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A Roadmap to High Quality Affordable Health Care for All Americans

This document reviews current research outlining the key drivers of health care costs and advances a new policy framework for bending the cost curve and improving the quality of patient care.

Reports/Research/White Papers | Issue: Affordable Care Act, Cost, Health Care Costs, Health Insurance Tax | Strategic Communications | 12/17/2013

Summary of Benefits and Coverage and Uniform Glossary Proposed Rule: Implementation and Annual Ongoing Costs of Compliance - [PDF]

In September 2011, AHIP conducted a survey of health insurance plans on costs of compliance with the new Summary of Benefits and Coverage (SBC) and the Uniform Glossary requirements detailed in a notice of proposed rulemaking (NPRM) issued by the Department of Health and Human Services (HHS), Department of Labor, and Department of Treasury on August 22, 2011.

Reports/Research/White Papers | Issue: Administrative Expenses, Affordable Care Act, Cost, Individual Market Health Insurance, Individual Market Health Insurance | Center for Policy and Research | 08/20/2013

Trends in Medigap Coverage and Enrollment, 2012

This report presents trends in enrollment in Medicare Supplement (Medigap) insurance coverage, using data on the number of policies in force as of December 2012 from the National Association of Insurance Commissioners (NAIC). The NAIC dataset contains information on most Medigap policies in force in the U.S., representing approximately 10.2 million covered lives, with policies from 262 carriers.

Reports/Research/White Papers | Issue: Affordable Care Act, Medicare Supplemental Insurance, Public Programs | Center for Policy and Research | 05/20/2013

Comprehensive Assessment of ACA Factors That Will Affect Individual Market Premiums in 2014

A new report from Milliman, Inc. helps explain how the Affordable Care Act’s (ACA) coverage expansion, new benefits, and market reforms will impact individual market health insurance premiums in 2014. The report highlights how some provisions will increase premiums while others will make health care coverage more affordable for consumers. The focus of this report is to highlight the broad range of changes happening in the marketplace and the wide variation in impact that is likely to occur.

Reports/Research/White Papers | Issue: Affordable Care Act, Age Rating, Essential Benefits, Health Care Costs, Health Insurance Tax | Strategic Communications | 04/25/2013

Impact of Market Reforms on Affordability - [PDF]

This presentation from Oliver Wyman examines the impact of ACA market reforms on affordability.

Reports/Research/White Papers | Issue: Affordable Care Act, Age Rating | 03/13/2013

Age Band Compression Under Health Care Reform

An article from actuaries at Oliver Wyman published in Contingencies highlights the impact of the Affordable Care Act’s (ACA) age rating restrictions on premiums.

Reports/Research/White Papers | Issue: Affordable Care Act, Age Rating | 01/07/2013

Annual Tax on Insurers Allocated by State

In this report we have quantified the total premiums by state that will be assessed and estimated per member per year costs of this assessment by line of business.

Reports/Research/White Papers | Issue: Affordable Care Act, Health Insurance Tax | 11/01/2012

Studies on Hospital Readmissions, Featuring Health Plan Innovations and Comparisons of Medicare Advantage (MA) and Medicare’s Traditional FFS Program

Studies on Hospital Readmissions, Featuring Health Plan Innovations and Comparisons of Medicare Advantage (MA) and Medicare’s Traditional FFS Program.

Reports/Research/White Papers | Issue: Affordable Care Act, Chronic Care, Disease Management, Medicare Advantage, Medicare Advantage (MA) and Medicare Prescription Drug Plans (PDP) | Center for Policy and Research | 10/03/2012

Low-Income & Minority Beneficiaries in Medicare Advantage Plans, 2010 - [PDF]

New data from the Medicare Current Beneficiary Survey (MCBS) show that Medicare Advantage plans, Medicare’s private comprehensive health plans, continue to be a vital source of coverage for low-income and minority beneficiaries in 2010.

The Impact of Guaranteed Issue and Community Rating Reforms on Individual Insurance Markets - [PDF]

Milliman examined states that enacted guaranteed issue and community rating reforms in the absence of an individual mandate, and found that they saw their individual insurance markets deteriorate. This report updates Milliman’s August 2007 report on the impact of guaranteed issue and community rating (CR) reforms adopted in eight states in the 1990s. 

Reports/Research/White Papers | Issue: Affordable Care Act, Guarantee Issue, Personal Coverage Requirement | 03/15/2012

Oliver Wyman Study: Estimated Premium Impacts of Annual Fees Assessed on Health Insurance Plans - [PDF]

A technical analysis by Oliver Wyman estimates that the new health insurance tax in the Affordable Care Act (ACA) “will increase premiums in the insured market on average by 1.9% to 2.3% in 2014,” and by 2023 “will increase premiums 2.8% to 3.7%.” AHIP commissioned this report as part of its ongoing effort to raise awareness about the impact the tax will have on consumers, employers and public program beneficiaries.

