Have Employer Coverage? GOP Proposals Will Affect You Too (Part 2)

Much of the focus of the debate over repealing and replacing the ACA has been on the individual insurance market. But over 150 million people get coverage through their employer, and bills pending in the House and Senate will affect them, too. In a post originally published on the Health Affairs’ Blog, CHIR’s JoAnn Volk and Sabrina Corlette explain what’s preserved, and what’s at risk, for people in job-based plans. Continue reading

What Makes Covering Maternity Care Different?

The United States has a higher maternal mortality rate than any other developed country, but federal policy makers are considering reducing access to insurance coverage for pregnancy care. In a post for the Health Affairs blog, CHIR experts Dania Palanker and Kevin Lucia and Harkness Fellow Dimitra Panteli assess the latest policy proposal to allow states to waive out of the requirement that insurance plans in the individual market cover maternity and newborn care. Continue reading

Amid Market Uncertainty, Trump Administration Retreats from Health Plan Oversight

In mid-April, the Trump administration announced it would stop monitoring marketplace plans for compliance with several important federal protections and instead defer to states. In their latest blog post for The Commonwealth Fund, Justin Giovannelli and Kevin Lucia explain the new changes to insurance oversight, and assess the potential impact of this federal deregulation for states and consumers. Continue reading

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