Rowe, professor of health policy and aging at the Columbia University Mailman School of Public Health, said insurers have not expressed much concern over antiselection
. But that very well could change as genomics matures.
But the insurance industry is beginning to draw a line in the sand with antiselection
, sometimes called "adverse selection" or "selection against the insurer."
However, the passage of the REA has created new pressures of antiselection
, which occurs when an individual decision to accept or discontinue participation in a benefit plan in some way worsens the financial position of the plan.
In the past, many insurance regulators and insurers have argued that various types of health plan purchasing coalition proposals would lead to antiselection
programs, but Doak told Paul he thinks the purchasing coalition idea has some merit.
The PPACA risk-adjustment program is supposed to use cash from issuers of PPACA-compliant individual and small-group plans with low-risk enrollees to compensate issuers of PPACA-compliant plans with high-risk enrollees, to protect market players against antiselection
Once the word is out--"the word" always gets out--about our rank naivete, a dark night of rampant antiselection
will descend upon us.
Nelson asked about strategies for controlling antiselection
in a health coverage system in which carriers must sell health coverage even to people with serious health problems.
Even if this assumption causes additional heterogeneity in the data, and therefore a certain amount of antiselection
, it is not as restrictive as it might seem.
Yet, because few companies do additional underwriting on individuals once they are deemed as acceptable risks for the purchase of insurance, there may be antiselection
occurring at the time that individuals decide how much insurance coverage to purchase.
Gap-filler product sellers might eventually have to limit sales, especially if a prolonged individual major medical shutdown leads to antiselection
State, federal and exchange rules require insurers that offer both on-exchange and off-exchange versions of plans to make both versions the same, to avoid antiselection
health insurers 32 million new enrollees, more revenue, a closer relationship with the enrollees, and a chance to accept older, sicker applicants with less fear of antiselection