Hybrid Approach to Resolving Payment Disputes Breaks Legislative Stalemates Over Balance Billing, How Will the No Surprises Act Affect These New State Laws?

Seven states in 2020 were able to break a longstanding stalemate and enact protections against surprise out-of-network billing. CHIR’s Jack Hoadley and Kevin Lucia delve into the factors that got these states across the finish line and how the federal No Surprises Act will impact these states’ new laws. Continue reading

Rookie Report: How did New Jersey and Pennsylvania State Marketplaces Fare in Their Inaugural Enrollment Period?

After seven enrollment cycles on HealthCare.gov, New Jersey and Pennsylvania both launched new state marketplace websites in time for the latest Open Enrollment Period. Both states saw increases in marketplace enrollment over previous years. To understand how this transition went for Pennsylvania and New Jersey residents, and to extract potential lessons for the states that are transitioning to running their own marketplaces, we sought insight from people on the ground: consumer assisters. Continue reading

New Georgetown CHIR Report: Taking the Disputes out of Dispute Resolution

The U.S. Congress enacted the No Surprises Act in 2020 to protect patients from surprise out-of-network medical bills. Now the federal agencies need to set up a process to resolve disputes between these providers and insurance companies. CHIR experts examine the experience in four states with similar dispute resolution programs and share lessons that can be applied at the national level. Continue reading

An Opportunity to Protect Consumers and Ensure a Level Playing Field: Reversing Trump-era Rules on Association Health Plans

An executive order from President Biden is likely to prompt a review of Trump administration rules encouraging association health plans (AHPs) exempt from critical Affordable Care Act protections. CHIR’s Sabrina Corlette and Kevin Lucia assess what’s at stake and share thoughts on optimal federal policy going forward. Continue reading

Workplace Wellness Programs Have Overlooked Health Equity

One of President Biden’s first executive actions was to require the U.S. Equal Employment Opportunity Commission to withdraw regulations governing workplace wellness programs. CHIR’s Julie Zuckerbrod considers how these programs can exacerbate racial and ethnic inequities in health care access and outcomes, and opportunities for the Biden administration to advance equity-focused regulations. Continue reading

Federal Policy Priorities for Preserving and Improving Access to Coverage: Perspectives from State-Based Marketplaces

The Affordable Care Act’s health insurance marketplaces provide a critical source of coverage and financial assistance. Federal actions under the Trump administration undermined the marketplaces, but the new administration and Congress have opportunities to implement and advocate for policies that strengthen state-based marketplaces (SBMs). In a new issue brief for the Commonwealth Fund, CHIR experts assessed how federal policy decisions have impacted SBMs and the consumers they serve by interviewing directors and officials from 17 marketplaces. Continue reading

Expanded Coverage For COVID-19 Testing Must Include Limits On Costs

President Biden has issued an Executive Order likely to expand the mandate for private insurers to cover, and waive cost-sharing, for COVID-19 testing. However, the Brookings Institution’s Loren Adler and Sabrina Corlette argue in a new blog post for Health Affairs that Congress will also need to act to ensure that the mandate doesn’t encourage price gouging by providers, and to fully eliminate cost barriers to universal testing. Continue reading