Health Plan Weekly

A study published Sept. 11 in the American Journal of Managed Care found that a federal law to rein in surprise medical billing could reduce overall health insurance premiums by 1% to 5%. The study, which was prepared by researchers at the USC-Brookings Schaeffer Initiative for Health Policy, was lauded by health insurance experts for looking at surprise billing’s impact on the insurance system at large, an area that they say has not been studied extensively.

The study is based on 2017 data compiled by the Health Care Cost Institute, which is drawn from claims submitted to UnitedHealthcare, Humana Inc. and CVS Health Corp.’s Aetna. The data is compiled from 568.5 million claims submitted by 44.8 million covered lives.

The COVID-19 pandemic and associated economic crisis have led to steep losses in the number of people with health insurance, and lawmakers should take swift action to provide temporary funding to bolster COBRA so that people can remain on their employer-sponsored plans, says a coalition that includes business groups, employer organizations, insurers and consumer groups.

The coalition, the Alliance to Fight for Health Care, released a report on Sept. 22 indicating that nearly 7.5 million Americans enrolled in commercial health insurance lost their coverage in April and May. This number, which is based on two surveys conducted by America’s Health Insurance Plans (AHIP), is expected to rise substantially by the end of 2020, as layoffs continue to outpace new job openings and temporary job losses turn permanent.

In a year when a pandemic and a presidential election are already fueling high levels of uncertainty, the Sept. 18 death of Justice Ruth Bader Ginsburg — which could tip the scales in favor of striking down the Affordable Care Act (ACA) — was hardly welcome news for health insurers. However, industry analysts and legal experts say there are plenty of reasons not to hit the panic button just yet.

“This definitely increases the chance of the Supreme Court striking down the full ACA. But we’re going from a pretty low likelihood base,” says Chris Sloan, an associate principal at consulting firm Avalere Health. “The odds are still really stacked against anything materially changing for the ACA.”

✦ Anthem, Inc. is teaming up with the University of California, Irvine, Apple, Inc., and a company called CareEvolution to launch a study that examines whether devices like the Apple Watch and iPhone can help people with asthma manage their condition. As part of a two-year, randomized controlled study, Anthem-affiliated health plan members who have been diagnosed with asthma will get a digital tool that includes “daily symptom and trigger tracking to provide awareness of asthma control and personalized nudges based on changes in signals from their Apple Watch including activity, heart rate, the new Blood Oxygen feature and other health metrics.” Read more at https://bit.ly/2EgbZI4.

✦ Between 2018 and 2019, the number of uninsured Americans rose from 28.6 million (8.9% of the population) to 29.6 million (9.2%), according to new data from the U.S. Census Bureau. Notably, those findings do not capture insurance losses due to the current recession related to the COVID-19 pandemic. Among other findings, the report said Hispanic Americans experienced the largest year-over-year change in uninsured rates among racial/ethnic groups, with that rate growing from 17.9% in 2018 to 18.7% in 2019 — primarily driven by “a 1.4 percentage-point decrease in the percentage of Hispanics with public coverage.” To view the Census Bureau report, visit https://bit.ly/3mwj1ty.