2020 – It’s a Wrap. CHIR Takes Stock of a Tumultuous, but Busy Year

We at Georgetown CHIR are thankful that our team has remained safe as we work from home, but we keep at the center of our vision those who have had to face the brutal effects of the COVID-19 pandemic. When the world went on lock down in early March, our team quickly pivoted to researching and writing about the government response and its impact on people’s access to health coverage and COVID-19-related testing and treatment.

We took a look at what states are doing to make private health insurance work better for consumers during the pandemic, how state health insurance marketplaces are working to enroll the newly uninsured, how states should handle asymptomatic testing for essential workers, and whether states should extend COVID-19 insurance coverage mandates beyond the current emergency period. As the nation begins to roll out COVID-19 vaccines, we wrote about how federal and state policies that can fill the gaps in insurance coverage for these vaccines.

We also looked into how insurers responded and how short-term plans continued to fail consumers during the pandemic, while advising states on how they can prevent surprise bills for patients seeking COVID-19 care.

This has been a busy year for those of us following federal and state surprise billing legislation. In addition to running a technical assistance program for federal and state policymakers, CHIR faculty also wrote pieces analyzing the various federal bills that were introduced this year and took a deep dive into the two ways that providers and insurers can resolve disputes over out-of-network bills—the use of a benchmark and independent dispute resolution.

The CHIR team also kept an eye on state attempts to improve affordability through public option and Medicaid buy-in proposals while sounding the alarm on Georgia’s attempt to use a 1332 ACA waiver proposal in a way that would jeopardize access to affordable coverage. With a couple of new states starting their own state-based insurance marketplaces (SBMs) this year, CHIR faculty assessed the benefits and limits of running an SBM and found that some SBMs experienced growth in their SHOP marketplaces for small businesses. Our work highlighted opportunities for states to protect consumers from health care sharing ministry plans. However, there are some problems states cannot fix by themselves, and two of our pieces focused on how a number of states have struggled to make coverage more affordable or protect consumers with preexisting conditions without federal policies to support them.

At the federal level, CHIR faculty analyzed how the Trump administration promoted coverage that fails to cover women’s key health care needs and took a broad look at how ten years under the Affordable Care Act has shaped the individual health insurance market. We also closely watched market trends, assessing how policymakers can minimize risk to patients when there are high-stakes provider-payer contract disputes, canvassing brokers to understand how the individual market is responding to evolving federal rules, and analyzing the benefit designs of short-term plans.

On a more personal note, the CHIR team has seen some significant changes this year. Two of our cherished colleagues, Emily Curran and Olivia Hoppe, left our team to pursue other opportunities but their indelible mark can be seen all across the work we produced this year. We also welcomed two new team members, Megan Houston and Nia Gooding, both of whom have hit the ground running.

CHIR wishes our readers the happiest and safest of holiday seasons. We look forward to meeting the new year with renewed spirits – and lots more health policy to write about!

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