Today most of the news is about PPACA enrollment, prices, and issues related thereto.
First up, paid enrollment as of mid-August was about 7.3 million via the Exchanges. That’s a pretty big number, and substantially above initial goals (and below the President’s late spring estimate). To be fair, the President’ estimate was for those that signed up, not those who paid, and as those of us who’ve been in the insurance business know all too well, there are always enrollees who don’t pay their initial premiums. A 9 percent non-pay is pretty good, actually.
Among those who got coverage via the Exchanges, most are generally happy. According to California Healthline;
- 71% expressed confidence they would receive high-quality care;
- 70% expressed confidence they could afford needed care;
- 68% rated their plans as good, very good or excellent
While many (including me) thought we’d see a spike in health care costs as the previously uninsured got coverage and sought care, the overall cost increase has actually been pretty modest. From Kaiser Health News:
health and social spending as measured by the Census Bureau grew by only 3.7 percent from the second quarter of 2013 to the same quarter of 2014. Hospital revenue increased 4.9 percent during the same period. Revenue for physician offices barely budged, growing by only 0.6 percent. Medical lab revenue rose 1.9 percent.
Amongst all the positive news let’s not forget there are still a bunch of hurdles to overcome, starting with the next enrollment process, and extending through the expiration of the feds’ backstop insurance plan for Exchange insurers. There’s a long way to go before we know how PPACA really turns out…
Finally, there’s been a good deal of intellectual arguments back-and-forth about the validity and utility of the Dartmouth Atlas, with critics claiming it is inaccurate and presents a false picture of practice pattern variation, and supporters (of which I am one) taking issue with the critics’ complaints. The best synopsis I’ve seen comes from Sarah Kliff writing at VOX.
Hope your teams win this weekend…
Minnesota’s largest exchange market share provider – Preferred One – this week announced it is exiting the MN exchange for 2015 citing unsustainable costs.
Mark – thanks for the comment. Preferred One was by far the cheapest health insurance plan offered on ANY exchange, and had many scratching their heads as to why their price was so low. Turns out, they screwed up the pricing. The issue wasn’t “cost” but rather “price”.
Another important metric that needs to be looked at is what % of the subscribers are paying full price and % receiving subsidies.
Making employer mandate work will also be a hurdle.
according to the WaPo, 87% of those enrolling via exchanges received a subsidy.