Benefits Of High Risk Pools

In 2010, the United States created The Affordable Care Act (ACA). The objective was to share the responsibility of costs between the government, individuals, and employers to provide affordable access to quality health insurance. “However, health coverage remains fragmented, with numerous private and public sources, as well as wide gaps in insured rates across the U.S. population.” (“United States: International Health Care System Profiles,” n.d.). Each individual state within the US, generally has control over private insurance.

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.

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

The cost of health insurance has changed drastically over the years as it has become more expensive. Depending on personal characteristic, the cost of health insurance may vary. For instance, as individuals grow older the more expensive it becomes. In this case, health insurance is more costly because “older individuals require more health care” therefore “the cost of providing health care is rising” (Madura &Atlantic, 2012). Not only does this affect the high cost of health insurance, but the number of individuals uninsured. As stated by Madura and Atlantic (2012), “about one in every five workers is uninsured” and has increased since then because health insurance has become unaffordable. As a result, individuals tend to seek health care elsewhere as they can no longer

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.

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.

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

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.

The complexity of health care could take the rates on a massive trajectory that does not favor the people covered. Therefore, the financial protection that the levels of health insurance covers, help to guard against the risks related to the unexpected costs of health care. The source of coverage could still have an impact by the insurance coverage and financing alternatives that one has access to; Conversely, private insurance, social insurance, and the national health services are the types of healthcare systems by funding and provision. As we look to health care coverage and the reform of Obamacare, I’ll analyze the impact of the uninsured in the industry and look for a resolution to improve the

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.

It is argued that reforms would not be a fix to insurer discrimination. Health policy institutes predict that patients would still be discriminated against - Especially those that have complicated health issues and as a result, multiple bills. This would theoretically make it more difficult such patients to contend with uncooperative insurance companies. Additionally, health plans could circumvent costs by not including enough doctors in their network that address ailments which require costly treatments. In a competitive market, it is unlikely that insurance companies will “play fair” (Hilzenrath, 2009).

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).

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