Effects of Medicaid Health Plan Dominance on the Health Insurance Marketplaces

Medicaid insurers dominate many of the Affordable Care Act health insurance marketplaces. Some health system stakeholders have raised concerns about the potential negative consequences of Medicaid insurer participation in the market, largely due to their limited networks. In a new report supported by the Robert Wood Johnson Foundation, CHIR and Urban Institute experts assess how Medicaid insurers function in the marketplace. Continue reading

On the Whole, Health Insurers Aren’t – Yet – Fearing COVID-19 Costs: A Review of 2021 Rate Filings

Several states ask for – and publicly post – health insurers’ proposed 2021 premium rates in May and June. These early rate filings can provide hints about how insurers are responding to market trends, policy changes, and emerging drivers of health care costs. CHIR’s Sabrina Corlette took a deep dive into insurers’ actuarial memos to find out how they’re thinking about COVID-19, repeal of the ACA’s individual mandate penalty, and more. Continue reading

A Pledge to Do Better

We at CHIR are reeling and taking stock in the wake of the tragic and callous murder of George Floyd, as well as the unsurprising unrest caused by our nation’s longstanding indifference to the pain of communities of color. At CHIR, we spend our professional lives focused on improving people’s access to affordable, high quality health insurance. The work is an honor and we believe we are helping to advance policies that allow more people to get better health care without facing financial ruin.

However, we know we have privileges we too often take for granted and that, at times, have blinded us to well-documented inequities in our health care system. The fact is that we have not thought deeply enough about the longstanding and structural racism that makes it more likely that Black, Hispanic, and Native American/Alaskan Native people are uninsured, more likely to suffer from high out-of-pocket costs, more likely to lack access to providers, and more likely to get poor quality care. We can and must do more. As researchers and policy analysts, we can study the data to better understand the challenges facing communities of color. We can proactively seek out voices in those communities who are documenting and sharing their lived experiences. We can consciously and carefully assess the disparate impacts of policy choices, and work a lot harder to lift up those policies that lift up people of color. We don’t pretend that our efforts to learn about these issues and integrate them into our work in a deeper and more conscious way will make a big difference, but they could make a small difference. What we realize is that these efforts are essential to our mission and values.

We would love to hear from you. If you know of ways in which we can better integrate these important issues into our work and share them with decision makers, please let us know. Continue reading

I’ve been calling for greater private insurance coverage of COVID-19 testing. I’ve been wrong

As the nation combats the biggest threat to its public health and economy that any of us have seen in our lifetimes, the key to recovery will lie in widespread, universally accessible testing for COVID-19. In a recent blog post for Health Affairs, CHIR’s Sabrina Corlette argues that our traditional, insurance-based model of financing health care services won’t work if we want to use testing to help us get back to work, schools, and community life. Continue reading

Idaho Misses Opportunities to Help Consumers Get Affordable, Comprehensive Health Coverage During COVID-19 Pandemic

Since the COVID-19 pandemic began, states have taken charge of responding to the public health emergency. As a state that runs its own health insurance marketplace, Idaho has tools at its disposal to help consumers enroll in comprehensive coverage. But like the federal marketplace, Idaho decided not to wield all of them, leaving large marketplace enrollment barriers and instead promoting alternative and less comprehensive coverage. Continue reading

The Provider Relief Fund: How Well Does it Protect Patients from Surprise Medical Bills for COVID-19 Related Services?

The $175 billion Provider Relief Fund prohibits participating providers from balance billing COVID-19 patients, regardless of their source of coverage. While this could help many patients avoid surprise medical bills, there remain several questions about the scope of protection this will provide. In an update to his April 30, 2020 post, Georgetown expert Jack Hoadley takes a look at the fine print of the program as well as new guidance from HHS. Continue reading

The Final 2021 Notice of Benefit and Payment Parameters: Implications for States

The Trump administration has released the annual rule governing insurance standards and marketplace operations under the Affordable Care Act. In an Expert Perspective for the Robert Wood Johnson Foundation’s State Health & Value Strategies project, Sabrina Corlette assesses the implications for state insurance regulation and the state-based marketplaces. Continue reading