Evensun Health Substack
Wesley Sanders, Andrew Staroscik, Rosa Solorio, JR Hill, Emily GrecoA Substack from Evensun Health about the Affordable Care Act, health policy, and health insurance operations
| Platform |  | Pricing | Only free issues | Publishes | Weekly |
|---|---|---|---|---|---|
| Issues | 20 | Founded | 10 months ago | Last Issue | 16 days ago |
| Active | |||||
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evensun.substack.comLatest Issues
Fewer Members, Same Revenue
By now, you’ve likely read about the 760,000 enrollees CMS terminated due to suspected fraud. I won’t belabor my thoughts on whether these were all fraudulent or not - other than to say that having no claims isn’t on its own an indicator of...
A $2.25 Billion Payable and Nobody to Pay It To: ACA Risk Adjustment After 1Q2026
In my last post I wrote the inconsistencies in quarterly NAIC filings, and how much verification it takes before Note 24 can tell you anything at all (Same Line, Different Meaning). Once you get the data standardized the 1Q2026 Note 24 data...
Same Line, Different Meaning: What Carrier NAIC Filings Actually Say About Risk Adjustment
I have been building out a quarterly view of the ACA market, using statutory financial data to track the cadence of risk adjustment through the year and year over year. Because insurance is a regulated industry, the financial statements of...
More Flexibility, More Choices: CMS Opens the Door to New Bronze Plan Designs
In the 2027 Notice of Benefit and Payment Parameters, CMS announced their ruling that allows issuers to offer bronze plans that exceed the statutory MOOP (Maximum-out-of-Pocket) limit as long as the issuer simultaneously offers at least one...
Expanded Catastrophic Plans: Opportunity, Risk, and the Questions Worth Asking
This is the 4th post in our series on the 2027 Notice of Benefit and Payment Parameters.
Catastrophic plans have generally received limited attention in the individual market. The plans were included in the original ACA legislation as a lo...
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Authors
The writers behind this newsletter.
Founder of Evensun Health. I write about the idiosyncrasies of the Affordable Care Act markets and related topics.
As the Operations Manager at Evensun Health, I am passionate about learning the ever-changing environment of the ACA and helping other carriers with the complexity of their data and processes.
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