Health Beat: Actuarial Group Looks At Outcomes Of Supreme Court Case

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ACTUARIAL GROUP LOOKS AT OUTCOMES OF SUPREME COURT CASE

The American Academy of Actuaries released a brief last week examining possible changes to the Affordable Care Act should the Supreme Court hand down a decision in the King v. Burwell case prohibiting premium subsidies in states with federally facilitated marketplaces (FFMs).

“Eliminating subsidies in FFM states would have enormous consequences for insurance enrollment, premiums, and the viability of health insurance markets,” said Catherine Murphy-Barron, vice president of the Academy’s Health Practice Council (HPC). “Policymakers should understand the implications of any policy proposal intending to address the disruption caused by the potential loss of subsidies. Of central concern, a viable health insurance system must attract a broad cross section of risks and operate as a level playing field.”

The new issue brief from the HPC, “Implications of Proposed Changes to ACA in Response to King v. Burwell,” urges policymakers to follow market reform principles for ensuring a sustainable health care system and examines how various policy proposals could play out under a post-King v. Burwell scenario in which federal premium subsidies are eliminated.

The publication of the issue brief follows the group’s February 2015 letter to Health and Human Services Secretary Sylvia Mathews Burwell, urging federal regulators to consider providing flexibility in health insurance rate filings in FFM states, and noting that elimination of subsidies in those states could precipitate major disruptions in the individual market.

Read the actuary group’s issue brief here.

HHS SAYS GOAL OF 9.1 MILLION ‘EFFECTUATED ENROLLEES’ IN HEALTHCARE MARKETPLACE REACHED IN 2015

The Centers for Medicare & Medicaid Services released a data snapshot on Tuesday providing a detailed look at how many consumers paid their premiums in 2015 and had “effectuated” coverage in March 2015.

During open enrollment for 2015 Health Insurance Marketplace coverage, through Feb. 22, about 11.7 million Americans selected plans through the marketplaces. On March 31, 2015, about 10.2 million consumers had “effectuated” coverage, which means those individuals paid for coverage and still had an active policy on that date.

Nearly 8.7 million (85%) consumers nationwide and 6.4 million consumers in the 34 states with federally-facilitated marketplaces received an average premium tax credit of $272 per month to make their premiums more affordable throughout the year. About 6.3 million consumers were enrolled in health coverage through the marketplaces and had paid their premiums on December 31, 2014.

In November 2014, the U.S. Department of Health and Human Services (HHS) set a goal of 9.1 million “effectuated enrollees” at the end of calendar year 2015. The March 2015 enrollment number is consistent with meeting the HHS’s goal for 2015, officials said.

To read more from this data snapshot on the number of consumers in each state who paid their premiums in 2014 and 2015, click here.

OUT OF POCKET EXPENSES FOR HEALTHCARE REACHED $416 BILLION FOR CONSUMERS IN 2014

The amount Americans spend on healthcare out of pocket reached $416 billion in 2014 and with growth of 8% will reach $608 billion by 2019, according to a recent report by Kalorama Information.

The findings in the report, called “Out of Pocket Healthcare Expenditures in the U.S.,” show that direct payments by consumers will see strong growth at 9.5% annually as more employers increasingly add high deductible plans.

Co-payments will also demonstrate healthy growth of 9.5% annually, as plans raise co-pay amounts and subject more products and services to co-payment. Premiums are projected to expand by 7.1% per year overall.

The report notes that HMOs in particular will seek double-digit monthly premium increases as these plans suffer from an exodus of young, healthy employees to low premium, high deductible plans leaving a higher proportion of participants with health problems.

Overall, Americans spend on three categories out of pocket: directly on expenditures, co-pays as part of office visits and hospital visits and drug purchases, and on premiums. Information on the report can be found here.

CDC: SKIN CANCER ON THE RISE

Melanoma rates doubled between 1982 and 2011 but comprehensive skin cancer prevention programs could prevent 20 percent of new cases between 2020 and 2030, according to report today by the U.S. Centers for Disease Control and Prevention.

Skin cancer is the most common form of cancer in the U.S., and melanoma is the most deadly type of skin cancer. More than 90% of melanoma skin cancers are due to skin cell damage from ultraviolet (UV) radiation exposure. Melanoma rates increased from 11.2 per 100,000 in 1982 to 22.7 per 100,000 in 2011.

The report notes that without additional community prevention efforts, melanoma will continue to increase over the next 15 years, with 112,000 new cases projected in 2030. The annual cost of treating new melanoma cases is projected to nearly triple from $457 million in 2011 to $1.6 billion in 2030.