The Affordable Care Act has helped reduce uninsurance, but has replaced it with underinsurance. Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and director of the Healthcare Markets and Regulation Lab in the Department of Health Care Policy at Harvard Medical School, explains how to address this new problem
The Affordable Care Act has helped reduce uninsurance, but has replaced it with underinsurance. Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and director of the Healthcare Markets and Regulation Lab in the Department of Health Care Policy at Harvard Medical School, explains how to address this new problem
Transcript
What are the challenges of underinsurance in the United States and what strategies can be used to reduce it?
So we've struggled a lot with uninsurance in the United States and the Affordable Care Act was meant to address that and it has made great stride, although it has certainly not eliminated uninsurance in the United States, but in many ways it has replaced uninsurance with underinsurance, which is a situation where people have insurance but there are considerable cost sharing. Even the silver plan in the Affordable Care Act, which is the benchmark plan for people on the exchanges, has what is known as a 70% actuarial value, which means the health plan pays 70% of the medical expenses. Leaving the beneficiary to pay, on average, 30%. That's an awful lot of cost sharing for people who are typically on the lower end of the income distribution.
The challenge that we face with that situation is, it's easy to want to fill all the cost sharing holes, but that comes at a fiscal consequence. So one strategy to address the underinsurance problem is to try and target your efforts toward those high-value services. And a number of us have been thinking through different ways to work with exchanges and other entities that are designing plans to figure out how you can build a plan that has a 70% actuarial value, but has better coverage for the most important services.
California Aims for Equity by Redefining Cancer Care
December 8th 2023Authors highlight key aspects of the California Cancer Care Equity Act, including its focus on Medi-Cal beneficiaries, the requirement for managed care plans to contract with specialized cancer centers, and the definition of complex cancers.
Read More
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen
New Insights on Breast Cancer Outcomes Among Sexual, Gender Minorities
December 7th 2023Despite there being a great demand for data collection on sexual orientation and gender identity in the cancer space, individuals who identify as a sexual and gender minority remain poorly represented.
Read More
Research Reveals the Role of Structural Racism in Lung Cancer Risk
December 7th 2023Spanning 22 studies, the analysis illuminated housing disparities, occupational hazards, unequal health care access, economic inequality, and discriminatory industry practices and how they collectively contribute to heightened lung cancer risks.
Read More