State Options Blog Series: Implications of Weakening the 80-20 Rule for States and Consumers

The Trump administration recently issued a proposed regulation that could significantly impact how much of consumers’ premium dollars are spent on their health care needs. CHIR expert Kevin Lucia assesses the proposed relaxation of the Affordable Care Act’s “80-20” or medical loss ratio standards and outlines policy options for states wishing to maintain them. Continue reading

State Marketplace Approaches to Financing and Sustainability

While the Affordable Care Act provided significant start-up funds for the development of the new health insurance marketplaces, by January 1, 2015 all the state-based marketplaces must be self-sustaining. In their latest blog post for the Commonwealth Fund, CHIR experts Sarah Dash, Kevin Lucia, Justin Giovannelli and Sean Miskell provide an update on states’ approaches to marketplace financing and sustainability. Continue reading

Major Policy Changes Take a Backseat to IT During a Transitional Year for Health Insurance Marketplaces

As the health insurance marketplaces prepare for the second year of operation under the Affordable Care Act, IT issues are driving many states’ decisions on whether to operate a state-based marketplace. In their latest blog post for the Commonwealth Fund, CHIR experts Sarah Dash and Kevin Lucia share findings on state IT transitions and major policy actions going into 2015. Continue reading

New Report Finds that Most States Have Taken Some Action To Prepare For Major Components of the ACA

States have taken substantially varying actions to implement and enforce the Affordable Care Act’s three major components designed to expand health insurance coverage and protect consumers—health insurance market reforms, health insurance marketplaces, and Medicaid expansion—according to a new report prepared for The Commonwealth Fund. Kevin Lucia summarizes the findings and what states’ varying approaches to implementation means for consumers. Continue reading

Health Insurance Exchanges Fulfill Both Liberal and Conservative Goals

Amid the controversial launch of the Affordable Care Act’s health insurance marketplaces, it is not easy to envision that liberals and conservatives might find common ground. However, Brookings scholar Henry J. Aaron and CHIR expert Kevin Lucia make a persuasive case in this blog, originally posted on the Harvard Business Review, that these marketplaces hold the key ingredients for both sides to achieve their objectives. Continue reading

New Report Examines Early Indications of Insurer Participation and Competition in Health Insurance Exchanges

One of the key goals of the Affordable Care Act is to make health insurance coverage more affordable and consumer-friendly by managing competition among health insurers through the creation of health insurance exchanges. A new report from researchers at the Urban Institute and CHIR released by the Robert Wood Johnson Foundation explores state actions to encourage or require participation on exchanges, and early indications of the level of competition among health insurers. Kevin Lucia highlights some of the findings from the report. Continue reading

Diving in on HHS' Recent FAQs on Preventive Services

HHS recently issued a new set of frequently asked questions designed to address some issues that have been raised by the coverage of preventive services under the Affordable Care Act. Kevin Lucia takes a look at the guidance in the context of screening colonoscopy and discusses how it adds up in light of a recent CHIR report that explored how private insurers are applying cost-sharing for colorectal cancer screening. Continue reading

New Report Finds Patients Pay for Confusion Over Colonoscopy Screening

Today, the Kaiser Family Foundation—in partnership with CHIR, the American Cancer Society, and the National Colorectal Cancer Roundtable—released a new report exploring how private insurers are applying cost-sharing for colorectal cancer screening, such as colonoscopies. Kevin Lucia, one of the report's authors, discusses what the findings mean for this new benefit under the Affordable Care Act. Continue reading