- Has the ACA death spiral kicked the bucket?
By Erik Huth, Peter Fielek | 22 July 2019
This article reviews ACA rates, enrollment, and morbidity to determine the likelihood of a death spiral occurring in the ACA marketplace.
- Commercial health insurance: Detailed 2017 financial results and emerging 2018 trends
By Paul R. Houchens, Jason A. Clarkson, Jason Melek | 07 May 2019
This report provides a detailed review of the commercial health insurance industry’s financial results for 2017 and evaluates changes in the market’s expense structure and enrollment relative to prior years.
- Congress asked nine questions about single payer. Here are 27 answers.
15 March 2019
Reflecting the many unique ways that the federal and state governments fund and regulate American healthcare, Milliman has identified three different single-payer scenarios, ranging from least disruptive to most disruptive compared to the status quo.
- Fiscal year 2019 HRRP impact to hospitals
By James Lucas | 11 September 2018
This paper describes the changes that are coming with the Hospital Readmission Reduction Program and explores what the likely effects will be.
- The short-term/limited-duration insurance rule and the potential impact on health insurance markets
By Erik Huth, Jason Karcher | 31 August 2018
This brief analyzes the provisions of the final short-term/limited-duration insurance rule, the accompanying commentary, and the potential implications to individual insurance markets.
- Is copper the new bronze? Six things every health plan should know about HR 6311 and ACA risk pools
By Jason Karcher, Jeffrey G. Milton-Hall | 24 August 2018
This paper examines the potential implications of House Resolution 6311, passed by the US House of Representatives in July, whose expansion of catastrophic plan eligibility could expose ACA health plans to significant rating risk if made into law.
- Association health plans after the final rule
By Fritz Busch, Jason Karcher | 22 August 2018
We examine the final rule released in June as part of the Trump administration’s executive order promoting healthcare choice, evaluate considerations for sponsors of association health plans, and briefly assess the impact on small-group health and individual ACA markets.
- Don’t TrOOP off the cliff: True out-of-pocket amount poses challenges starting in 2020
By Todd M. Wanta | 20 June 2018
With significant changes to Medicare Part D from the Bipartisan Budget Act of 2018 and the Centers for Medicare and Medicaid Services Final Rule, one provision from the Patient Protection and Affordable Care Act that has gone largely unnoticed is the forthcoming TrOOP Cliff in 2020, for which plan sponsors should prepare.
- The impact of the $0 individual mandate penalty
By Andrew Bourg, Fritz Busch, Stacey V. Muller | 08 June 2018
Understanding the impact of the $0 individual mandate penalty on the health insurance risk pool is important to both insurers offering ACA-compliant products and state policymakers evaluating its alternatives.
- Commercial health insurance: Overview of 2016 financial results and emerging enrollment and premium data
By Paul R. Houchens, Jason A. Clarkson, Jason Melek | 17 May 2018
This report provides a detailed review of the commercial health insurance industry’s financial results in 2016 and evaluates changes in the market’s expense structure and enrollment prior to relative years.