The ACA changed the way we purchase health insurance. For this assignment, we will look at pre-ACA days. It seems that the only ones who could get insurance were the ones who did not need it. Why is this? This is the topic of this weeks paper. First, discuss the different private health insurance markets. Employment-based Individual Medicaid Medicare Tricare/CHAMPVA Uninsured What are the determinants of private health insurance premiums? Determinants of Claims Experience (85 percent) o Benefit coverage o State Mandates o Demographic characteristics of the insured population o Industry o Region o Medical inflation rate o Cost-containment policies ? Copayment ? Deductible ? Benefit design ? Utilization review ? Case management ? Preferred provider Determinants of Loading Charge o Administrative costs o Marketing costs o Reserves o Profits Identify and discuss 3 factors that determine how insurance premiums are determined. Lastly, how does all of the information you presented, answer the question: Why was it that the only ones who could get insurance were the ones who didnt need it?
