States Leaning In: Washington Doubles Down on Efforts to Shore up Market, Protect Consumers

In the wake of federal actions to roll back the Affordable Care Act’s reforms, states have assumed an even greater role in protecting consumers and ensuring market stability. Washington State, a long-time leader in state health insurance reform, has taken up that mantle. Since our last post highlighting Washington’s policy playbook, the state has implemented several more policies to preserve their insurance market and bolster consumer protections. CHIR’s Rachel Schwab takes a look at some of the state’s new developments. Continue reading

Coming up Short: The Problem with Counting Short-Term, Limited Duration Insurance as Coverage

In April, the nonpartisan Congressional Budget Office (CBO) released an analysis of federal legislation to reverse the Trump administration’s rule expanding access to short-term, limited duration insurance policies, which do not have to comply with the Affordable Care Act’s consumer protections. CBO estimated that reversing the rule would result in 500,000 people going uninsured, predicated on the assumption that most short-term plans count as “insurance.” For people with preexisting conditions, nothing could be further from the truth. Continue reading

Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 2: State Insurance Departments and Marketplaces

On April 18, 2019, the Department of Health and Human Services finalized changes to the Affordable Care Act marketplaces and insurance rules in the Notice of Benefit and Payment Parameters for the 2020 plan year. The agency received over 26,000 comments on the proposal. To gauge stakeholder reactions, CHIR reviewed a sample of these comments. In the second part of our blog series, Rachel Schwab summarizes responses from a selection of state insurance departments and state-based marketplaces. Continue reading

Trump Administration Pushes for Sale of Insurance Across State Lines

Recently, the Trump administration issued a request for information (RFI) seeking recommendations on ways to facilitate the sale of insurance across state lines, allowing insurers to bypass the insurance standards of states that have strong consumer protections and benefit requirements by headquartering in a state with few regulations in place. The policy is often touted as a way to reduce the cost of coverage and improve consumer choice, but states and insurers have been reluctant to embrace it. A CHIR study conducted after the ACA was signed into law sheds light on why. Continue reading

House Hearings Shed Light on a Key Policy Priority: Protecting People with Pre-Existing Conditions

After becoming a rallying cry in the midterm elections, pre-existing condition protections have taken center stage on Capitol Hill: in January and February, the House of Representatives held three hearings about protecting people with pre-existing conditions, before the Ways & Means Committee, the Education & Labor Committee, and the Energy & Commerce Subcommittee. As the ACA faces legal challenges in federal court, these proceedings set the scene for how this policy debate will play out in Congress and offer insight into potential legislative action. Continue reading

Stakeholders Respond to the Proposed Health Reimbursement Arrangement Rule. Part I: State Insurance Departments and Marketplaces

In October 2018, the Trump administration proposed rules to expand the use of health reimbursement arrangements (HRAs) by loosening current federal limitations. The administration’s proposal would allow employers to offer employees the tax-advantaged accounts to assist with health care expenses, including premiums, in lieu of employer-sponsored coverage. To understand the potential impact of the proposals, CHIR reviewed comments from various stakeholder groups. For the first blog in our series, Rachel Schwab summarizes comments from state marketplaces and state insurance departments. Continue reading

Translating Coverage into Care: Answers to Common Post-Enrollment Questions

Open Enrollment has ended in the majority of states, and almost 8.5 million people signed up for coverage through HealthCare.gov. As consumers begin to use their 2019 plans, a host of questions about covered services, cost sharing, provider networks and more are sure to crop up. Luckily, CHIR has answers to frequently asked post-enrollment questions in our recently updated Navigator Resource Guide. Continue reading

States Opt to Run their Own Exchanges to Save Money, Reclaim Autonomy

Last month, the Board of New Mexico’s health insurance exchange voted to transition from HealthCare.gov to a state-based exchange. The state will undertake the task of building its own eligibility and enrollment platform with the hopes of launching a website in time for the 2021 plan year. This is the same exchange that, in 2015, called the federal platform HealthCare.gov the “safest, most risk-free way to proceed.” So, what changed? CHIR’s Rachel Schwab looks at the reasons behind the growing call to leave HealthCare.gov. Continue reading

Federal Flexibility Grants Highlight State Priorities for Market Stability

Last month, the Department of Health & Human Services awarded $8.6 million in grants to 30 states and the District of Columbia to provide additional support to implement certain ACA market reforms, including guaranteed issue, guaranteed renewal, and the Essential Health Benefits. CHIR’s Rachel Schwab took a look at how states plan to use the federal funding, and what tops the list of state market stabilization and consumer protection priorities. Continue reading

The District of Columbia’s Coverage Requirement Is Caught in Congressional Crosshairs, and Consumers Could Pay the Price

When Congress repealed the individual mandate’s financial penalty, some states acted quickly to protect their markets from deterioration. A handful of state legislatures and the Council of the District of Columbia considered or enacted legislation creating a state-based coverage requirement. While many states faced political hurdles and unforgiving timelines in enacting their own mandates, D.C. now has an additional obstacle: the U.S. Congress. Continue reading