Insight, analysis & opinion from Joe Paduda

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Friday catch-up

Got to love May!  Everything is greening up, baseball season is in full swing, college graduations, flowers are blooming.

While I was out smelling the new blossoms, a bunch of stuff happened.

Implementing health reform

There’s been a lot of press about UnitedHealthcare’s decision to leave the Exchanges, with opponents citing the move as more proof of the impending demise of wrongly-named “Obamacare” and others noting it’s much ado about not much.

A brief and compelling post by David Williams is in the latter camp; David notes:

[United] specializes in selling high-priced plans to corporate accounts. In the price-sensitive world of the exchanges that’s a losing proposition. No surprise — United wasn’t getting traction.

As a former UHC employee (albeit from two decades ago), I have to agree.  UHC never focused on the individuals or employers or demographic groups that seem to be signing up for insurance via the Exchanges.  There are several distinct attributes of health plans winning in the Exchanges; Health plans that have expertise in Medicaid, understand local markets and have very strong local brands, and/or are vertically integrated delivery systems are succeeding.

Bernie Sanders’ campaign appears to have “inspired” Hillary Clinton to talk more about offering a public option in the Exchanges, namely allowing a to-be-defined group to buy-in to Medicare. Notably, Sec. Clinton first broached the public option back in February, so this isn’t really new news. However, it does mark the first time she’s mentioned the Medicare buy-in. (a more detailed review of Clinton’s health policy platform is coming up next week)

From JAMA, the news that employer coverage of health insurance has not changed over the last few years.  This is a key reason the Exchanges have not enrolled more higher-income folks; they are getting their insurance thru their workplace.

Finally, before you get too wrapped up in the media nonsense about prices, enrollment, and the failure/success of ACA, read Larry Levitt’s piece in Vox on Obamacare 2017.

Workers’ comp

WCRI in partnership with the good folks at IAIABC published a must-have guide to State Workers’ Compensation Laws.  Order your copy at the link; investors, analysts, compliance departments and regulators all need this on the virtual bookshelf.

Friend and colleague Peter Rousmaniere’s Working Immigrants blog has been especially active of late; Peter’s been documenting the reality behind immigration trends, and his charts and graphs will speed your understanding of what’s ACTUALLY happening.

(spoiler alert – there is no big influx of Mexicans these days…)

Finally, a terrific post by a woman – a neuroscientist – who finally decided to treat her anxiety with medication.  It is an excellent piece addressing the balance between over-medication and the positive impact drugs can have – when they are the right choice.

Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



© Joe Paduda 2021. We encourage links to any material on this page. Fair use excerpts of material written by Joe Paduda may be used with attribution to Joe Paduda, Managed Care Matters.

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