As the fall season heats up, just a couple of scenarios to think through: Scenario A: What do you do? Scenario A-1 — what happens if the keeper smothers the ball one bounce before it is in the net? Scenario A-2 — what happens if the keeper actually gets his hands on the …
And Kentucky just got worse
Kentucky released their revised Medicaid waiver application earlier this week. We had looked at their draft application a few months ago. The base story in their draft application was that people on Legacy Medicaid would barely be touched by the institution of road blocks, bureaucratic barriers, confusion and add-on requirements. The Medicaid expansion population that …
APTC Hacks – buggering the competitors
On the whole I want as many insurers and states to engage in a Silver Gap strategies. However there are situations where it can be used offensively to bugger and beggar competitors. Let’s walk though an example. The scenario needs one insurer that actually wants to cover people in a county. It also needs an …
Oscar lays off their underpants gnomes
February: Oscar is able to get young and healthy people on an expensive network and high risk adjustment payments. I can’t figure out their business model past the buzzwords. March: Oscar is incurring losses of roughly $145 Per Member Per Month (PMPM) in its biggest market. It is charging roughly $190 PMPM in net …
APTC Hacks, BHP and 1332 Waivers
The ACA has two non-Exchange means of significantly expanding and configuring coverage. The Basic Health Plan (BHP) allocated 95% of the combined funding of the Advanced Premium Tax Credit (APTC) and Cost-Sharing Reduction (CSR) subsidies of a state that would have been paid to cover people earning between 138% and 200% of the Federal Poverty …
APTC Hacks, Non subsidized plans and choice revelation
Advanced Premium Tax Credits (APTC) are only relevant for people who buy policies on the Exchanges. However the subsidized universe is only about half of the entire individual market. The non-subsidized and off-Exchange universes will help us determine how carriers embark on their Silver pricing strategies. If an individual would have qualified for an APTC …
APTC Hacks, Non subsidized plans and choice revelationPost + Comments (4)
Zika and abortions
Scientific America has some bad news about Zika in Puerto Rico: “Based on the limited available information on the risk of microcephaly, we estimate between 100 to 270 cases of microcephaly might occur” between mid-2016 and mid-2017, said Dr. Margaret Honein, chief of the birth defects branch at the CDC, who was one of several …