• 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.

Our job is not to persuade republicans but to defeat them.

A democracy can’t function when people can’t distinguish facts from lies.

Republicans are the party of chaos and catastrophe.

Sitting here in limbo waiting for the dice to roll

It’s time for the GOP to dust off that post-2012 autopsy, completely ignore it, and light the party on fire again.

No one could have predicted…

I’d hate to be the candidate who lost to this guy.

Battle won, war still ongoing.

No offense, but this thread hasn’t been about you for quite a while.

Come on, man.

And now I have baud making fun of me. this day can’t get worse.

Republicans do not pay their debts.

Conservatism: there are some people the law protects but does not bind and others who the law binds but does not protect.

Never entrust democracy to any process that requires republicans to act in good faith.

Infrastructure week. at last.

You don’t get rid of your umbrella while it’s still raining.

Everybody saw this coming.

They are lying in pursuit of an agenda.

I’d like to think you all would remain faithful to me if i ever tried to have some of you killed.

Their freedom requires your slavery.

You cannot shame the shameless.

Give the craziest people you know everything they want and hope they don’t ask for more? Great plan.

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

White supremacy is terrorism.

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 / Statewide monopolies on Healthcare.gov

Statewide monopolies on Healthcare.gov

by David Anderson|  March 21, 20197:00 am| 1 Comment

This post is in: Anderson On Health Insurance

FacebookTweetEmail

Monopolies are usually a bad thing.  They lead to higher prices.  They lead to poor service.  They lead to rent extraction to pay for hookers snorting the finest blow.  All of that is true.  But given price linked subsidies for the 100% to 400% Federal Poverty Level, monopoly insurers have the ability to choose the size of their covered risk pool.

There are several flavors of monopolies within a given state.  The smallest and least powerful is a single insurer covers a county or set of counties in the state while adjoining counties have multiple insurers.  In 2019, UPMC Health Plan (my former employer) in Pennsylvania is the sole ACA insurer in several rural counties.  UPMC’s pricing and plan offerings would be influenced by risk adjustment concerns and potentially marketing concerns from other, more competitive regions. A state can have multiple counties with a single insurer while having multiple monopoly insurers.

The next flavor is a state where every county has only a  single insurer but there are two or more insurers.  Arizona in 2018 was like this.  Insurers still need to be concerned about how other insurers price due to risk adjustment concerns but there is a good amount of flexibility.

Finally, there is a single insurer covering the entire state.  From 2014-2016, this was rare on Healthcare.gov.  Now it is becoming more common.

 

I think 2018 is fundamentally an analytical mulligan for most ACA studies. It is a dividing year between how the Obama administration ran the exchanges and how the Trump Administration will run the exchanges. Insurers did not know what the rules would be until three weeks before open enrollment when CSR payments were terminated. When insurers don’t know the rules they either raise rates or run like hell.

In 2019, the four monopoly states have no more than three Congressional districts (Nebraska) and most have only a single representative.  These are very small states.  The same pattern was true 2014-2016.

I am curious about the insurer strategies in these true monopoly states.  I think going forward, we should expect a few states to be single insurer every year and that those states will have the opportunity to choose their own risk pool and enrollment profiles.

FacebookTweetEmail
Previous Post: « On the Road and In Your Backyard
Next Post: Kansas Medicaid expansion moves forward »

Reader Interactions

1Comments

  1. 1.

    johncarter

    March 21, 2019 at 4:47 pm

    Being from Southwestern Pa and having to live through the BS from Allegheny County’s largest employer who claims non-profit and tax exempt status, I can well understand UPMC’s plan is to make themselves, by ANY means, Pennsylvania’s ONLY insurance provider, and with rates as high as the public can’t bear.
    UPMC is NOT a friend to anyone who desires healthcare who isn’t already well off, and I mean WELL OFF!

Comments are closed.

Primary Sidebar

Fundraising 2023-24

Wis*Dems Supreme Court + SD-8

Recent Comments

  • Lacuna Synecdoche on Late Night Open Thread: Schadenfreude Shots All Round! (Mar 21, 2023 @ 2:41am)
  • piratedan on Late Night Open Thread: Schadenfreude Shots All Round! (Mar 21, 2023 @ 2:40am)
  • Hangö Kex on War for Ukraine Day 390: The Owl Has Sharp Talons! (Mar 21, 2023 @ 2:23am)
  • prostratedragon on Late Night Open Thread: Schadenfreude Shots All Round! (Mar 21, 2023 @ 2:20am)
  • Gretchen on Their Own Private Idaho (Mar 21, 2023 @ 2:19am)

🎈Keep Balloon Juice Ad Free

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

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!