Health Affairs July 30, 2018
Individual-market premiums were high and rising, even before recent years’ federal policy changes triggered large price spikes. Why? And how can state or federal policy makers help?
In connection with a fresh dispute over the administration’s suspension of risk-transfer payments, the Department of Health and Human Services (HHS) issued a report on July 9, 2018, that contains important information highlighting the role played by adverse selection in elevating individual-market premiums. Relatively young and healthy people who qualify for individual-market coverage often do not enroll. Average claims costs, hence premiums, are thus higher in the individual than the group market, even for coverage of comparable value. This analysis points the way toward strategies that lower individual-market premiums without forgoing the consumer...
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