• Menu
  • Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar

Before Header

  • About Us
  • Lexicon
  • Contact Us
  • Our Store
  • ↑
  • ↓
  • ←
  • →

Balloon Juice

Come for the politics, stay for the snark.

The most dangerous place for a black man in America is in a white man’s imagination.

Take your GOP plan out of the witness protection program.

The words do not have to be perfect.

Don’t expect peaches from an apple tree.

JFC, are there no editors left at that goddamn rag?

This blog will pay for itself.

Spilling the end game before they can coat it in frankl luntz-approved dogwhistles.

After roe, women are no longer free.

Fuck these fucking interesting times.

Nothing worth doing is easy.

Today’s GOP: why go just far enough when too far is right there?

We are builders in a constant struggle with destroyers. let’s win this.

You can’t attract Republican voters. You can only out organize them.

They’re not red states to be hated; they are voter suppression states to be fixed.

The worst democrat is better than the best republican.

This really is a full service blog.

We’ll be taking my thoughts and prayers to the ballot box.

There are consequences to being an arrogant, sullen prick.

In my day, never was longer.

Joe Lieberman disappointingly reemerged to remind us that he’s still alive.

… riddled with inexplicable and elementary errors of law and fact

The arc of history bends toward the same old fuckery.

It’s the corruption, stupid.

Hot air and ill-informed banter

Mobile Menu

  • Winnable House Races
  • Donate with Venmo, Zelle & PayPal
  • Site Feedback
  • War in Ukraine
  • Submit Photos to On the Road
  • Politics
  • On The Road
  • Open Threads
  • Topics
  • Balloon Juice 2023 Pet Calendar (coming soon)
  • COVID-19 Coronavirus
  • Authors
  • About Us
  • Contact Us
  • Lexicon
  • Our Store
  • Politics
  • Open Threads
  • War in Ukraine
  • Garden Chats
  • On The Road
  • 2021-22 Fundraising!
You are here: Home / Anderson On Health Insurance / Variations in the lived experience in the ACA

Variations in the lived experience in the ACA

by David Anderson|  February 6, 20186:55 am| 4 Comments

This post is in: Anderson On Health Insurance

FacebookTweetEmail

The ACA has always been a tremendously heterogeneous lived experience. It varies by year and it varies by county. There is some consistency when the stars and the moon line up. There is inconsistency as a function of the very design of the subsidy structure as well as normal business decision combined with federal policy changes as well.

I want to highlight the picture below as I had to throw it out off of the poster I presented at the National Health Policy Conference on Monday as it was out of the time scope of the work I showed. But I still think it is pretty cool. The left hand side is a set of counties in Tennessee with the Silver Spread (Least Expensive Silver plan minus Benchmark Silver plan) for a 40 year old non-smoker in 2017. The right hand side is the Silver Spread for a 40 year old non-smoker in 2018 in the same counties.

So what is going on here?

In 2017, Blue Cross and Blue Shield of Tennessee insured the west side of the line. In those counties they offered two Silver plans. One Silver plan was significantly more expensive than the other. On the east side of the line, Humana was the only insurer in the light yellow counties. Humana only offered a single Silver plan. That was the least expensive plan and the Benchmark plan for the no-gap counties. The counties on the west side offered much more affordable, net of subsidy, deals to healthy, subsidized individuals than the eastern counties.

In 2018, Humana bailed from the individual market. Blue Cross and Blue Shield expanded into the counties that Humana used to cover in Tennessee. In these counties, they are the only insurer. They kept their previous strategy of offering two Silver plans; a high premium and low premium plan. They also assumed (correctly) that Cost Sharing Reduction Subsidies (CSR) would not be paid for the 2018 plan year so they built CSR costs into the baseline Silver rates. From here, the counties that always had BCBS coverage saw a doubling of the Silver Gap. The new to BCBS counties saw a new Silver Gap worth $194. A 40 year old individual in Roane County earning $29,500 now qualifies for a $0 Silver plan in 2018. Last year, they would have been paying about $130 for that Silver plan.