Reports/Research/White Papers | Issue: Affordable Care Act, Health Insurance Tax | 10/31/2011

Higher Costs and the Affordable Care Act: The Case of the Premium Tax - [PDF]

The Affordable Act imposes a fee on health insurers that amounts to a de facto “health insurance premium tax” that will raise the cost of health insurance for American families and small employers. Specifically, under the law, an annual fee applies to any U.S. health insurance provider, with the intent of raising nearly $90 billion over the budget window.

Reports/Research/White Papers | Issue: Affordable Care Act, Health Insurance Tax | 03/09/2011

Low-Income & Minority Beneficiaries in Medicare Advantage Plans, 2008 - [PDF]

New data from the Medicare Current Beneficiary Survey (MCBS) show that Medicare Advantage plans, Medicare’s private comprehensive health plans, were a vital source of coverage for low-income and minority beneficiaries in 2008.

Accountable Care Organizations and Market Power Issues - [PDF]

In an effort to assist policymakers, regulators, providers, health plans, and others in considering the rules and regulations that are being formulated for ACOs, AHIP hosted a forum on ACOs on September 23, 2010, in Washington, DC that included a panel of four experts who provided guidance on the implementation of the Shared Savings Program and discussed various aspects of market power and antitrust concerns as they relate to ACOs.  This paper summarizes the key lessons and themes discussed by the presenters as well as the participants.

Reports/Research/White Papers | Issue: Accountable Care Organizations, Affordable Care Act | 10/20/2010

Reductions in Medicare Advantage Payments: The Impact on Seniors by Region - [PDF]

Heritage Foundation backgrounder on the impact of new Medicare Advantage cuts included in the ACA, which states that these cuts “will restrict senior citizens and the disabled to fewer and worse health care choices, reducing their access to quality health care.”

Reports/Research/White Papers | Issue: Affordable Care Act, Medicare Advantage, Public Programs | 09/14/2010

Expanding the ACO Concept to Encourage Innovation, Accountability and High Performance and the Value Health Plans Bring to Delivery System Transformation - [PDF]

Both the public and private sectors are exploring and implementing innovative care and payment models designed to improve delivery of care and encourage Americans to stay healthy. This white paper examines the concept of Accountable Care Organizations (ACOs), often defined as organizations of health care providers that agree to be held accountable for the quality, cost and overall care for a defined population of patients and that seek to receive shared savings if they meet certain quality and costs goals.

Reports/Research/White Papers | Issue: Accountable Care Organizations, Affordable Care Act | 09/13/2010

Setting the Baseline for the Individual Market - [PDF]

This Hay Group presentation provides an overview of how health insurance premiums are calculated and the factors that contribute to premium increases.

Reports/Research/White Papers | Issue: Affordable Care Act, Rate Review, Rate Review | 07/20/2010

Comparison of Projected Enrollment in Medicare Advantage Plans - [PDF]

The Congressional Budget Office released its latest projections on the impact new cuts to Medicare Advantage will have on the millions of seniors enrolled in the program. CBO is projecting MA enrollment will decline from 11.7 million enrollees in 2011 to 7.5 million in 2018.

Reports/Research/White Papers | Issue: Affordable Care Act, Medicare Advantage, Public Programs | 03/19/2010

Impact of Changing Age Rating Bands in “America’s Healthy Future Act of 2009” - [PDF]

Oliver Wyman has developed an actuarial model to study the impact of different reform proposals on the individual and small employer health insurance market.  According to this model, if the age band is compressed to 3:1, premiums for the youngest-healthiest third of individuals would be 35% higher in Year 1 compared to reform with 5:1 rating bands.

Reports/Research/White Papers | Issue: Affordable Care Act, Age Rating | 09/28/2009

The Impact of Guaranteed Issue and Community Rating Reforms on Individual Insurance Markets - [PDF]

A report by Milliman, Inc. examined the impact of enacting guarantee issue and community rating without covering everyone. According to the report, these initiatives have the potential to cause individuals to wait until they have health problems to buy insurance. This could cause premiums to increase for all policyholders, increasing the likelihood that lower-risk individuals leave the market, which could lead to further rate increases. If this continues, the pool or market could essentially collapse or shrink to include only the high-risk population.

Reports/Research/White Papers | Issue: Affordable Care Act, Personal Coverage Requirement | 08/30/2007