, implying we could maximize welfare by moving towards market competition or quality competition using altruistic providers.