Issue: There has been relatively little discussion about the small-group employer insurance market since the implementation of reforms under the Affordable Care Act. It is important to understand the condition of this market before the impact of recent regulatory changes from the Trump administration.
Goal: To understand how the ACA’s market reforms have affected prices, enrollment, and competition in the small-group market.
Methods: Analysis of financial data filed by small-group insurers with the federal government, along with relevant published literature.
Findings And Conclusions: Enrollment has declined in the small-group market, although this is largely a continuation of a trend in place prior to the ACA. Substantially more small-business owners and workers now have coverage than prior to the ACA because many have been able to take advantage of subsidized individual plans through the marketplaces. For those who remain in the small-group market, price increases have been similar to those in the large-group market. The ACA has not reduced the cost of small-group insurance, but has made it more accessible and comprehensive without harming the market. It will be important to continue monitoring the small-group market to ensure that recent regulatory changes do not worsen market conditions.
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Front Reprod Health
December 2024
Collaborative Center to Advance Health Services, University of Missouri Kansas City, Kanas City, MO, United States.
Health Aff (Millwood)
December 2024
Karen Stockley, Medicare Payment Advisory Commission, Washington, D.C.
Numerous studies show that employer plans pay providers significantly more than Medicare, but less is known about prices in nongroup plans sold both on and off the Marketplaces established by the Affordable Care Act (ACA), where narrow networks and low-cost insurers are more prevalent. We estimated prices for three market segments (Marketplace nongroup, off-Marketplace nongroup, and employer small group) and three types of services (professional, outpatient hospital, and inpatient hospital) relative to a Medicare benchmark. We used 2021 claims data covering virtually all enrollment in ACA risk-adjusted plans.
View Article and Find Full Text PDFJ Clin Epidemiol
November 2024
School of Population Health, The University of Queensland, Brisbane, Queensland, Australia.
Background And Objectives: Programmed-death-1/ligand-1 inhibitors (PD-1/L1is) have emerged as pivotal treatments for many cancers. A notable feature of this class of medicines is the dichotomous response pattern: A small (but clinically relevant) percentage of patients (5%-20%) benefit from deep and durable responses resembling functional cures (durable responders), while most patients experience only a modest or negligible response. Accurately predicting durable responders remains elusive due to the lack of a reliable biomarker.
View Article and Find Full Text PDFHealth Aff Sch
November 2024
Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA 90089, USA.
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