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

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

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

Responding to the Opioid Crisis: Insurers Balance Stepped up Monitoring, Restrictions with Need for Appropriate Pain Treatment

The United States has an opioid epidemic, with an unprecedented number of opioid-related deaths in recent years. The rise in opioid addiction and overdose is further complicated by the need to effectively treat the approximately 100 million people living with chronic pain. In their latest issue brief for the Robert Wood Johnson Foundation, CHIR experts report on how insurers are responding to the opioid crisis while also meeting the needs of members living with chronic pain. Continue reading

2017 Federal and State Marketplace Trends Show Value of Outreach

The fourth open enrollment period ended in early 2017, with dwindling momentum behind enrollment efforts at the federal level following the presidential election. In a new publication for the Commonwealth Fund, Emily Curran, Sabrina Corlette, Kevin Lucia and Justin Giovannelli provide an overview of potential factors influencing enrollment changes in the state-based marketplaces, including increased efforts that may have had a positive effect on final selections. Continue reading

Alexander-Corker Bill Would Likely Reduce, Not Expand, Consumers’ Health Insurance Options

Humana’s decision to pull out of the individual market in 2018 has prompted more concern over areas facing a dearth of marketplace plans next year, or “bare” counties. Tennessee Senators Lamar Alexander and Bob Corker recently introduced a bill that would waive the individual mandate for residents of bare counties, and allow them to receive federal premium tax credits to purchase plans outside of the marketplace. Sarah Lueck of the Center on Budget and Policy Priorities shares a new analysis of the bill and its potential impact on insurers and consumers. Continue reading

What’s Going on in Tennessee? One Possible Reason for Its Affordable Care Act Challenges

Recently the Governor of Tennessee observed that his state was “ground zero” for insurers pulling out of the ACA marketplaces. In the wake of Humana’s decision to withdraw from the marketplaces for 2018, the residents of 16 counties in that state face the prospect of no insurance company at all from which to buy a subsidized health plan. Tennessee is not alone in having a fragile ACA marketplace, but its situation is particularly acute, especially if no other insurer can be persuaded to operate in those counties. Why is Tennessee’s market struggling, when other states with similar demographics, such as Arkansas, have more competition and market stability? Continue reading