ACA enrollment at a record high
Plus: Fewer large employers are opting for self-funded insurance
Good morning and happy Friday. This is the Friday Pulse Check from Fulcrum Strategies. Today’s newsletter is a bit abbreviated but still covers the issues that matter to your practice and patients.
In the news:
ACA enrollment reaches record high
Analysis from the Kaiser Family Foundation shows that in early 2023, 15.7 million people were enrolled in Affordable Care Act marketplace plans. Of those, 14.3 million received government subsidies to help pay for the insurance. KFF also estimated that enrollment in non-ACA-compliant plans, such as short-term plans (which President Biden has referred to as “junk insurance”) is at an all-time low. Read more from the Kaiser Family Foundation.
Fewer large employers opt for self-funded insurance
A new study from the Employee Benefit Research Institute found the number of employers offering self-funded options to their employees is dropping. Only, 72% of employers with more than 500 employees are offering self-funded plans; that is the lowest level since 2010. Smaller employers are seeing an uptick, however. Of employers with 100 to 499 employees, 37% are offering a self-funded option, up from 27% in 2010. Read more from EBRI.
Other articles of interest:
The FLATLINING Podcast from Fulcrum Strategies
This week on the podcast, Ron and I took some time to discuss a debate raging among some on the right: Should the Centers for Medicare and Medicaid Services be allowed to deny coverage of a drug that was approved by the Food and Drug Administration?
Some on the right say that CMS should cover any drug approved by the FDA because both are government agencies and administrators in CMS have no right to override the medical knowledge of the FDA.
As Ron and I discussed, however, you hear crickets when it comes to asking the same question about the health insurance payors. Should payors cover every drug approved by the FDA? After all, they are administrators (for the most part) and they even say they are not making medical determinations when they deny coverage for other procedures.
Check out the podcast this week for our interesting discussion.
Or listen to it on YouTube:
Have a good weekend,