Tag Archives: Covered California

How Californians Could Benefit From ACA ‘Repeal And Replace’

There are at least two major areas where California could cooperate with the Trump Administration and the Republican Congress: improving coverage and access for the working poor, and controlling health care costs.

February 9, 2017

Obamacare Premiums Are Lower Than You Think

Since the ACA's health insurance marketplaces first took effect in 2014, news story after story has focused on premium increases. Missing from this narrative, however, is that average premiums in the individual market actually dropped significantly upon implementation of the ACA.

July 21, 2016

Lessons From California’s Public Reporting On Pathways To Health Insurance Coverage

California launched an ambitious effort to collect and report key data on the pathways to publicly subsidized health care coverage. The systematic understanding that the state is building about the flow of enrollment lays the groundwork for fully understanding the challenges of connecting...

May 4, 2016

What Risk Adjustment Does — The Perspective Of A Health Insurance Actuary Who Relies On It

Under the ACA, insurers offering new policies in the individual market must cover anyone who can pay. However, there are still ways for insurers to avoid the sickest people. What could Congress do to minimize avoidance of people more likely to use care? One good answer: risk adjustment.

March 29, 2016

How Do We Make Special Enrollment Periods Work?

Special Enrollment Periods are a critical part of the health insurance safety net created under the ACA. But the SEP safety net could be weakened if CMS or Marketplaces take steps that would make it more difficult for individuals to enroll using SEPs, a policy change that insurers are advocating.

February 16, 2016

Health Risk Continues To Improve In Covered California

The health risk scores of enrollees for individual plans in the California exchange have stabilized in the second year (regressed to the mean), with risk being more evenly distributed across all of the plans, and the overall risk score statewide for enrollees with chronic conditions has decreased.

October 26, 2015

The New Era Of Narrow Networks: Do They Come At The Cost Of Quality?

As we approach another period of Open Enrollment under the Affordable Care Act (ACA), it is a good time to revisit whether plan offerings reflect consumer preferences. Are exchange participants getting a good value?

October 13, 2015

Whither Health Insurance Exchanges Under The Affordable Care Act? Active Purchasing Versus Passive Marketplaces

Health insurance exchanges are here to stay, and the principle of consumer choice among private health plans, with financial subsidies for low-income households, is now firmly entrenched. Two models, active purchasing versus passive marketplaces, have dominated the policy literature on health...

October 2, 2015