Can States Fill the Gap if the Federal Courts Overturn Preexisting Condition Protections?

The 5th Circuit Court of Appeals is expected to rule soon on the future of the Affordable Care Act in the Texas v. U.S. case. In their latest post for the Commonwealth Fund’s To The Point blog, CHIR’s Sabrina Corlette and Emily Curran evaluate whether states can protect their residents from the fallout, particularly for those with pre-existing conditions, and provide an update on the latest state efforts. Continue reading

Will Sutter Health Settlement Dampen Provider Systems’ Anti-Competitive Tactics or Prompt More States to Take Action on Costs?

On October 16, Sutter Health announced that it had reached a tentative agreement to settle the class-action lawsuit against it, which alleged that the system has used its market dominance to drive up the cost of care. Though Sutter Health denied all allegations, the plaintiffs argued that the system relies on three core tactics to maintain a competitive edge, including: all-or-nothing contracting, anti-incentive contract terms, and price secrecy contract terms. CHIR’s Emily Curran and Sabrina Corlette explain these tactics and recent findings on the impacts of provider consolidation. Continue reading

Seeing Fraud and Misleading Marketing, States Warn Consumers About Alternative Health Insurance Products

States are warning consumers of fraud and about the inadequate nature of some insurance products being sold that masquerade as health coverage. Over the last year, we identified alerts or press releases issued by 15 states warning consumers to be on their guard against deceptive marketing pitches for these products. In their latest post for the Commonwealth Fund’s To The Point blog, CHIR experts spoke with regulators in five of these states to better understand what was behind these warnings and get insight into potential pitfalls for consumers. Continue reading

New Georgetown CHIR Report Finds Ability of Insurers, Employers to Respond to Provider Consolidation is Limited

A new Georgetown CHIR report synthesizing the case studies of 6 health care markets finds that insurers and employer-purchasers have limited tools and incentives to effectively counter the market clout of increasingly consolidated provider systems. With a lack of market-based solutions, the report raises questions about whether and what policy interventions might be needed. Continue reading

New Georgetown CHIR Report: In Trump Era, States Revisit the Benefits and Risks of Running Their Own Health Care Marketplace

Half a dozen states have announced they will transition from HealthCare.gov to their own, state-run health insurance marketplaces. In a new report with the Urban Institute, CHIR researchers assess states’ reasons for making the switch, risks and benefits, and considerations for policymakers in other states contemplating a similar move. Continue reading

CHIR Launches New Resource Center for Policymakers on Surprise Medical Bills

CHIR experts have launched a new project to provide policymakers with a dedicated, independent resource for unbiased and comprehensive information on the issue of surprise medical bills. Leveraging our experience advising state insurance regulators and monitoring surprise medical bill legislation in all 50 states and before Congress, our goal is to help policymakers protect consumers, promote affordability, and adopt comprehensive surprise medical bill protections. Continue reading

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