Recent expensive innovations, from hepatitis drugs to proton beam therapy, raise a recurring and uncomfortable question: how much is too much to pay for new innovative treatments?
Unsurprisingly, high per-inmate health care spending results from similar problems that plague other national health care programs.
Premium rate increase submissions are the health reform metric of the summer. Opponents of the Affordable Care Act are looking to double digit rate increases as a harbinger of the program’s collapse, while supporters are pointing to moderate increases as evidence that the new Marketplaces will survive.
Competition is good. The adage has been a mantra for free market economists, antitrust lawsuits, and now, the Health Insurance Marketplace.
From a 30,000 foot view, subsidy eligibility requirements under the Affordable Care Act (ACA) seem straight forward. A household applies for coverage through the newly created insurance exchange and receives assistance if the household’s income is between 100 percent and 400 percent of the federal poverty level (FPL).
The crisis of American health care cost involves an abundance of moving parts with varying degrees of responsibility.
In a pair of rules released in March and May of this year, the Department of Health and Human Services prescibed a methodology for determining the rate health insurance premium growth and the rate household income growth. Together, these two measures are important for the future of the Health Insurance Marketplace.
In the search for the holy grail of health care cost containment, economists and policy wonks have offered up a pricing structure referred to as “reference pricing.”
In the final weeks of open enrollment, nearly 90 percent of enrollees chose a Silver or Bronze plan over the more generous Gold and Platinum plans offered in the new Health Insurance Marketplaces.
The story of a successful or unsuccessful Affordable Care Act rollout needs to be examined at the state level.