Health Plan Weekly

  • News Briefs

     As of March 15, 10.7 million people had effectuated coverage in the Affordable Care Act exchanges, according to new data released by CMS on July 23. Total effectuated enrollment — encompassing people who selected a plan, paid their first month’s premium, if applicable, and had coverage in February 2020 — increased by about 1% compared with total effectuated enrollment for February 2019. Visit to learn more.

     Enrollment for Nebraska’s Medicaid expansion program will begin Aug. 1, according to local news reports, with coverage slated to begin Oct. 1. Nebraska voters approved Medicaid expansion in November 2018, but the implementation was delayed amid the state’s ultimately abandoned attempt to get CMS approval for a Section 1115 waiver, Credit Suisse analyst A.J. Rice pointed out in a July 21 note. Anthem, Inc., Centene Corp. and UnitedHealth Group cover about 230,000 Medicaid lives combined in Nebraska, and the expansion of eligibility will add about 90,000 lives, Rice said, though he noted the additional lives will have a very small impact on those firms’ earnings. Email Rice at

  • ACA Risk Adjustment Transfers Total More Than $10B

    Risk adjustment transfers reached $10.8 billion in the Affordable Care Act program for the 2019 benefit year, with the individual market accounting for about $7.98 billion, according to CMS. Among the 561 issuers that participated in the program, a handful were slated to receive significant payments. Blue Shield of California was due to collect more than $1 billion, with $873.8 million related to its individual market plans. Florida Blue followed with an expected $773.9 million payout. Meanwhile, Kaiser Foundation Health Plan, Inc. in California will have to pay nearly $796.6 million into the risk adjustment program.

  • D.C. Appeals Court Upholds Short-Term Plan Rule

    A Trump administration rule expanding the availability of short-term, limited duration (STLD) health insurance plans will continue after an appeals court panel ruled 2-1 against a suit brought by the Association for Community Affiliated Plans (ACAP). A July 17 statement by ACAP CEO Margaret Murray suggests the trade group for safety net health plans is likely to continue pursuing the case.

    “We are disappointed in the court’s decision but remain firm in our belief that junk insurance plans violate both the Affordable Care Act and the Administrative Procedure Act,” Murray wrote in the statement. ACAP has the option of petitioning the D.C. Circuit Court of Appeals to hear the case en banc, which would bring every member of the circuit’s bench together to hear the suit again. Murray’s statement indicates ACAP is likely to pursue that option. “We’re confident the full D.C. Circuit will agree,” Murray added.

  • Insurers Launch Management Programs for Chronic Conditions

    Both UnitedHealthcare and Humana Inc. are rolling out new disease-specific care management programs aimed at providing patients with the tools they need to help control their chronic conditions.

    The programs — UnitedHealth’s focusing on type 2 diabetes and Humana’s on chronic kidney disease — highlight both new digital and time-tested interpersonal ways of managing chronic conditions, observers say.

  • New Research Highlights Need for More Education About HSAs

    In recent years, high-deductible health plans (HDHPs) — now common in both employer-sponsored and individual markets — have faced increasing scrutiny as evidence emerges that they may not actually cause people to be savvier health care consumers. Now, a new study adds another layer to the debate by finding that access to and uptake of health savings accounts (HSAs) is low among people enrolled in HDHPs. Experts have varied opinions on the study’s implications, but they agree that the findings underscore the need for better consumer education about the benefits of HSAs.

    The study, published on July 17 by JAMA Network Open, details findings from a 2016 survey of a nationally representative sample of U.S. adults ages 18 to 64 who were enrolled in an HDHP for at least 12 months. Researchers reported that 32% of HDHP enrollees did not have an HSA, and 55% of HDHP enrollees who did have an HSA had not contributed any pretax funds to their account in the past 12 months.

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