The No Surprises Act: Implications for States

In the waning days of 2020, Congress enacted the No Surprises Act, which provides, for the first time, protections for consumers against surprise bills from out-of-network medical providers. The legislation has numerous implications for states that have their own balance billing protections, as well as for those that do not. In their latest Expert Perspective article for the State Health & Value Strategies program, JoAnn Volk and Sabrina Corlette review some of the more critical issues state regulators will need to consider as this new federal law is implemented. Continue reading

Unpacking The No Surprises Act: An Opportunity To Protect Millions

Congress included the No Surprises Act in the omnibus spending bill that was passed and signed into law by President Trump on December 27, 2020. The bill protects patients from unexpected bills for out-of-network emergency and other services consumers are unable to agree to in advance. Georgetown experts Jack Hoadley, Katie Keith, and Kevin Lucia unpack the legislation in a blog post for Health Affairs. Continue reading

Surprise Billing Protections: Help Finally Arrives for Millions of Americans

Congress enacted the “No Surprises Act” as part of the $900 billion COVID-19 relief and government spending bill. The Act will protect millions of patients from surprise out-of-network medical bills. In their latest To the Point post for the Commonwealth Fund, CHIR experts Jack Hoadley, Kevin Lucia, and Beth Fuchs unpack the legislation and what it means for patients. Continue reading

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

We at Georgetown CHIR look back at this tumultuous, tragic, and eventful year and are thankful we have the opportunity to do the work we do. When the world went on lock down in early March, our team quickly pivoted to researching and writing about the government response to COVID-19 and its impact on health care coverage. We also wrote about surprise balance billing, junk insurance, and trends in provider-payer dynamics We share some of the highlights from our work here. Continue reading

The Benefits and Limitations of State-Run Individual Market Reinsurance

The Affordable Care Act brought about historic coverage gains, providing millions of Americans with vital access to comprehensive health insurance. But for many, high premiums continue to present a major barrier to coverage. States have adopted various policies to make health plans on the individual market more affordable, pursuing one approach more than others: reinsurance. In a new issue brief for the Commonwealth Fund, CHIR experts explore the benefits and limitations of state-run individual market reinsurance programs. Continue reading

The COVID-19 Vaccine is Coming, but Will it Be Paid For? Federal and State Policies to Fill Gaps in Insurance Coverage

Vaccinations against COVID-19 are on their way. For consumers in Affordable Care Act plans, immunization should have it fully covered by their insurance. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Sabrina Corlette and Madeline O’Brien review federal and state mandates to cover the COVID-19 vaccine, as well as potential gaps consumers could still fall into. Continue reading

Stable Rates Reflect Strength of ACA Marketplaces

At the start of the COVID-19 pandemic, many predicted that insurers would need to dramatically hike their premiums. As it turned out, the opposite occurred, with average rates declining for 2021. In an Expert Perspective post for the State Health & Value Strategies program, CHIR’s Sabrina Corlette and Manatt Health’s Joel Ario examine the factors that led to a stable year for ACA insurance rates. Continue reading

COVID-19 and MLR Guidance on Risk Corridor Recoveries: State Options for Restoring Funds to Policyholders and the Public

The Supreme Court has required the federal government to reimburse health insurers for an estimated $12.3 billion in unpaid risk corridor funds and the Trump administration recently published guidance to insurers that affects the amount to be returned to policyholders. In an Expert Perspective for the State Health & Value Strategies program, Sabrina Corlette and Jason Levitis consider the effects of this guidance and state options for redirecting insurers’ extra cash to benefit policyholders and the public. Continue reading

State Efforts to Protect Preexisting Conditions Unsustainable Without the ACA

On November 10, the Supreme Court will hear oral arguments in a case that could result in the Affordable Care Act being declared unconstitutional. While there is no clear federal plan to protect people with preexisting conditions if this happens, some states have tried to enact their own laws. In their latest analysis for the Commonwealth Fund’s To the Point blog, CHIR’s Maanasa Kona and Sabrina Corlette assess whether these state-level efforts can fully protect people with preexisting conditions. Continue reading