DOJ’s Proposed Remedy in Texas v. United States Is an Unrealistic Solution

In supplemental briefings to the Fifth Circuit Court of Appeals, the Department of Justice recently proposed that the Affordable Care Act be struck down in the eighteen plaintiff states bringing suit in Texas v. United States, but upheld in all other states. CHIR’s Emily Curran, Dania Palanker, and Sabrina Corlette explain why this “solution” would upend our system of employer-based coverage and is illogical given the ACA’s national reforms. Continue reading

New Addition to Advocate Toolkit Highlights Options for Protecting Consumers Amidst Expansion of Short-Term Plans

In July, a federal district court judge upheld the Trump administration’s rule expanding availability of short-term, limited duration insurance, or short-term plans, which do not have to comply with the Affordable Care Act’s consumer protections. With the help of CHIR experts, Community Catalyst has published another resource for state advocates and policymakers, providing an overview of short-term plans, insight on unscrupulous sales practices that leave consumers at risk, and state regulatory options. Continue reading

New Resources Arm Advocates with Tools to Defend Essential Health Benefits, Pre-Existing Condition Protections

On July 9, the Fifth Circuit Court of Appeals heard oral arguments in Texas v. United States, the court case challenging the Affordable Care Act’s (ACA) constitutionality. The litigation is ongoing, but if the plaintiffs prevail, the law could be overturned in its entirety. With the federal court case looming, state policymakers and advocates are looking for ways to preserve access to coverage in the absence of the ACA’s protections, including steps to codify the law’s key provisions into state law. To aid in these efforts, Community Catalyst has teamed up with CHIR experts to create two new guides for its health insurance reform toolkit: The Advocate’s Guide to Pre-Existing Condition Protections and The Advocate’s Guide to Essential Health Benefits. Continue reading

States Are Taking New Steps to Protect Consumers from Balance Billing, But Federal Action Is Necessary to Fill Gaps

This year has seen a flurry of state-level action to protect patients from surprise balance billing. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Jack Hoadley, Kevin Lucia and Maanasa Kona take a closer look at the latest set of state bills to tackle the issue. They find that lawmakers’ approaches to solving this problem are evolving. Continue reading

Successfully Splitting the Baby: Design Considerations for Federal Balance Billing Legislation

The U.S. Congress is advancing legislation to protect patients from surprise medical bills. Yet consensus on how to resolve payment disputes between providers and health plans has been difficult to reach. In their latest post for the Health Affairs Blog, Sabrina Corlette, Jack Hoadley, and Kevin Lucia break down different policy approaches, their pros and cons, and how recent state action could suggest a path forward. Continue reading

States Looking to Run Their Own Health Insurance Marketplace See Opportunity for Funding, Flexibility

Last week, Pennsylvania Governor Tom Wolf signed legislation to establish a state-based health insurance marketplace. Recently, along with Pennsylvania, several states have taken steps towards transitioning to their own marketplace and enrollment platform. In their newest post for the Commonwealth Fund’s To the Point blog, CHIR’s Rachel Schwab and JoAnn Volk review the latest state actions to transition to a state-run platform and break down some of the incentives for states to leave the federal marketplace. Continue reading

2019 Insurer Participation: A “Quieter” Year As Companies Maintain, Expand Their Presence

Since implementation of the Affordable Care Act, insurer participation in the ACA marketplaces has fluctuated. As states prepare to enter their annual rate review processes for 2020, CHIR’s Emily Curran and Justin Giovannelli interviewed officials in seven of the state-based marketplaces to understand their strategies for maintaining insurer participation in 2019 and ensuring marketplace competition in the future. Continue reading