Category Archives: Insurance

Actuaries’ analysis of ACA alternatives can inform news coverage

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Photo: Andy via Flickr

Photo: Andy via Flickr

For those of us deluged with analyses and opinions from the left and the right over replacements for the Affordable Care Act – the actuarial cavalry has arrived.

The American Academy of Actuaries has released three papers analyzing long-time conservative ideas about health reform. These alternatives – high-risk pools, selling insurance across state lines, and association health plans (AHPs) – are playing a high-profile role in the debate over ACA “repeal and replace.” Continue reading

Lawsuit may indicate change in government’s pursuit of insurance fraud

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Photo: Urban Bohemian via Flickr

Photo: Urban Bohemian via Flickr

A 2011 lawsuit unsealed last week reveals the inner workings of the nation’s largest health insurer, UnitedHealth Group. In the lawsuit, lawyers for the plaintiff allege that UnitedHealth evaluated certain employees on how well they raised risk adjustment scores.

The lawyers contend the practice was part of a scheme to increase payments from the federal Centers for Medicare & Medicaid Services by submitting false statements about the level of illness among Medicare Advantage patients. Continue reading

New reports show uninsured rate continued to drop in 2016

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Source: NCHS, National Health Interview Survey, 2010-2016, Family Care component, released February 2017.Data from the National Center for Health Statistics shows the rate of growth of high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs) since 2010. A CDHP is an HDHP with a tax-advantaged health savings account.

Source: NCHS, National Health Interview Survey, 2010-2016, Family Care component, released February 2017.Data from the National Center for Health Statistics shows the rate of growth of high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs) since 2010. A CDHP is an HDHP with a tax-advantaged health savings account. (Click to enlarge.)

A report released today by the National Center for Health Statistics indicates that the uninsured rate among Americans of all ages was 8.8 percent in the third quarter of 2016.

The report shows that in the first nine months of last year, 28.2 million Americans remained uninsured, and this number was 20.4 million fewer than those uninsured in 2010, the year Congress passed the Affordable Care Act (ACA). Continue reading

Judge cites anti-competitive concerns in blocking Anthem-Cigna merger

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

By AgnosticPreachersKid (Own work) (CC BY-SA 3.0 or GFDL), via Wikimedia Commons

By AgnosticPreachersKid (Own work) (CC BY-SA 3.0 or GFDL), via Wikimedia Commons

U.S. District Judge Amy Berman Jackson has blocked the merger of Anthem and Cigna, the second court ruling this year against megamergers in the health insurance industry.

On Thursday, Anthem said it would appeal the Feb. 8 ruling promptly and request an expedited hearing. Cigna said it would review the decision and evaluate its options. Anthem has a financial incentive to appeal given that under the terms of the merger proposal, Anthem agreed to pay Cigna $1.85 billion if the deal fell apart. Continue reading

Time to look at the potential impact of ACA repeal on mental health care

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Photo: mattwalker69 via Flickr

Photo: mattwalker69 via Flickr

Sarah Ferris has written a new tip sheet for AHCJ members that provides ideas on exploring how partial or complete repeal of the Affordable Care Act could reduce access to mental health care for millions of people.

This comes at a time when the country is grappling with an opioid addiction crisis and scores of people are without adequate access to behavioral health care. Continue reading