Health insurance high risk pools have been mentioned by President Trump and Congressional Republicans as a potential element of their Obamacare replacement plans, but they are not a new idea. Past experience with high risk pools suggests that they can help to address issues of affordability, stability, and fairness in the individual health insurance market. However, to do so, they must be adequately publicly subsidized and have benefit designs and cost-sharing structures that are comparable to health insurance products available on the open market.
High risk pools were initially one of the options that states could adopt under the Health Insurance Portability and Accountability Act (HIPAA) for ensuring portability from the group health
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This arrangement works because the insurance company is able to pool risks from lots of different individuals or organizations. As long as the risks are uncorrelated, the likely cost associated with the pooled risk is much more predictable than for the un-pooled risk.
Many people in the U.S. receive health insurance through their employers, which operate as natural groups to gather individuals into pools. Since most people do not select jobs to get health insurance coverage, there is little reason to believe that the incidence of health care costs for the individuals in the groups established through employment arrangements will be correlated. The individual health insurance market, on the other hand, is referred to in industry jargon as the ‘non-group’ market for a reason. There is no natural group for aggregating individuals into a pool that is established for reasons other than purchasing insurance. There is also reason to believe that the set of individuals seeking to purchase individual/non-group health insurance does not represent a representative sample of the population with respect to health status.
The individual health insurance market is bedeviled by certain empirical realities about health care spending, and characteristics of health insurance markets – the distribution of health care spending is highly skewed, health insurance has a
Several studies sought to investigate the effect of the universal health reform and its impact on the labor market outcomes, such as the unemployment rate and average wage (Buchmueller, 2013; Kolstad, 2012). However, they failed to take into account the potential legal loopholes in part-time status, employer-provided coverage and Medicaid, and the impact of companies’ size, even though studies have shown that employer-provided regulations are not equally demanding to different businesses (Gruber, 2004).
JLT Re’s reserve notice dated 12/20/16 notes Odyssey Reinsurance Company’s (Odyssey) 30% ceded share of this loss excess $1,000,000 is $219,087. However, my review of the cede’s, IAT / Harco National (IAT) supporting documentation notes a total incurred of $2,848,432.43, based on this information, Odyssey’s correct 30% share excess of $1,000,000 is $543,791.65 ($525,000 Loss & $18,791.65 pro rated expense). Please advise whether you’re in agreement with our calculations.
This paper will look at the impact of Affordable Care Act on supply and demand in healthcare. The goal is to show if there is equilibrium of supply and demand since the Affordable Care Act was enacted. This has been done by looking at a variety of articles such as The Impact of the Affordable Care Act on the Health Care Workforce. The Affordable Care Act has created provisions to address some of the supply shortages. Through the provision it will take time for the full effects to come to light. This paper will provide valuable information regarding the Affordable Care Act impact on supply and demand.
A., & Fonkych, K. (2008). Hospital pricing and the uninsured: Do the uninsured pay higher prices? Health Affairs, 27(2), 116-122. Retrieved from doi: 10.1377/hlthaff.27.2.w116
Rising health insurance premiums have made healthcare unaffordable in the United States. Health insurance premiums in this country have undergone a steady rise over the past few years while incomes have remained the same. More than 50% of individuals with low incomes holding private insurance in the United States are unable to afford their healthcare costs (Collins, Gunja, Doty & Buetel, 2015). In addition, costs related to healthcare are equally unaffordable to 25% of working-age individuals who hold private health insurance policies (Collins et al., 2015). According to the Kaiser Family Foundation/Health Research and Educational Trust (Kaiser/HRET) survey on employer health benefits, employer-sponsored health insurance plans have also had moderate rises in premiums in 2013 for both individuals and family coverage (Claxton et al., 2013). While
Health insurance is provided by Medicaid and Medicare to elderly and disabled people and poor children. People working for large companies receive health insurance through their employer. Unfortunately, people working for small businesses, those self-employed, and the working poor are left without options to purchase health insurance at an affordable cost. This creates a divide between the haves and have-nots in terms of health care. Those who have health insurance will access the care they need, but those who do not have insurance will go without. This may include primary care interventions such as immunizations and regular health screenings. Rising health care costs have a direct effect on the number of uninsured individuals and, therefore, a direct effect the number of individuals that can access care.
