MHA Health Care Aide

Law won't lead most employers to drop health coverage, study finds

A study by the Urban Institute found that even after enactment of the federal health care law, most employers will still offer coverage to workers rather than pay fines and leave employees to get insurance from state health exchanges. The study found that employers' desire to keep highly skilled workers will prompt them to continue offering health insurance, but employers with many low-wage workers are likely to drop coverage.

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Study looks at competition in state insurance markets

The health insurance market for individuals and small groups is highly concentrated in many states, according to a new study by the Kaiser Family Foundation. The study found a single health insurer dominates at least half of the individual market in 30 states and at least half of the small group market in 26 states.

The market share for a state's largest insurer in the individual market ranged from 86% in Alabama to 21% in Wisconsin, while the market share for the largest insurer in the small group market ranged from 96% in Alabama to 24% in Oregon and Pennsylvania. "As state policymakers consider their options as implementation of the [Patient Protection and Affordable Care Act] proceeds, they may want to examine the level of competitiveness in their insurance markets as a factor in the choices they make with respect to insurance market rules, exchanges and rate review," the authors state.

IOM issues guidelines for ACA essential benefits package

A new Institute of Medicine report recommends criteria and methods to guide the Department of Health and Human Services in developing a package of essential benefits for qualified health plans under the Patient Protection and Affordable Care Act. The ACA requires HHS to define the minimum package of benefits that certain health plans must cover, including those participating in health insurance exchanges.

The report recommends that the cost of the average premium for the initial package not exceed the national average premium for the typical small employer plan. It says HHS should gauge potential services and products against a set of criteria, including medical effectiveness, safety and relative value compared with alternative options, and evaluate whether the package as a whole protects the most vulnerable individuals, promotes services that have proved effective, and addresses the medical concerns of greatest importance to the public.

The report also recommends creating an independent National Benefits Advisory Council to advise the HHS secretary on annual updates to the benefits package.

HHS begins posting premium rate review information

The Department of Health and Human Services on Oct. 7 began posting information submitted by health insurers requesting premium increases of 10% or more. On Sept. 1, the Patient Protection and Affordable Care Act began requiring health insurers to publicly disclose and justify such premium increases.

To access the rate review information, visit http://companyprofiles.healthcare.gov.