What’s New for 2020 Marketplace Enrollment?

On November 1, the seventh open enrollment period begins for marketplace coverage under the Affordable Care Act. We at CHIR are tracking several policy changes that could affect marketplace enrollment and plan affordability in 2020, including: changes to health reimbursement arrangements, new direct enrollment pathways, and recent court rulings on association health plans and the public charge rule. To learn what’s new for 2020, read our CHIRBlog summarizing the major policy changes consumers might encounter this year. Continue reading

Stakeholders Weigh in on the Risk Corridor Litigation: Are Public-Private Partnerships At Risk?

On December 10, the U.S. Supreme Court will hear oral arguments in Maine Community Health Options v. U.S., a case concerning the Affordable Care Act’s risk corridors program. This month, nine stakeholders filed amicus briefs in preparation of the arguments and we reviewed these briefs to identify common themes. One key theme emerged from the stakeholders reviewed: that the Court’s decision could negatively impact public-private partnerships. Continue reading

Aliera Healthcare Prompts Increased State Activity on Health Care Sharing Ministries

Over the last few months, state officials have increasingly acted to warn consumers about the potential risks of enrolling in health care sharing ministries (HCSMs). These efforts have ranged from educating consumers on HCSMs to initiating legal action against fraudulent practices. While some consumers may find value in HCSMs, recent actions by Aliera Healthcare provide one example of how entities may use HCSMs’ unregulated status to skirt oversight and take advantage of consumers. Continue reading

Proposed Rule on Basic Health Program Impedes States’ Progress

Recently, CMS issued a proposed rule modifying the federal funding methodology for the Basic Health Program (BHP) for 2019 and 2020. Under the proposal, technical changes could cause participating states to lose $300 million in federal funding. While funding for the programs is being debated, we checked in on how Minnesota and New York’s BHPs are faring amidst federal uncertainty. Continue reading

Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 1: Insurers

On January 18, the Department of Health and Human Services issued its Notice of Benefit and Payment Parameters for 2020, which outlines the changes that it plans to apply to the Affordable Care Act marketplaces and insurance rules in the next plan year. The agency received over 26,100 comments on the proposal, including many from insurers, state-based marketplaces, departments of insurance, and consumer advocates. To better understand stakeholder reactions to the proposals, CHIR reviewed a sample of these comments, and, in Part I of this series, we summarize areas of support and concern from major medical insurers and associations. Continue reading

Shopping for a Short-Term Plan? The Information You Get about it Will Depend on Your State

Stakeholders have expressed mixed views on the value of short-term limited duration insurance. However, most seem to agree that, at a minimum, consumers should know what they are purchasing. States have the authority to require insurers to provide disclosures in addition to the federal minimum standard. We looked at short-term disclosures in four states – Nebraska, North Dakota, Ohio, and Washington – and found that a wide spectrum exists regarding the amount of detail states require their insurers to disclose. Continue reading

Stakeholders Respond to the Proposed Health Reimbursement Arrangement Rule. Part 2: Insurers

In October, the Departments of Treasury, Labor, and Health and Human Services issued a proposed rule that aims to expand the “flexibility and use” of health reimbursement arrangements. To understand reactions to the proposal, CHIR reviewed a sample of comments from state officials, insurers, consumer advocates, and employer, broker and benefit advisor groups. In Part 2 of this blog series, we highlight comments from ten major medical insurers and associations, who argued that stronger non-discrimination provisions are needed to prevent adverse selection and ensure stability in the individual market. Continue reading

Large Employer Strategies to Combat Increasing Healthcare Costs: Trends in Direct Contracting, On-Site Clinics and More

Employers currently insure 155 million people, but many are finding it increasingly challenging to maintain this benefit in the face of rising costs. One of the primary drivers of these costs is high provider prices. Some employers are taking matters into their own hands by disrupting traditional modes of care delivery. CHIR’s Emily Curran takes look at some of the tactics that have been gaining traction among employers. Continue reading

Navigator Guide FAQ of the Week: Can Insurers Ask About Your Health History?

With just one month left in the open enrollment period for most of the Affordable Care Act’s marketplaces, we’ve updated our Navigator Resource Guide to reflect all of the federal health policy changes that have occurred over the last year and have provided answers to hundreds of frequently asked questions (FAQs). In light of the recent wave of health care-related robocalls from scammers, our FAQ of the Week focuses on: Is an insurer allowed to ask me about my health history? Continue reading