ACA & Insurance

Companies Bianca Cole

Prof. Parsons

What

conce

rns

insu

rance

com

panie

s th

e m

ost

? How will private health

insurance companies

remain profitable? What will be the

overall effect on their

bottom lines?

Qualifi

ed d

ependent

child

ren o

n p

are

nt’

s polic

y unti

l 26 Premiums for such a

low-risk pool would be

a windfall for insurers

since, historically, they

wouldn’t be paying out

much in claims.

Main

pro

ble

m

wit

h t

his

…. Is that the number of

eligible dependent children being signed

up under their parents’ plans isn’t as

significant as planned.

The expected windfall

of premiums has not

flowed in from this age

group; experts believe

that the penalty for not buying insurance

does not outweigh or

come close to the cost

of actually purchasing

it.

Preex

isti

ng a

nd

chro

nic

co

ndit

ions

Insurers are prohibited

from denying coverage to anyone with a preexisting condition, can no longer impose annual

or lifetime dollar limits

on benefits and can only rescind coverage

in cases of fraud.

So if fewer members

of the low-risk pool are

not signing up for coverage and more is

being paid out to cover members that

make up the high-risk

pool...

Do insurance companies need to attempt to help the problem from

becoming worse?

Yes!

Insurance companies

have the money and

the power to help the

US healthcare system

from being place in a

worst condition.

Then t

he b

ad

new

s…

The insurance companies are not going to be able to foot the bill of these individuals that continuously visit the

hospital for long-term

visits before passing

the payments down to

fellow insurance holders.

Welln

ess

pla

ns Aetna offers discounted gym

membersBlue Shield has rolled

out a program called

Blue365

Ince

nti

ves

Smoking cessations Weight loss Improvement on laboratory tests to observe the risks for

chronic illnesses.

How was insurance companies affected by the Affordable Care Act?

Sole

Win

ner In my eyes insurance

companies was the sole winner in the expansion of healthcare.

Sole

Win

ner

With potentially 32 million new customers, this

increase in cash will allow these companies

to decrease their prices

Sole

Win

ner

Another benefit for insurance companies

is that they are beginning to provide a

certain minimum level

of benefits in the health insurance exchanges that individuals and small

businesses must use

to buy coverage.

To get into an exchange, a carrier has to be certified by

the National Committee of Quality

Assurance, with no incentive to do so, many insurers never

gave a thought to certification.

In c

oncl

usi

on…

Quest

ions,

C

om

ments

or

Conce

rns

Refe

rence

s

Brown, A. (2013, June). In U.S., Uninsured

Rate for 18-25-Year-Olds Ticks Down.

Gallup http://www.gallup.com/poll/155108/Uninsured-Rat

e-Year-Olds-Ticks-down.aspx

Cox, C., Claxton, G., Levitt L. (June 2013).

Beyond Rebates: How much are Consumers

Saving from the ACA’s Medical Loss Ratio

Provision? The Kaiser Family Foundation

http://kff.org/health-reform/perspective/bey

ond-rebates-howmuch-are-consumers-savin

g-from-the-acas-medical-loss-ratio-provisio

n/ Dafny, L., Gruber, J., & Ody, C. (n.d.). More

Insurers Lower Premiums. http://

www.mitpressjournals.org/doi/pdf/10.1162/

AJHE_a_00003 Davidson, A. (2013, October 30). The

President Wants You to Get Rich on

Obamacare.http://navihealth.us/wp

-content/uploads/2014/01/NYT_Magazine_n

H.pdf  Foster, R. (April, 2010) Estimated Financial

Effects of the “Patient Protection and

Affordable Care Act,” as Amended. Centers

for Medicare and Medicaid Services.

Refe

rence

s

Goodman, S. (2010) The U.S. Health Care

Industry after Reform: Every Player Gets New

Rules and the Details Matter. Aspatore Special

Report: Understanding the Health Care Reform

Bill U.S.A.: Thomson Reuters/Aspatore

Koning Beals, R. (2012, February 14). Employees

Get Paid to Exercise, While Some Pay to Sit Out -

US News. http://money.usnews.com/money/personal-finance/artic

les/2012/02/14/employees-get-paid-to-exercise-w

hile-some-pay-to-sit-out

MacDonald, J. (2013, May 15). Reforms Shake Up

Health Insurance Companies | Bankrate.com.

http://www.bankrate.com/finance/insurance/reforms-sh

ake-health-insurance-companies.aspx

McCloskey, A., Miller, T., (March 2014) The

Individual Mandate Goes Poof. The Wall Street

Journal Retrieved from http://

online.wsj.com/news/articles

Refe

rence

s

Radnofsky, L., (February, 2014) How the ACA

may Affect Health Costs. The Wall Street Journal

http://online.wsj.com/news/articles

Shi, L., & Singh, D. (2014). Delivering Health Care

In America: A Systems Approach, 4th Edition By

Leiyu Shi And Douglas A. Singh. Journal for

Healthcare Quality.

Sullivan, K., (August, 2010) Why did the ‘public

option’ fail? Jacob Hacker won’t say. Physicians

for a National Health Program Retrieved from

http://pnhp.org/blog/2010/08/30/why-did-the-

public-option-fall-jacob-hacker-won’t-say/

Terry, K. (2010, March 22). Big Winner in

Healthcare Reform? Insurance

Companies,Eventually.

http://www.cbsnews.com/news/big-winner-in-heal

thcare-reform-insurance- companies-eventually/

Timiraos, N. (2015, March 9). Health Law to Cost

Less Than Forecast Earlier. http

://www.wsj.com/articles/cbo-sees-slightly-higher-2

015-deficit-than-previously-forecast-1425914251