Individual Health Insurance Market

Price May Drive Affordable Care Act Marketplace Plan Selection

September 15, 2023 - The Affordable Care Act (ACA) marketplace was designed to incentivize enrollees to choose specific plans based on price and it seems to be fulfilling that goal, an analysis from the Urban Institute found. “The incentives in the structure of the ACA seem to be working, as there is evidence that consumers are making plan choices based on...

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How the Top 4 Disruptive Insurtechs Have Evolved Since Their IPOs

by Kelsey Waddill

The insurtechs that saw the greatest success after the start of the coronavirus pandemic have faced a tumultuous path since their initial public offerings (IPOs). In 2021, four insurtechs achieved their IPO. Their goal was to disrupt the...

Exploring the History of the Blue Cross Blue Shield Association

by Victoria Bailey

Blue Cross Blue Shield is an easily recognizable name in the healthcare industry, but just how many health plans fall under this organization and what are the differences between them? In the following article, HealthPayerIntelligence...

HHS Proposed Rule Aims to Distinguish STLDI from Comprehensive Plans

by Kelsey Waddill

The Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury have released a notice of proposed rulemaking that applies to short-term, limited-duration...

Employer Sponsored Health Plan Enrollment Will Hit 159M in 2033

by Kelsey Waddill

Employer-sponsored health plan enrollment among nonelderly Americans will grow after 2025, accompanied by higher private payer premiums, a Health Affairs study found. The study used Congressional...

KFF: Over Half of Insured Adults Face Problems with Health Insurance

by Victoria Bailey

More than half of adults experienced problems with their health insurance, with issues ranging from payment discrepancies to limited mental healthcare coverage, a KFF survey found. The survey was...

Loss of ACA Preventive Care Mandate Could Impact 10M Enrollees

by Kelsey Waddill

With the Affordable Care Act’s preventive care coverage requirement under scrutiny, Peterson-KFF researchers investigated how many Americans rely on the law’s coverage and determined that...

KFF: Payers Will Issue $1.1B in Medical Loss Ratio Rebates in 2023

by Victoria Bailey

Payers will issue around $1.1 billion in medical loss ratio (MLR) rebates across commercial markets in 2023, KFF projected. In the individual and small group markets, payers must spend at least...

Potential Outcomes of Basic Health Programs for States, Consumers

by Kelsey Waddill

Basic Health Programs (BHPs) can streamline coverage and increase coverage continuity for certain populations, but the cost to states will vary, a report from the Urban Institute shared. “The...

The Role of Affordable Care Act Premium Tax Credits in the Payer Industry

by Kelsey Waddill

The Affordable Care Act marketplace premium tax credits were introduced in 2010 and continue to play an integral role in US health insurance. A Google search on premium tax credits will demonstrate...

PHE Expiration Will Lead to Medicaid Coverage Losses for 18M People

by Victoria Bailey

If the COVID-19 public health emergency (PHE) ends in April 2023, 18 million people may lose Medicaid coverage in the 14 months following its expiration, according to a brief from the Robert Wood...

Health Insurance Coverage Disruptions Tied to Higher Mortality Risks

by Victoria Bailey

Health insurance coverage disruptions were associated with higher mortality risks for people with private and public insurance, a JAMA Health Forum study found. Health insurance coverage is typically...

How Health Insurance Coverage Varies Across, Within Families

by Victoria Bailey

The Affordable Care Act (ACA) increased access to Medicaid and group health insurance, but the family glitch created a barrier to non-group coverage, leading to variations in health insurance coverage...

Community Health Plans Lowered Consumer Healthcare Spending in 2022

by Kelsey Waddill

Alliance of Community Health Plan (ACHP) payers have secured lower healthcare spending for members in 2022 through premium adjustments, efforts related to prescription drug pricing, and more, according...

Better Access to Health Insurance Coverage Boosted Healthcare Use

by Victoria Bailey

One in five Americans received regular healthcare during the COVID-19 pandemic due to increased access to health insurance coverage resulting from enhanced marketplace subsidies and Medicaid...

Subsidies Drive Individual Health Insurance Marketplace Enrollment

by Kelsey Waddill

Enrollment on the individual health insurance marketplace has grown with most enrollees finding their health plan through the Affordable Care Act marketplace, according to enrollment data compiled by...

Aetna CVS Health Intends to Enter CA Individual Health Insurance Marketplace

by Kelsey Waddill

Aetna CVS Health announced that it plans to enter California’s individual health insurance marketplace. “With millions of Americans being uninsured or underinsured, our plans provide...

Key Factors in 2023 Individual Health Insurance Market Premiums

by Kelsey Waddill

As payers finalize premiums for 2023 for the individual market, 2023 individual health insurance market premiums will be subject to a variety of factors, according to an issue brief from AHIP. The...

Colorado Implements Section 1332 Waiver to Advance Health Equity

by Kelsey Waddill

The US Department of Health and Human Services (HHS) has approved the “Colorado Option,” a Section 1332 state innovation waiver amendment intended to address health equity in the Centennial...

Payers Expected to Issue $1B in Medical Loss Ratio Rebates in 2022

by Victoria Bailey

Payers will issue about $1 billion in medical loss ratio rebates across the individual market, small group market, and large group market in 2022, according to research from the Kaiser Family...

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