The lived experience of the ACA changes every year and over every county line. And this will be even more true as more and more states adopt 1332 waivers going forward.

FacebookTweetEmail
Previous Post: « On the Road and In Your Backyard
Next Post: Russiagate Open Thread: Nixon Wept »

Reader Interactions

4Comments

  1. 1.

    Patricia Kayden

    February 6, 2018 at 7:30 am

    Thanks for explaining a market which appears very complex to non-experts. With all that Republicans are doing, I’m surprised that the ACA is surviving, to be quite honest.

  2. 2.

    Brad F

    February 6, 2018 at 8:58 am

    Dave
    “The counties on the west side offered much more affordable, net of subsidy, deals to healthy, subsidized individuals than the eastern counties.”

    “Deals to healthy?” You mean people, regardless of health, who chose to buy that particular silver product, correct?

    Thanks
    Brad

  3. 3.

    ProfDamatu

    February 6, 2018 at 4:00 pm

    @Brad F: I’m not David, but my guess based on past experience is that the cheaper Silver probably has higher deductible and out of pocket costs (and possibly even a narrower network and/or drug formulary) than the benchmark silver, making it much more attractive to healthy individuals than to folks who think they might have substantial health care needs.

  4. 4.

    David Anderson

    February 6, 2018 at 10:48 pm

    @Brad F: correct.

    My implied assumption is that the known sick are buying no matter what so pricing is irrelevant but on the intensive margin pricing matters for the healthy

Comments are closed.

Primary Sidebar

Recent Comments

  • Anne Laurie on Late Night Open Thread: Ron DeSaster In New Hampshire (Jun 2, 2023 @ 3:57am)
  • dirge on Sexy and He Knows It (Jun 2, 2023 @ 3:53am)
  • Origuy on Late Night Open Thread: Ron DeSaster In New Hampshire (Jun 2, 2023 @ 3:46am)
  • dirge on Sexy and He Knows It (Jun 2, 2023 @ 3:44am)
  • Tony Jay on Late Night Open Thread: Ron DeSaster In New Hampshire (Jun 2, 2023 @ 3:41am)

Balloon Juice Meetups!

All Meetups
Seattle Meetup on Sat 5/13 at 5pm!

🎈Keep Balloon Juice Ad Free

Become a Balloon Juice Patreon
Donate with Venmo, Zelle or PayPal

Fundraising 2023-24

Wis*Dems Supreme Court + SD-8

Balloon Juice Posts

View by Topic
View by Author
View by Month & Year
View by Past Author

Featuring

Medium Cool
Artists in Our Midst
Authors in Our Midst
We All Need A Little Kindness
Classified Documents: A Primer
State & Local Elections Discussion

Calling All Jackals

Site Feedback
Nominate a Rotating Tag
Submit Photos to On the Road
Balloon Juice Mailing List Signup
Balloon Juice Anniversary (All Links)
Balloon Juice Anniversary (All Posts)

Twitter / Spoutible

Balloon Juice (Spoutible)
WaterGirl (Spoutible)
TaMara (Spoutible)
John Cole
DougJ (aka NYT Pitchbot)
Betty Cracker
Tom Levenson
TaMara
David Anderson
Major Major Major Major
ActualCitizensUnited

Join the Fight!

Join the Fight Signup Form
All Join the Fight Posts

Balloon Juice Events

5/14  The Apocalypse
5/20  Home Away from Home
5/29  We’re Back, Baby
7/21  Merging!

Balloon Juice for Ukraine

Donate

Site Footer

Come for the politics, stay for the snark.

  • Facebook
  • RSS
  • Twitter
  • YouTube
  • Comment Policy
  • Our Authors
  • Blogroll
  • Our Artists
  • Privacy Policy

Copyright © 2023 Dev Balloon Juice · All Rights Reserved · Powered by BizBudding Inc

Share this ArticleLike this article? Email it to a friend!

Email sent!