Research Roundup: Cost Sharing Reductions; Insurance Gains
Here is a selection of news coverage of other recent research:
Urban Institute/Robert Wood Johnson Foundation:
How Would Coverage, Federal Spending, And Private Premiums Change If The Federal Government Stopped Reimbursing Insurers For The ACA's Cost-Sharing Reductions?
The Affordable Care Act (ACA) requires insurers to provide cost-sharing reductions (CSRs) that lower deductibles, co-payments, co-insurance, and out-of-pocket maximums for people eligible for tax credits and with incomes below 250 percent of the federal poverty level. With current policy uncertainty surrounding these CSRs, there are multiple future scenarios, but all involve increases in insurance premiums for consumers and there is a potential for large reductions in the insured population. In 2018, the number of uninsured Americans could increase by 9.4 million, and average premiums could increase by nearly 37 percent, if insurers abandon the marketplaces because of a decision to eliminate federal reimbursement of health insurance CSRs. (Blumberg, Buettgens and Wang, 9/8)
Sustained Gains In Coverage, Access, And Affordability Under The ACA: A 2017 Update
The significant gains in health insurance coverage and improvements in health care access and affordability that followed the implementation of the key coverage provisions of the Affordable Care Act in 2014 have persisted into 2017. Adults in all parts of the country, of all ages, and across all income groups have benefited from a large and sustained increase in the percentage of the US population that has health insurance. The gains have been particularly striking among low- and moderate-income Americans living in states that expanded Medicaid. Our latest survey data from the Urban Institute’s 2017 Health Reform Monitoring Survey shows that only 10.2 percent of nonelderly adults are now uninsured—a decline of almost 41 percent from the period before implementation of the ACA. (Long, Bart, Karpman et. al, 9/7)
State Efforts To Lower Consumer Cost-Sharing For High-Cost Prescription Drugs
While lowering the cost of prescription drugs has broad support across the political spectrum, there has been little change in federal policy on drug pricing and costs. In the meantime, several states have taken the lead to lower out-of-pocket costs for consumers with chronic diseases needing expensive prescription drugs or specialty drugs. In this brief, the authors provide their findings from a 50-state survey of action on such policies. Eight states have policies protecting their consumers from high out-of-pocket costs for expensive specialty medication. These states either place limits on out-of-pocket spending or require certain plan formulary designs. (Ahn and Corlette, 9/6)
The Commonwealth Fund:
Where Does The U.S. Stand On Insurance Coverage?
The uninsured rate among 19-to-64-year-old adults was 14 percent in 2017, or an estimated 27 million people, statistically unchanged from one year earlier. Uninsured rates ticked up significantly in three subgroups: 35-to-49-year-olds, adults with incomes of 400 percent of poverty or more (about $48,000 for an individual), and adults living in states that had not expanded Medicaid. Half of uninsured adults, or an estimated 13 million, are likely eligible for marketplace subsidies or the Medicaid expansion in their state. Four of 10 uninsured adults are unaware of the marketplaces. Adults in marketplace plans with incomes below 250 percent of poverty are much more likely to view their premiums as easy to afford compared with people with higher incomes. Policies to improve coverage include a federal commitment to supporting the marketplaces and the 2018 open enrollment period, expansion of Medicaid in 19 remaining states, and enhanced subsidies for people with incomes of 250 percent of poverty or more. (Collins, Gunja and Doty, 9/7)