Research Roundup: Limited Health Plan Networks; Analyzing Marketplace Premium Increases
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Health Affairs:
Regulation Of Health Plan Provider Networks
Health insurance plans with limited networks of providers are common on the Affordable Care Act's (ACA's) health insurance Marketplaces. ... Limited network plans might offer value to consumers. Coverage that pairs a low premium with a network that provides meaningful access to health care might meet the needs of many enrollees .... But these plans also pose risks. A network can be too narrow, jeopardizing the ability of consumers to obtain needed services in a timely manner. This can happen if the network contains an inadequate mix of provider types. ... This brief offers an overview of state and federal actions that address ... network standards and provider directories -- with a focus on rules that govern plans sold on the ACA's health insurance Marketplaces. (Giovannelli, Lucia and Corlette, 7/28)
The Kaiser Family Foundation:
How ACA Marketplace Premiums Measure Up To Expectations
Premium increases in the health insurance marketplaces created under the Affordable Care Act (ACA) will likely be higher in 2017 than in recent years. While premiums generally go up every year as the underlying cost of care rises, there are a number of reasons to expect faster growth this coming year, including the expiration of the ACA’s temporary reinsurance program at the end of 2016 and miscalculations by many insurers about how much health care enrollees would use. Kaiser Family Foundation analysis of proposed rates in states that make the information publicly-available shows an average premium increase in the benchmark second-lowest-cost Silver plan in 17 major cities of 9% in 2017, compared to an average increase of 2% in these cities in 2016. (Levitt, Cox and Claxton, 8/1)
The Kaiser Family Foundation:
High-Risk Pools For Uninsurable Individuals
In the debate over the future of the Affordable Care Act (ACA), proposals have emerged that would repeal or weaken rules prohibiting health insurance discrimination based on health status, instead offering high-risk pools as a source of coverage for people who would be uninsurable due to pre-existing conditions. ... Nearly four decades of experience with high-risk pools suggests they have the potential to provide health coverage to a substantial number of people with pre-existing conditions. State high-risk pools that existed prior to passage of the ACA covered over 200,000 people at their peak, and the temporary PCIP pool created as part of the ACA covered over 100,000 individuals. ... the government subsidies required to cover losses in these high-risk pools were substantial – over $1 billion per year in the state pools and about $2 billion in the final year of PCIP. A high-risk pool that had minimal barriers to enrollment could cost substantially more. (Pollitz, 8/1)
Heritage Foundation:
Medicare’s Next 50 Years: Preserving The Program For Future Retirees
[I]t is time for reforms that will not only improve Medicare to secure value for patients, but also enhance the program’s solvency and reduce its growing burden on current and future taxpayers. Left unreformed, Medicare will continue to put intense pressure on the federal budget, contribute to coming deficits, and generate massive future debt. But there are grounds for optimism. Medicare has used new systems of defined contribution for payment of comprehensive private health plans and prescription drug coverage, and both programs have demonstrated the benefits of consumer choice and genuine competition. Congress should now take the final step and subject hospital and physician benefits to the same intense market forces of personal choice and provider competition that today govern private plans and prescription drugs. (Moffit, 8/2)
Here is a selection of news coverage of other recent research:
HealthDay:
Smoking Rates Still High In Some Racial Groups, CDC Reports
Despite a lot of progress in getting Americans to stop smoking, some groups still have high smoking rates, a U.S. government study shows. ... Between 2002-2005 and 2010-2013, smoking rates fell from 28 percent to 25 percent for whites and blacks. Native Hawaiian and other Pacific Islanders in the United States saw a significant drop in their smoking rates -- from 31 percent to 23 percent, the report said. But American Indians and Alaska Natives didn't fare as well. Their smoking rates actually went from 37 percent to 39 percent, the research found. The overall smoking rate for Asian-Americans fell from 14.5 percent to 11 percent. But within that group many had lower smoking rates, including Asian Indians, Chinese and Japanese. Filipinos, Vietnamese and Koreans all had higher smoking rates. (Preidt, 8/4)
MedPage Today:
CDC: Access To Better Contraception Needed For Zika Threat
Uptake of long-acting reversible contraception remains low among women in states facing the risk of active Zika virus transmission, a comprehensive review of data from several CDC surveys found. Overall, long-acting reversible contraception (LARC) methods, including implants, were used by fewer than one-fourth of non-pregnant women, one-third of women who delivered a live birth and fewer than one-tenth of sexually active high school students, reported Sheree L. Boulet, DrPH, of the CDC, and colleagues. (Walker, 8/3)