A Mixed Bag for States: The Proposed 2021 Notice of Benefit and Payment Parameters

The Trump administration’s proposed rule governing the Affordable Care Act insurance markets for 2021 has been published, and comments are due from the public by March 2, 2020. In her latest article for the State Health & Value Strategies program, CHIR’s Sabrina Corlette provides a detailed overview of changes proposed in the rule, with a focus on the implications for state departments of insurance and the health insurance marketplaces. Continue reading

5th Circuit Decision in Texas v. U.S. Prolongs Uncertainty for Health Care Consumers, Markets

Perhaps knowing their decision would sow consumer confusion and market uncertainty, the 5th Circuit Court of Appeals delayed its decision in the Texas v. U.S. litigation until after the close of open enrollment for Affordable Care Act (ACA) insurance coverage. CHIR’s Sabrina Corlette delves into the consequences of the long-awaited December 18, 2019 decision. Continue reading

Disputes over Dispute Resolution: Analyses of New York & California-style Surprise Billing Protections Offer Divergent Pictures

The U.S. Congressional Budget Office (CBO) has a new analysis of legislation that would protect patients from surprise medical bills and help settle physician-insurer payment disputes through an arbitration process. CHIR’s Sabrina Corlette takes a look at their projections and three recent assessments of the effect of balance billing laws in New York and California Continue reading

Will it Fly? Wyoming Attempts End Run Around High Air Ambulance Prices

Air ambulance charges are a significant source of surprise out-of-network bills for many patients, with charges running into 5 figures. States have been frustrated in their efforts to protect consumers in this context due to a federal law preempting regulation of air carrier prices, including air ambulances. However, the state of Wyoming may have hit on a unique solution – effectively making air ambulance a public utility. Will it work? CHIR’s Sabrina Corlette takes a look. Continue reading

Are the Affordable Care Act Markets “Stabilizing”? Early 2020 Rate Filings Give Little Cause for Celebration

Changes in premiums are a key indicator of the overall health of an insurance market. CHIR’s Sabrina Corlette dug into the rate submissions of 2020 individual market health insurers in several states that have publicly released their filings. She finds a less rosy picture than the relatively modest average rate changes might suggest. Continue reading

What Does the Latest Federal Court Decision Mean for Association Health Plans – and the States that Regulate Them?

On March 28, 2019, a federal district court invalidated the Trump administration’s rule encouraging the formation of association health plans that would be exempt from many Affordable Care Act protections. In her latest “Expert Perspective” for the Robert Wood Johnson Foundation’s State Health & Value Strategies project, CHIR’s Sabrina Corlette provides an update on the court ruling and implications for state insurance departments. Continue reading

Affordable Care Act Back in the Spotlight: Build on its Progress or Scrap it Entirely?

It is hard to find a starker example of the different approaches our two political parties take to health care than the events of March 26, 2019. CHIR’s Sabrina Corlette breaks down the Trump administration’s push to have the Affordable Care Act declared unconstitutional and a comprehensive bill to expand coverage and improve affordability, introduced just hours later by leaders in the U.S. House of Representatives. Continue reading

What, if Anything, Do the Latest Cost Sharing Reduction (CSR) Court Rulings Mean for 2020 Premiums?

The federal government could be on the hook for billions of dollars in reimbursement to insurance companies, if recent court decisions relating to the elimination of the ACA’s cost-sharing reduction subsidies are upheld. Sabrina Corlette, in her latest Expert Perspective for the State Health & Value Strategies project, reviews the status of the litigation and the implications for state oversight of insurers’ 2020 premium rates. Continue reading