Health Plan Weekly

An annual report on the cost of health care prepared by Milliman, Inc. found that, for the first time in years, health care costs for the average American family fell in 2020. However, experts say that is unlikely to happen again any time soon, as the COVID-19 pandemic caused a steep decline in health care utilization.

The report, the 2021 Milliman Medical Index, found that the cost of health care for an average American family of four covered by an employer-sponsored PPO health plan was $26,078, down from $27,233 in 2019, a decrease of 4.2%. The drop will not be permanent, warn the authors: Milliman projects costs will increase to $28,256 in 2021.

More than one-third of privately insured health plan members in the U.S. accessed telehealth services in 2020, up from just 9% a year ago. The increased use of telemedicine and other digital tools and services is correlated with a jump in overall member satisfaction, a study from J.D. Power shows.

The numbers, contained in the J.D. Power 2021 U.S. Commercial Member Health Plan Study, can’t prove the increase in telehealth, a shift caused by the pandemic, has a causal relationship to improved member satisfaction. But James Beem, managing director for global healthcare intelligence at the data analytics firm, says the study shows “that health plans are becoming more customer-driven and that they came through for member responses” during the COVID-19 pandemic.

Nevada lawmakers this week passed a public option bill, which experts say is the most ambitious and aggressive in a wave of similar policies that have been seriously discussed in recent years. Payers and providers alike objected to the bill, which will go into effect in 2026 and Democratic Gov. Steve Sisolak on Tuesday promised to sign.

Nevada’s public option bill will require any carrier that participates in the state’s Medicaid managed care program or individual exchange to provide a silver- or gold-level public option plan. Premiums for those plans will be set 5% lower than the benchmark silver plan sold on the state Affordable Care Act exchange, and both individuals and small group purchasers will be able to buy into the plan.

✦ After being confirmed by the Senate, Chiquita Brooks-LaSure was sworn in as the new CMS administrator on May 27 by HHS Secretary Xavier Becerra. “Chiquita Brooks-LaSure’s historic appointment and confirmation as the first Black woman to lead the Centers for Medicare and Medicaid Services further demonstrates the Biden-Harris Administration’s commitment to bringing diverse perspectives and seasoned leaders to drive and improve the U.S. health care system,” Becerra said in a statement. Brooks-LaSure, whose past roles include deputy director for policy at CMS’s Center for Consumer Information and Insurance Oversight, House Democratic staffer and managing director at the professional services firm Manatt Health, is a longtime Affordable Care Act champion.

✦ In 2021, the average benchmark premium for Affordable Care Act exchange plans fell 1.7% year over year, a slightly larger decline than the declines of 1.2% and 3.2% in 2019 and 2020, according to a new analysis from the Urban Institute. “The stability of Marketplace premiums in recent years likely owes to both market-level factors and state policy decisions,” including states’ implementation of reinsurance programs, the report says. While the majority of states saw declines ranging from 0% to 10% (34 states) or small increases of less than 6% (seven states), 10 states saw double-digit declines in their benchmark premiums in 2021. Only one state saw a large increase in benchmark premiums in 2021: North Dakota with 23%. Insurers’ exchange participation in 2021 also increased for the third year in row, with an average of 4.3 insurers participating per rating region. In addition, the analysis suggests that its data “do not reveal a substantial increase in Marketplace enrollment” tied to COVID-19, but it says the pandemic “may have contributed toward the decline in premiums for 2021” since many insurers experienced significant surpluses due to the steep drop in routine and elective care.

by Jinghong Chen
More than half of insurers surveyed said they do not anticipate raising health plan premiums due to the pandemic, according to a recent poll conducted by eHealth, Inc. The private insurance marketplace surveyed more than 4,700 consumers and 26 insurance industry representatives on the impact of COVID-19, technology and public policy reforms. Among the respondents, 60% favor expanding the Medicare program in some form, while half of current Medicare beneficiary respondents say Medicare should continue to be run by public and private cooperation between government and insurance companies.