Signs of Marketplace Stability May Be Undercut by Federal Policy Uncertainty

Recently, analysts have found evidence of marketplace stability after a number of insurers scaled back participation and increased premiums for 2017. Despite this progress, federal efforts to repeal and replace the ACA have sparked growing concerns about the marketplace’s sustainability. To understand how insurers are faring in the marketplaces amidst federal reform activity, CHIR experts reviewed the first quarter financial earnings of seven of the largest, publicly traded insurers. Continue reading

Lots of Changes for 2018 Marketplace Enrollment Mean Confusion for Consumers

Open enrollment will be here sooner than we know it. But this year’s open enrollment, will be quite different from previous years due to numerous policy changes and proposed budget cuts to marketplace consumer outreach, assistance, and enrollment system under the Trump administration. These changes will make it much more confusing for consumers and place much more of a burden on the assisters that help them. CHIR’s Sandy Ahn summarizes some of the change in store for 2018 open enrollment. Continue reading

New Georgetown Issue Brief: 50-state Survey of State Action to Protect Consumers from Surprise Medical Bills

Balance billing occurs when a consumer who is treated by an out-of-network provider is subsequently billed by that provider for the difference between what their health plan paid and what the provider charges. In their latest issue brief published by the Commonwealth Fund, Kevin Lucia, Jack Hoadley, and Ashley Williams analyzed laws in all fifty states and the District of Columbia to understand the current scope of state laws that protect consumers from balance billing. Continue reading

State Efforts to Lower Cost-Sharing Barriers to Health Care for the Privately Insured

Current federal proposals to replace the Affordable Care Act are likely to result in higher out-of-pocket costs for consumers. Six states and D.C., however, have policies to lower cost-sharing barriers to important health care services and drugs for the privately insured. In a new research brief, CHIR researchers take a closer look at some of these states’ experiences developing and implementing these policies. Continue reading

The Ins and Outs of the New Approach to Special Enrollment Periods: Pre-enrollment Verification (SEPV)

Starting June 23, 2017, healthcare.gov will be rolling out a special enrollment period pre-enrollment verification (SEPV) process, which will require new consumers applying for marketplace coverage because of loss of minimum essential coverage (MEC) or permanently moving to prove their eligibility for a special enrollment period. How will this process work and what do consumer assisters need to know? CHIR’s Sandy Ahn provides a summary. Continue reading

Relaxing the Affordable Care Act’s Guaranteed Issue Protection: Issues for Consumers and State Options

As we’ve been blogging about, the Trump administration finalized a Market Stabilization rule that makes numerous changes in how marketplaces and insurers are operating. One of the biggest changes affecting consumers is the Trump administration’s new interpretation of guaranteed issue or availability; but states have a range of options regarding this policy under the rule. CHIR’s Sandy Ahn and JoAnn Volk break it down for us. Continue reading

Running Down the Clock: Policy Uncertainty over Affordable Care Act Means Less Time for Oversight of Premium Hikes

Insurers are required to submit their health plans and premium rates for regulatory review in the face of considerable uncertainty over the future of the Affordable Care Act’s marketplaces. In their latest post for The Commonwealth Fund, Sabrina Corlette and Kevin Lucia examine the sources of this uncertainty, how it affects insurers’ ability to plan for the coming year, and what it means for state and federal regulators who must assess the reasonableness of proposed premium hikes. Continue reading