Category: ACA and Policy

A little over 10 years ago, I was sitting in a tiny hotel room in Washington, D.C., waiting for a phone call from a friend who is a lobbyist for our Blue Cross and Blue Shield Association. It was Christmas Eve 2009, and we were awaiting the final vote of the U.S. Senate on the Affordable Care Act (ACA). I remember very clearly thinking that there was nothing to stop the then-Democratic majority from passing the ACA. Certainly, they had put a ton of work, time and effort into the law. But — they put much less time into gaining the trust of the opposition.

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One of the more interesting things the Affordable Care Act did to the private health insurance business was to tell health insurance companies that the Feds were now in control of their profit margins. What does that mean?

Imagine you are the CEO of your own health insurance company. In fact, let’s call it Your Own Health Insurance Company, or YOHIC for short! How do you think you would feel if YOHIC collected $1 billion in premiums over a year, but only had to pay out $500 million in healthcare costs? Sounds like YOHIC is doing really well, turning a 50% profit. Does YOHIC get to keep the rest of the premiums for its own payroll and profits?

Since 2010, the answer to that question is a resounding NO! Read more

It’s the eve of your 26th birthday, you must take your first steps into this alien world alone. For 25 years, you’ve lived in safety on the Mother Ship, er, your parents’ health insurance plan. PPOs, HMOs, cost shares and deductibles weren’t even on your radar.

What should you (or your kid who is turning 26) do? Healthcare Economist Mike Bertaut explains your options. Read more

Welcome to our first podcast in the age of COVID-19. In this podcast, Mike and his producer, Lindsey, talk about what has changed at Blue Cross (about 90% of our employees are working from home), along with how we’ve adjusted programs and services for our members. And, he talks about what hasn’t changed — our commitment to continue serving our customers.

Mike explains why it’s vital to continue seeking treatment for regular health concerns. Emergencies like heart attacks and appendicitis don’t stop in the face of a public health crisis, but more Americans are delaying care for them, at a great risk. Mike discusses how telehealth can help you figure out if and when you need to head to the hospital. Read more

In this episode of the Straight Talk podcast (23:32), Mike sits down to answer some questions from readers.

Mike takes on your tough questions, including how the Health Insurance Tax is affecting your premiums (hint: they are taking a hit, but there are other factors that can cause your rates to go up. Mike spells them out).
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Want in on an inside conversation between Healthcare Economist Mike Bertaut and one of his Straight Talk producers? They are interesting exchanges. In this one, which we recorded for you, we talk about the latest news with the ACA, even going back in time a bit.

We also talk about how the ruling could affect some really popular benefits of the ACA, Read more