The MEWA Files: Lifting the Curtain on DOL’s Investigation into AHPs and Other Fraudulent Health Plans

CHIR is releasing several thousand pages of Department of Labor (DOL) investigative records regarding Multiple Employer Welfare Arrangements (MEWAs), including Association Health Plans (AHPs), which it received through a 2018 Freedom of Information Act request. CHIR alumna Christine Monahan takes us through what is in these files and how you can access them yourself. Continue reading

Navigator Guide FAQ of the Week: Can I Get Help Paying for Coverage and Care?

Open Enrollment is in full swing in all 50 states and Washington, DC. As consumers consider their coverage options, many will qualify for subsidies to help pay for premiums and out-of-pocket expenses if they enroll in a plan through the marketplace. Throughout the enrollment period, CHIR is highlighting frequently asked questions from our recently updated Navigator Resource Guide. In this installation, we answer questions about financial assistance available to individuals and families. Continue reading

Can States Fill the Gap if the Federal Courts Overturn Preexisting Condition Protections?

The 5th Circuit Court of Appeals is expected to rule soon on the future of the Affordable Care Act in the Texas v. U.S. case. In their latest post for the Commonwealth Fund’s To The Point blog, CHIR’s Sabrina Corlette and Emily Curran evaluate whether states can protect their residents from the fallout, particularly for those with pre-existing conditions, and provide an update on the latest state efforts. Continue reading

Will Sutter Health Settlement Dampen Provider Systems’ Anti-Competitive Tactics or Prompt More States to Take Action on Costs?

On October 16, Sutter Health announced that it had reached a tentative agreement to settle the class-action lawsuit against it, which alleged that the system has used its market dominance to drive up the cost of care. Though Sutter Health denied all allegations, the plaintiffs argued that the system relies on three core tactics to maintain a competitive edge, including: all-or-nothing contracting, anti-incentive contract terms, and price secrecy contract terms. CHIR’s Emily Curran and Sabrina Corlette explain these tactics and recent findings on the impacts of provider consolidation. Continue reading

Seeing Fraud and Misleading Marketing, States Warn Consumers About Alternative Health Insurance Products

States are warning consumers of fraud and about the inadequate nature of some insurance products being sold that masquerade as health coverage. Over the last year, we identified alerts or press releases issued by 15 states warning consumers to be on their guard against deceptive marketing pitches for these products. In their latest post for the Commonwealth Fund’s To The Point blog, CHIR experts spoke with regulators in five of these states to better understand what was behind these warnings and get insight into potential pitfalls for consumers. Continue reading

Navigator Guide FAQ of the Week: Am I Required to Get Coverage?

Open Enrollment for marketplace coverage under the Affordable Care Act begins on November 1. To help assisters and consumers navigate this enrollment season, CHIR has updated its Navigator Resource Guide. Throughout Open Enrollment, we will highlight FAQs that are likely to be top of mind for consumers as they apply for and enroll in health coverage. This week, we are focusing on whether health insurance is still mandatory, and why it is important to have. Continue reading

New Georgetown CHIR Report Finds Ability of Insurers, Employers to Respond to Provider Consolidation is Limited

A new Georgetown CHIR report synthesizing the case studies of 6 health care markets finds that insurers and employer-purchasers have limited tools and incentives to effectively counter the market clout of increasingly consolidated provider systems. With a lack of market-based solutions, the report raises questions about whether and what policy interventions might be needed. Continue reading

What’s New for 2020 Marketplace Enrollment?

On November 1, the seventh open enrollment period begins for marketplace coverage under the Affordable Care Act. We at CHIR are tracking several policy changes that could affect marketplace enrollment and plan affordability in 2020, including: changes to health reimbursement arrangements, new direct enrollment pathways, and recent court rulings on association health plans and the public charge rule. To learn what’s new for 2020, read our CHIRBlog summarizing the major policy changes consumers might encounter this year. Continue reading