The Next Round of Obamacare Regulations are Coming Soon: What Consumer Advocates Want to See

With the annual rule on marketplace operations and health plans expected this fall, we take a look at how consumer advocates responded to the Trump administration’s request earlier this summer on how it could reduce the regulatory burdens of the Affordable Care Act in the last of our three-part series. These comments, along with comments from insurers and state officials, may be used to inform future rulemaking, including the rule expected this fall.
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States Take the Lead with Policies to Protect Residents with Chronic Conditions from High Out-of-Pocket Drug Costs

Lowering the cost of prescription medication has broad support over the political spectrum and there were many campaign promises to reduce prices. But to date, there’s been little federal action. States, however, are taking the lead with policies designed to protect consumers with chronic conditions from high out-of-pocket costs associated with expensive specialty drugs. A new CHIR brief details the findings from a 50-state survey of such policies and observations from supplementary interviews with state regulators, insurance company representatives and consumer advocates. Continue reading

Healthcare.gov Rolls out Two Operational Changes Related to Verifying Special Enrollment Periods and Immigration Status

While Congress shifts away from talking about how to replace the Affordable Care Act to stabilizing the individual market, enrollment in ACA marketplaces continues. Recently, the administration made two operational changes affecting federally facilitated marketplaces and states using healthcare.gov: phase 2 of pre-verifying special enrollment eligibility and a process to electronically resolve data matching issues related to immigration status. CHIR’s Sandy Ahn summarizes the changes. Continue reading

New Special Enrollment Roadblocks for Consumers: Hindering, not Helping Consumers Get Coverage

While Congressional leaders debate how to repeal and replace the Affordable Care Act, the Trump administration recently implemented new requirements for consumers seeking a special enrollment period for marketplace coverage. Designed to prevent people from waiting until they are sick before signing up for coverage, some of these new requirements could make it more difficult to enroll; others could reduce consumers’ plan choices. Sandy Ahn summarizes the new policy changes that went into effect last month.
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Lots of Changes for 2018 Marketplace Enrollment Mean Confusion for Consumers

Open enrollment will be here sooner than we know it. But this year’s open enrollment, will be quite different from previous years due to numerous policy changes and proposed budget cuts to marketplace consumer outreach, assistance, and enrollment system under the Trump administration. These changes will make it much more confusing for consumers and place much more of a burden on the assisters that help them. CHIR’s Sandy Ahn summarizes some of the change in store for 2018 open enrollment. Continue reading

State Efforts to Lower Cost-Sharing Barriers to Health Care for the Privately Insured

Current federal proposals to replace the Affordable Care Act are likely to result in higher out-of-pocket costs for consumers. Six states and D.C., however, have policies to lower cost-sharing barriers to important health care services and drugs for the privately insured. In a new research brief, CHIR researchers take a closer look at some of these states’ experiences developing and implementing these policies. Continue reading

The Ins and Outs of the New Approach to Special Enrollment Periods: Pre-enrollment Verification (SEPV)

Starting June 23, 2017, healthcare.gov will be rolling out a special enrollment period pre-enrollment verification (SEPV) process, which will require new consumers applying for marketplace coverage because of loss of minimum essential coverage (MEC) or permanently moving to prove their eligibility for a special enrollment period. How will this process work and what do consumer assisters need to know? CHIR’s Sandy Ahn provides a summary. Continue reading

Proposed Pre-Verification Process for Special Enrollment Periods: Policy Goals, Potential Impact, and the need for State Flexibility

In the wake of failed congressional attempts to repeal and replace the Affordable Care Act, we turn back our focus on the administration and its approach to the marketplaces. The proposed market stabilization rule would require a pre-verification process for special enrollment periods for all marketplaces, including states operating their own. This move is largely in response to insurer concerns, indicating an interest in working with participating marketplace insurers. But how does this fare with states that have their own special enrollment processes? CHIR’s Sandy Ahn takes a look. Continue reading