New Mexico released its 2025 proposed state health policy plans yesterday afternoon. The state has been aggressive in the past several years in its actions to make the ACA more affordable and actionable for its citizens. It has used substantial state funds to do this. Yesterday, it proposed to partially revamp the entire ACA subsidy …
Anderson On Health Insurance
Proposing cost-sharing certainty for shoppable services
In this week’s JAMA Internal Medicine, Michal Horny, myself and Mark Fendrick argue that insurers should do a better job at doing their job. Currently, patient cost-sharing expenses are determined after care is delivered based on the realized treatment intensity, which may vary due to circumstantial factors such as the occurrence of midprocedure complications that …
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Unintended Consequences of Section 1332 Waivers
In this month’s Health Affairs, I have a new article co-authored with Coleman Drake of Pitt and Ezra Golberstein of the University of Minnesota. We examine the enrollment effects of Georgia’s Section 1332 Reinsurance Waiver on subsidized enrollment using a matched border county design between Georgia (which adopted a waiver) and the five surrounding states that …
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Medicaid Expansion in Mississippi???
BREAKING: The Mississippi House just passed Medicaid expansion by a 96-20 vote. That’s more than enough to overcome a veto from Gov. Tate Reeves. It now heads to the Senate. Background: https://t.co/exDyzFAcJX — Ashton Pittman (@ashtonpittman) February 28, 2024 The Mississippi bill text requested that the state file a Section 1115 waiver to expand Medicaid …
Idaho wants to kidney-ize its hospitals
Idaho’s House has a Medicaid expansion modification bill under consideration. The big thing it wants is work requirements. It is unlikely to get that without an act of Congress given the litigation that went against work requirements for Medicaid during the Trump administration. However, it also wants to transfer a lot of funds to its …
Lots of people on the ACA down South
Yesterday, the Centers for Medicare and Medicaid Services released the final enrollment for the 2024 Open Enrollment Period for the ACA: Marketplace and Consumer Type Cumulative 2024 OEP Plan Selections Total: All Marketplaces 21,310,538 New Consumers 5,045,290 Returning Consumers 16,265,248 The Confederacy has substantial …
Brand to Generic spreads
Stat News has an article on a DOD IG report on the White House pharmacy during the Trump Administration. Lots of things stood out to me but one that is relevant for a lot of insurance design is the brand to generic spread: White House medical staff also regularly asked for brand name medications like …