Author Archives: Joseph Burns

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.

In the midst of a pandemic, employers begin to negotiate insurance coverage for next year

Photo: Rachel via Flickr

Every year, all employers negotiate with health insurers over what they’ll pay in insurance premiums for the coming year. And many employers also negotiate with hospitals, health systems and physician groups over what they’ll pay in direct-contracting arrangements that bypass traditional insurance contracts.

In both negotiations, the employers will be seeking better care and lower costs, as they do each year. Continue reading

Webcast to explore the high cost of failing to cover the uninsured during pandemic

Clinical lab scientist Nancy Leonard prepares samples to be tested for COVID-19. She wears a face shield and gloves for protection because she is handling material that may contain the virus and will transfer patient samples into smaller tubes for testing.

Photo: Sarah Pack, Medical University of South Carolina

Leaving anyone uninsured during this viral pandemic increases the risk of spreading the disease.  A warning report on Monday from the Urban Institute projects that an estimated 25 million to 43 million Americans may lose their employer-sponsored health insurance coverage in the coming months due to the economic effects of the new coronavirus.

In “How the COVID-19 Recession Could Affect Health Insurance Coverage,” UI senior fellow Bowen Garrett and research associate Anuj Gangopadhyaya base their estimate on the possibility that the unemployment rate could reach as high as 20%. The report was produced with support from the Robert Wood Johnson Foundation. Continue reading

Scrutiny of hospital charges likely to intensify in wake of pandemic

hospital-roomAs the nation’s hospitals strain to keep up with the demand to care for COVID-19 patients, it seems almost unfair to ask how much all of this treatment will cost. Still, we know that the costs will be high, both for the care itself and for what health insurers, employers and consumers will end up paying.

In a recent report, the health insurance marketplace Covered California projected that the one-year costs of testing and treatment related to COVID-19 could range from $34 billion to $251 billion. These new costs could cause health insurance premiums for individuals and employers to rise by 40% or more next year in the absence of federal action, the report said, adding that insurance premiums would increase because insurers would want to recoup any losses from the pandemic this year and plan for any future losses they might incur next year. Continue reading

Trump administration will pay to treat uninsured coronavirus patients

Photo: Quinn Dombrowski via Flickr

Recognizing that the potentially high cost of COVID-19-related hospital and physician care may cause the uninsured to forego care, the Trump administration announced Friday that it would use funds from a federal stimulus law to pay hospitals and physicians for treating those patients. In return for accepting Medicare rates in these cases, the hospitals and doctors would need to agree not to bill those patients, Stephanie Armour reported for The Wall Street Journal.

President Trump announced the plan during a daily Coronavirus Task Force briefing at the White House. The administration had been criticized when it said earlier that it would not open a special enrollment period under the Affordable Care Act for those who are uninsured or who lose their employer-sponsored coverage when they lose their jobs. Continue reading

How to monitor the effects of insurance mergers

InsuranceCompetition

Photo: Tyler via Flickr

When the American Medical Association publishes its next report on competition among health insurers, notice if Georgia makes into the top 10 among states with the least-competitive health insurance markets.

In the latest AMA report on competition, “The 2019 update to Competition in Health Insurance: A Comprehensive Study of U.S. Markets, Georgia had an overall score of 2,284, meaning the market for health insurers was below the highly concentrated level of 2,500 under the Herfindahl–Hirschman Index (HHI).

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Actuaries report on shortcomings of short-term, limited-duration health plans

In a new study, Milliman actuaries compared costs under health insurance plans that comply with the requirements of the Affordable Care Act versus costs of short-term health plans that do not meet the ACA’s requirements.

Milliman actuaries compared costs under health insurance plans that comply with the requirements of the Affordable Care Act versus costs of short-term health plans that do not meet the ACA’s requirements.

New research about short-term, limited-duration health plans shows that none of the plans studied covered pre-existing conditions and all had coverage limits, according to a new report from Milliman, an actuarial consulting firm. Only one-third of the plans covered prescription drugs and only 42% covered mental health, according to the report.

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