Healthcare in the United States is in a crisis situation. Healthcare costs are rising to the point where people are required to pay their health insurance premiums and deductibles over having enough money to cover groceries to feed the family. It seems our government is at odds in terms of the success with the Affordable Care Act and the outcomes we are witnessing from its’ implementation in our country. Many Americans understand the incentives of having healthcare insurance coverage and the benefits it can provide. With so many more individuals entering the healthcare insurance marketplace due to the guidelines of the Affordable Care Act we also see an impact to the supply and demand of healthcare availability and healthy outcomes.
While there are provisions within the law that provide for some safeguards for an insurance company accepting a higher percentage of higher risk patients compared to others, the insurance company is no longer in control of the amount of risk it accepts and these safeguards may be limited in time (American Academy of Actuaries, 2013).
As the implementation of The Affordable Care Act (ACA) nears, news media is featuring a large number of individuals whose health insurance coverage is being cancelled. The current administration claims that their objective is for everyone to have health insurance, but there is a gap between their new legislation and the results. American consumers are falling in the gap between private insurance plans that are too expensive, and the poorly developed government system. Despite claims from the Obama administration, the Affordable Care Act limits the American public’s choice of private health insurance plans.
There is a connection between socio-economics and health.79 Therefore, it’s expected when a states decided to expand Medicaid for more low-income residents, and then that population of people tend to be sicker than the rest of the population (Gershon & Sullivan, 2014). These reasons for expanding Medicaid will transfer those individual’s off the exchange policy into Medicaid, especially those within 100%-133% FPL range. Medicaid expansion could cause the exchange risk pools to become healthier, which means a healthier-risk pool that may be a financial boom for insurance companies that have participated in the exchange. Insurers that participate in the exchange are subject under law, to loss of medical ratio’s; which prevents them from retaining more than a certain level of profit (Gershon & Sullivan, 2014). In cost savings, with a healthier- risk pool possibly can be passed down for other consumer’s to use.
In America, we not only have the problem of the non-insured but the under insured which causes just about as much problem as the underinsured. Each group has contributed to the vast growing cost of healthcare. Over the last decade or two, the amount of uninsured has risen due to the job market in the economy and the fact that most insurances are tied to employment, which is also a problem as the unemployment rate rises. The purpose of this paper is to explore this issue.
Propaganda is a word used for advertising, spreading ideas, and spreading opinions. There are many types of propaganda that everyone sees almost every day with many ways to show it, the bandwagon effect, the common folk, the name-calling, and many more. You see it as advertising for companies, or for politics. You see propaganda everywhere and may not even know it.
There is a spacious room for lemon in insurance field. The price for health insurance is not fixed, it varies based on the level of the need an applicant may require for the insurance. As in the case of elderly people over the age 65, it is well known that it is very difficult for them to get health insurance because of its high price as they certainly will need it more than other applicants. On the other hand, employees working in companies are offered health insurance as a part of the companies’ policies and regulations. This actually create more room for lemon in the insurance field and less chance for old people who need it more. This ended up with adverse selection by the insurance companies. (A.Akerlof, Aug
Health insurance in the United States is a highly politicized issue. In recent years, many strides have been made to extend health insurance coverage to all Americans with the passage of the Patient Protection and Affordable Care Act (PPACA). While the program has been vigorously debated in the public realm, arguments are often centered around political ideology rather than economic theory. This paper seeks to challenge the entire structure of the current health insurance model, since its inception in the 1950s. Through the overuse of a third-party payer model, a magnitude of problems have emerged that severely diminish the efficiency of health care allocation in the United States. This paper proposes a model that seeks to correct issues of cost, access, and market efficiency by adapting the Medicare Part D payment scheme for an all encompassing insurance model.
An Air Handling Unit is a device that circulates air in a building as part of heating, ventilation and air conditioning