ACA & Insurance Companies
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Transcript of ACA & Insurance Companies
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ACA & Insurance
Companies Bianca Cole
Prof. Parsons
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What
conce
rns
insu
rance
com
panie
s th
e m
ost
? How will private health
insurance companies
remain profitable? What will be the
overall effect on their
bottom lines?
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Qualifi
ed d
ependent
child
ren o
n p
are
nt’
s polic
y unti
l 26 Premiums for such a
low-risk pool would be
a windfall for insurers
since, historically, they
wouldn’t be paying out
much in claims.
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Main
pro
ble
m
wit
h t
his
…. Is that the number of
eligible dependent children being signed
up under their parents’ plans isn’t as
significant as planned.
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The expected windfall
of premiums has not
flowed in from this age
group; experts believe
that the penalty for not buying insurance
does not outweigh or
come close to the cost
of actually purchasing
it.
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Preex
isti
ng a
nd
chro
nic
co
ndit
ions
Insurers are prohibited
from denying coverage to anyone with a preexisting condition, can no longer impose annual
or lifetime dollar limits
on benefits and can only rescind coverage
in cases of fraud.
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So if fewer members
of the low-risk pool are
not signing up for coverage and more is
being paid out to cover members that
make up the high-risk
pool...
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Do insurance companies need to attempt to help the problem from
becoming worse?
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Yes!
Insurance companies
have the money and
the power to help the
US healthcare system
from being place in a
worst condition.
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Then t
he b
ad
new
s…
The insurance companies are not going to be able to foot the bill of these individuals that continuously visit the
hospital for long-term
visits before passing
the payments down to
fellow insurance holders.
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Welln
ess
pla
ns Aetna offers discounted gym
membersBlue Shield has rolled
out a program called
Blue365
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Ince
nti
ves
Smoking cessations Weight loss Improvement on laboratory tests to observe the risks for
chronic illnesses.
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How was insurance companies affected by the Affordable Care Act?
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Sole
Win
ner In my eyes insurance
companies was the sole winner in the expansion of healthcare.
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Sole
Win
ner
With potentially 32 million new customers, this
increase in cash will allow these companies
to decrease their prices
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Sole
Win
ner
Another benefit for insurance companies
is that they are beginning to provide a
certain minimum level
of benefits in the health insurance exchanges that individuals and small
businesses must use
to buy coverage.
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To get into an exchange, a carrier has to be certified by
the National Committee of Quality
Assurance, with no incentive to do so, many insurers never
gave a thought to certification.
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In c
oncl
usi
on…
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Quest
ions,
C
om
ments
or
Conce
rns
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Refe
rence
s
Brown, A. (2013, June). In U.S., Uninsured
Rate for 18-25-Year-Olds Ticks Down.
Gallup http://www.gallup.com/poll/155108/Uninsured-Rat
e-Year-Olds-Ticks-down.aspx
Cox, C., Claxton, G., Levitt L. (June 2013).
Beyond Rebates: How much are Consumers
Saving from the ACA’s Medical Loss Ratio
Provision? The Kaiser Family Foundation
http://kff.org/health-reform/perspective/bey
ond-rebates-howmuch-are-consumers-savin
g-from-the-acas-medical-loss-ratio-provisio
n/ Dafny, L., Gruber, J., & Ody, C. (n.d.). More
Insurers Lower Premiums. http://
www.mitpressjournals.org/doi/pdf/10.1162/
AJHE_a_00003 Davidson, A. (2013, October 30). The
President Wants You to Get Rich on
Obamacare.http://navihealth.us/wp
-content/uploads/2014/01/NYT_Magazine_n
H.pdf Foster, R. (April, 2010) Estimated Financial
Effects of the “Patient Protection and
Affordable Care Act,” as Amended. Centers
for Medicare and Medicaid Services.
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Refe
rence
s
Goodman, S. (2010) The U.S. Health Care
Industry after Reform: Every Player Gets New
Rules and the Details Matter. Aspatore Special
Report: Understanding the Health Care Reform
Bill U.S.A.: Thomson Reuters/Aspatore
Koning Beals, R. (2012, February 14). Employees
Get Paid to Exercise, While Some Pay to Sit Out -
US News. http://money.usnews.com/money/personal-finance/artic
les/2012/02/14/employees-get-paid-to-exercise-w
hile-some-pay-to-sit-out
MacDonald, J. (2013, May 15). Reforms Shake Up
Health Insurance Companies | Bankrate.com.
http://www.bankrate.com/finance/insurance/reforms-sh
ake-health-insurance-companies.aspx
McCloskey, A., Miller, T., (March 2014) The
Individual Mandate Goes Poof. The Wall Street
Journal Retrieved from http://
online.wsj.com/news/articles
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Refe
rence
s
Radnofsky, L., (February, 2014) How the ACA
may Affect Health Costs. The Wall Street Journal
http://online.wsj.com/news/articles
Shi, L., & Singh, D. (2014). Delivering Health Care
In America: A Systems Approach, 4th Edition By
Leiyu Shi And Douglas A. Singh. Journal for
Healthcare Quality.
Sullivan, K., (August, 2010) Why did the ‘public
option’ fail? Jacob Hacker won’t say. Physicians
for a National Health Program Retrieved from
http://pnhp.org/blog/2010/08/30/why-did-the-
public-option-fall-jacob-hacker-won’t-say/
Terry, K. (2010, March 22). Big Winner in
Healthcare Reform? Insurance
Companies,Eventually.
http://www.cbsnews.com/news/big-winner-in-heal
thcare-reform-insurance- companies-eventually/
Timiraos, N. (2015, March 9). Health Law to Cost
Less Than Forecast Earlier. http
://www.wsj.com/articles/cbo-sees-slightly-higher-2
015-deficit-than-previously-forecast-1425914251