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

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

The 5th Circuit Court of Appeals is expected to hear arguments in litigation over the future of the Affordable Care Act the week of July 8, 2019. If the plaintiffs prevail, millions could lose insurance coverage and millions more will lose preexisting condition protections. In their latest post for the Commonwealth Fund, CHIR’s Sabrina Corlette and Emily Curran document state-level efforts to preserve the ACA’s insurance market reforms. Continue reading

States Step Up to Protect Insurance Markets and Consumers from Short-Term Health Plans

Short-term plans are now being sold to consumers as a replacement for Affordable Care Act (ACA) coverage. However, because these plans are exempt from many consumer protections and ACA rules, a number of states have stepped up to regulate the design and marketing of these plans. In their latest issue brief for The Commonwealth Fund, CHIR experts document recent state action to regulate short-term plans and protect their residents and markets. Continue reading

Protecting People with Preexisting Conditions Requires More Than a Piecemeal Approach: An Assessment of a Louisiana Bill to Codify Some, But Not All, ACA Protections

Several state legislatures are considering bills to re-instate the Affordable Care Act’s preexisting condition protections in the event a federal court invalidates the law in Texas v. Azar. While no state can fully protect consumers from the fallout of a bad court decision, attempts to “bake in” the preexisting protections shouldn’t leave large loopholes for insurance companies to exploit. CHIR experts examine a Louisiana bill that would codify some, but not all, of the ACA’s insurance reforms. Continue reading

New York’s Law to Protect People from Surprise Balance Bills is Working as Intended, but Gaps Remain

New York’s 2014 law to protect consumers from surprise out-of-network medical bills has been touted as a model for other states and even potential federal legislation. In their latest report for the Robert Wood Johnson Foundation, CHIR experts Sabrina Corlette and Olivia Hoppe share findings from a case study of how New York’s law has affected patients, providers, and insurers, 5 years post-enactment. Continue reading

New Reinsurance Toolkit for State Advocates

Last month, North Dakota enacted legislation to establish a state reinsurance program, and a number states are considering similar bills. To help state consumer advocates engage with state officials on reinsurance and other health insurance reform issues, Community Catalyst, with support from CHIR experts, launched a new website that will house a health insurance reform toolkit for advocates. First up: The Advocate’s Guide to Reinsurance. Continue reading