Health insurers have been preparing for an expected rise in coverage for dental care under the ACA, with some insurers offering coverage on a par with or higher than they did in 2015, a new analysis shows.
The number of people insured through the ACA’s National Health Security Program, or NGS, jumped by about 50% from 2016 to 2017 to more than 10.3 million people, according to a Kaiser Family Foundation analysis of the state and local Medicaid data.
In 2019, it had about 1.7 million.
The increase in coverage in 2018 reflects that many of the new enrollees were younger than 55, who were already on the ACA-covered plans, Kaiser said.
The data is a sign that insurers are getting a better sense of what consumers are likely to need in order to navigate the health care system, said Kevin Hsieh, a senior policy analyst at Kaiser.
The insurance market is likely to remain volatile, and there is no single point where insurers can tell which people will be able to obtain coverage.
The biggest uncertainty is how much insurers will spend, and what that will mean for insurers, who have been under pressure to lower prices amid rising premiums.
Insurers in the ACA market are paying $1,500 for a colonoscopy, up from $700 in 2015.
A colonoscopist will also charge $100 for the initial consultation, and $25 for a follow-up exam, up to $500 a visit.
Insurance companies are also charging $3,500 per hip or knee replacement, up $300 from 2016.
That’s a big jump from $1 a pop last year.
“You can see where they’re trying to drive prices down,” said Steven Schoen, a research analyst at the Kaiser Family Trust.
“There’s no one silver bullet.
The answer to that is that they’re going to have to find ways to drive the prices down.”
A large percentage of the increase in NGS coverage was among those who had coverage through the Blue Cross Blue Shield program, which has been expanding its insurance offerings in the face of rising costs for its members.
Blue Cross Blue Shields, which includes Blue Cross, Blue Shield and Cigna, had more than 1.2 million enrollees in 2019, an increase of more than 20% from 2015.
That means it’s spending more on its health care services than any other insurer in the country, according a Kaiser analysis of data from the Centers for Medicare and Medicaid Services.
The Blue Cross enrollment increase also reflects the expansion of Blue Cross plans that are expanding to cover more people, and to lower premiums, as the number of enrollees has increased.
Blue Cross now covers almost 3 million people with private insurance, up almost 3% from the previous year.
The expansion of plans that cover older people and people with disabilities is the biggest reason why the Blue Shield rate of return has increased to 9.6% from 8.5% in the first six months of 2018.
The rise in the Blue Pill premium has also been a big factor.
Insurer executives say the expansion is helping drive down premiums, and that the Blue Insurers Association, the industry’s largest trade group, expects that trend to continue.
Insuring older people is a good fit for the ACA.
The ACA’s Medicaid expansion has made it easier for them to get coverage, and they are more likely to have a high-deductible plan.
“People in the older cohort who are most in need of coverage are the ones who have a very good relationship with their health care providers,” said Rob Nichols, the chief executive officer of Kaiser Health News.
“We’re seeing an increase in the number and number of older enrollees.”
The rise in NHS plans also reflects an expectation that more people will buy insurance, because insurance companies are increasingly seeing a shortage of workers, who are less likely to buy plans on their own.
“It’s a combination of the ACA and Medicaid expansion, and a rising number of more people buying coverage,” said Paul Rietberg, a health care economist at the University of Chicago Booth School of Business.
“There’s also a greater willingness to shop around for cheaper plans, because they’re getting better quality care at lower prices.”
Health plans have also been more cautious about covering certain procedures that are less expensive than standard care.
In 2019, the number one reason for the number two reason for getting dental treatment was cost.
Nearly half of all dental procedures were covered by health plans, and nearly 30% of all medical procedures were also covered by insurers.
Insure companies will have to figure out how to cover procedures that would cost more than $500, and those costs could become more expensive, as more people get older and as more surgeries are covered by plans.
But the biggest change in coverage has been to the level of coverage for people with chronic diseases, which include diabetes, heart disease and arthritis.
That is changing.
In 2020, the majority of